Root Canal Therapy
What is root canal therapy?
Within the hard white surface of the tooth (enamel) the nerve, blood vessels, and connective tissue are found, which are collectively called the ‘pulp’. The pulp provides our teeth with sensation and the nutrients in order to perform protective functions. When dental caries (cavities) progress close to the pulp, the bacteria from the cavity is likely to get into the pulp. Bacteria can also enter the pulp after a tooth is fractured or cracked. As this occurs, the pulp will become inflamed – which causes pain.
There is common stigma about root canal therapy being painful. This is largely a misconception, as the treatment itself is performed under local anaesthesia. The pain arises prior to root canal therapy due to the infection.
Root canal therapy is performed once bacteria has entered the pulp and the tooth shows signs and symptoms of infection. The goal of root canal therapy is to clean the infection from inside the tooth, while simultaneously removing the pulp. The tooth is then precisely filled and sealed to prevent re-infection by bacteria.
Do I need root canal therapy?
Visiting us at All Seasons Dental Clinic every 6 months is the best way to stay on top of your oral health. In the event that you are feeling pain or discomfort, don’t hesitate to book a consultation with one of our dentists. Attempting to fight through pain or forget about an issue with your teeth will nearly always end up a larger problem down the line. Some symptoms which may indicate that a root canal is needed include:
- Pain when biting or chewing on that side
- Spontaneous throbbing from a tooth, waking up at night with tooth pain
- Severe pain after eating / drinking something cold, hot, or sweet
- Pain which was previously present but has now gone away (indicates a dead tooth)
If a patient describes symptoms which align with pulpal infection, your dentist will perform a few quick clinical tests and usually take an X-ray to assess the health status of the tooth and surrounding tissues. From this information, your dentist will be able to tell if the pulp is irreversibly inflamed or necrotic (dead tooth). The dentist will always examine the mouth, head, and neck during this visit to comprehensively assess your oral health.
Should I get root canal therapy or tooth extraction?
As dentists, we always aim to preserve our patients’ natural teeth, this maintains chewing function, speech, and your smile. Root canal therapy is a highly successful treatment, however, if a tooth is very broken down or has cavities too large to fix, removing the tooth may the preferred treatment. Additionally, if the infection has spread from the tooth, beyond the bone, and into the soft tissues causing systemic symptoms like fever, removing the tooth may be indicated.
Depending on which tooth is removed, chewing ability is reduced and your smile may be affected – therefore, extractions often necessitate replacement of the tooth. A replacement may be an implant, a bridge, or a partial denture. In a partnership between you and your dentist, we’ll holistically consider your long-term smile goals and oral function when choosing a the right treatment.
What should I expect during the procedure?
First Stage:
Every effort will be made by our team to ensure you are comfortable throughout the procedure. Your dentist will first profoundly numb the area, and the tooth will be isolated to prevent contamination from saliva. A small hole will be made in the top of the tooth, to access the nerve. Any cavities or defective fillings will be removed at this stage as well.
Depending on the tooth, there is between 1 and 4 canals within the root(s) of a tooth. Your dentist will locate each of these canals, then the inside of the tooth will be meticulously cleaned, removing the pulp and any bacteria present. This is performed using a cleaning solution and a series of dental files that reach down to the bottom of the tooth. Even with magnification and modern technology this is still a timely procedure, as we strive to make the tooth as clean as possible to ensure a successful procedure.
Root canal therapy often is performed in just one session, although in some cases the inside of the tooth is dressed a medication and is finished at a second visit the following week. In this instance, a temporary filling would be placed.
Second Stage:
After disinfecting the tooth, the next stage focuses on sealing and filling up the inside of the tooth. Your dentist will measure the length of the tooth using another X-ray, then fill the root canals with a rubber-like material. This will seal off the apex of the tooth with the goal of preventing re-infection. A white filling material will then be used to replace the tooth structure that was removed when accessing the pulp and from the cavities.
Does my tooth need a crown after a root canal?
Depending on the extent of tooth structure loss due to the previous cavities, fillings, and root canal treatment, certain restorations are more appropriate to ensure the long-term survival of the tooth. Root canal treated teeth are more susceptible to fracture and may discolour over time, therefore, your dentist will recommend the ideal restorative option.
For front teeth, or teeth with lots of healthy tooth structure, a typical white filling material that would be used to restore a cavity is often suitable. Years down the line, these front teeth do sometimes require whitening, a veneer, or crown due to discolouration.
Back teeth (molars and premolars) are under tremendous chewing forces, therefore, in most cases a crown or partial crown (Onlay) is the ideal restoration. Both restorations cover the top of the tooth, which ‘hugs’ the tooth, effectively preventing the tooth from fracturing.