Root canal treatment (endodontics) is a dental procedure used to treat infection at the centre of a tooth. Root canal treatment is not painful and can save a tooth that might otherwise have to be removed completely. The infection at the centre of a tooth (the root canal) is caused by bacteria that live in the mouth and invade the tooth.
This can happen after:
A tooth is made up of 2 parts. The crown is the top part of the tooth that’s visible in the mouth.
The root extends into the bone of the jaw, anchoring the tooth in position.
Teeth also consist of:
The root canal system contains the dental pulp and extends from the crown of the tooth to the end of the root.
A single tooth can have more than 1 root canal.
Root canal treatment is only required when dental X-rays show that the pulp has been damaged by a bacterial infection.
The pulp will begin to die if it’s infected by bacteria, allowing the bacteria to then multiply and spread.
The symptoms of a pulp infection include:
As the infection progresses, these symptoms often disappear as the pulp dies.
Your tooth then appears to have healed, but the infection has in fact spread through the root canal system.
You eventually get further symptoms such as:
It’s important to see your dentist if you develop toothache. If your tooth is infected, the pulp cannot heal by itself.
Leaving the infected tooth in your mouth may make it worse.
There may also be less chance of the root canal treatment working if the infection within your tooth becomes established.
Antibiotics, a medicine to treat bacterial infections, are not effective in treating root canal infections.
To treat the infection in the root canal, the bacteria need to be removed.
This can be done by either:
But removing the tooth is not usually recommended as it’s better to keep as many of your natural teeth as possible.
After the bacteria have been removed, the root canal is filled and the tooth sealed with a filling or crown.
In most cases the inflamed tissue near the tooth will heal naturally.
Before having root canal treatment, you’ll usually be given a local anaesthetic.
This means the procedure should be painless and no more unpleasant than having a filling.
Root canal treatment is usually successful. In about 9 out of 10 cases a tooth can survive for up to 10 years after root canal treatment.
Before having root canal treatment, your dentist may take a series of X-rays of the affected tooth.
This allows them to build up a clear picture of the root canal and assess the extent of any damage.
Root canal treatment is usually carried out under local anaesthetic, a painkilling medicine that numbs your infected tooth and the gum around it.
In some cases where the tooth has died and is no longer sensitive, it may not be necessary to use a local anaesthetic.
Your dentist will place a rubber sheet (dam) around the tooth to ensure it’s dry during treatment.
The dam also prevents you swallowing or breathing in any chemicals the dentist uses.
Your dentist will open your tooth through the crown, the flat part at the top, to access the soft tissue at the centre of the tooth (pulp). They’ll then remove any infected pulp that remains.
If you have a dental abscess, which is a pus-filled swelling, your dentist will be able to drain it at the same time.
After the pulp has been removed, your dentist will clean and enlarge the root canal.
The root canal is usually very narrow, which makes it difficult to fill.
Your dentist will use a series of small files to enlarge the canals and make them a regular shape so they can be filled.
This part of the treatment may take several hours, and may need to be carried out over a number of visits.
Your front incisor and canine teeth (biting teeth) usually have a single root containing 1 root canal.
The premolars and back molar teeth (chewing teeth) have 2 or 3 roots, each containing either 1 or 2 root canals.
The more roots a tooth has, the longer the treatment will take to complete.
If the treatment needs to be carried out over several sessions, your dentist may put a small amount of medicine in the cleaned canal in between visits to kill any remaining bacteria.
The tooth will then be sealed using a temporary filling.
If you have symptoms from the infection, such as a raised temperature or large swelling, you may be given antibiotics to help manage and prevent further infection.
At your next visit, the temporary filling and medicine within the tooth is removed and the root canal filling will be inserted.
This, along with a filling, seals the tooth and prevents reinfection.
Root-filled teeth are more likely to break than healthy unrestored teeth, so your dentist may suggest placing a crown on the tooth to protect it.
In some cases a root-filled tooth may darken, particularly if it’s died as a result of injury like a knock to the tooth.
There are several ways your dentist can treat discolouration, such as whitening the tooth using chemicals.
A crown is a cap that completely covers a real tooth. It might be necessary to use a crown after root canal treatment to prevent the tooth fracturing.
Crowns can be made from:
The dentist will reduce the size of your tooth and use the crown to replace what’s removed.
A mould of your tooth will be taken to ensure the crown is the right shape and size, and fits your tooth accurately.
When fitting the crown, cement will be used to glue the crown to the trimmed-down tooth.
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