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Root canal treatment (also called ‘endodontics’) is needed when the blood or nerve supply of the tooth (called the ‘pulp’) is infected through decay or injury. You may not feel any pain in the early stages of the infection. In some cases your tooth could darken in colour, which may mean that the nerve of the tooth has died (or is dying). This would need root canal treatment.
If the pulp becomes infected, the infection may spread through the root canal system of the tooth. This may eventually lead to an abscess. An abscess is an inflamed area in which pus collects and can cause swelling of the tissues around the tooth. The symptoms of an abscess can range from a dull ache to severe pain, and the tooth may be tender when you bite. If root canal treatment is not done, the infection will spread and the tooth may need to be taken out.
The first aim of treatment is to get the patient out of any pain. This will often be done by your regular dentist. The next aim is to remove the infected and inflamed pulp tissue, thoroughly clean the root canals and then fill them. It is a time-consuming procedure and can involve two or sometimes three appointments to complete treatment. The success rate of treatment is high. The alternative to root canal treatment is usually extraction.
Root canal treatment or endodontic treatment can be difficult to perform. Root canals are not always easy to find and they can be narrow, they are often curved and they are sometimes long.
An endodontist only carries out root canal treatments and is treating patients with root canal problems all the time. They have specialised equipment such as a microscopes for magnification and ultrasonic instruments for precise canal location and preparation. They are also experienced in diagnosing the cause of endodontic problems when the cause is not very clear e.g. which tooth is the one causing the pain or the infection.
An endodontist is accustomed to treating patients with routine as well as challenging root canal problems and therefore the probability of successful outcomes is high.
With the use of local anaesthetic techniques the treatment is normally quite comfortable. There may be some tenderness following treatment but it can be controlled by the use of medication of the type one might use for a headache.
In the past, a root-filled tooth would often darken after treatment. However, with modern techniques this does not usually happen. If there is any discolouration, there are several treatments that will restore the natural appearance.
Root canal treatment is usually very successful. However, if the infection comes back, the treatment can sometimes be repeated.
The alternative is to have the tooth out. Once the pulp is destroyed it can’t heal, and it is not recommended to leave an infected tooth in the mouth.
Although some people would prefer to have the tooth out, it is usually best to keep as many natural teeth as possible.
Yes. However, because a ‘dead’ tooth is more brittle, you may need to have a crown to provide extra support and strength to the tooth.
Root-treated teeth should be looked after just the same as any other tooth. Remember to clean your teeth last thing at night and at least one other time during the day, with a fluoride toothpaste. Cut down on sugary foods and drinks, and have them only at mealtimes if possible. See your dental team as often as they recommend for regular check-ups.
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