Endodontics (Root Canal Therapy)

A discipline in dentistry that deals with maintaining the health of the living tissues inside a tooth (pulp), and preventing infection of the surrounding tissues, which is commonly referred to as “Root Canal Treatment” (RCT). The aim of Root Canal Treatment is to eliminate the damaged pulp as well as the bacteria that are causing the infection, and restore the tooth to a pleasing appearance and functional state. It involves removing inflamed or dead nerves and blood vessels from the centre of your tooth, which is accomplished by creating an access through the top of your tooth to the root canals and removing the dead tissue. The empty root canal system is then cleaned, shaped and filled with special materials, and finally a permanent seal is put over the top of your tooth. The procedure may be carried out over one or two visits to your dentist.

Why is root canal treatment needed?

Your teeth have a core of blood vessels and nerves at their centre; referred to as the pulp occupying a space called the root canal. The number of root canals varies depending on the location of the tooth (far back) in your mouth. Front teeth often have just one root canal, while back teeth may have three or more. If your tooth is injured or has severe decay, the pulp can be damaged and the blood vessels may die. This results in a “dead” tooth which is likely to get infected because it is no longer protected by your immune system. Tooth sensitivity to hot / cold food and drinks may be warning signs of tooth decay, and warrant a visit to your dentist to evaluate the cause of discomfort and administration of preventive measures.

There are a number of ways that a tooth’s pulp can be damaged. These include:

• decay
• injury
• Sometimes gum disease

All of the above mentioned conditions can lead to bacterial infection, causing blood vessels and nerves to die. Without treatment, a collection of pus (abscess) can form at the root tip, causing pain and swelling and even damage to the bone around your tooth. Failure to treat the infected tooth may exasperate the damage and lead to the extraction (removal) of the tooth (extracted).

Root Canal Treatment (RCT) is needed to remove the damaged tissue, disinfect the root canal system and restore the tooth to function. Certain teeth may have complex anatomy or may be part of a bridge and require careful treatment. However, current modern day endodontic practices, such as the use of a microscope which allows for greater visual access, enables for the completion of such cases to a high standard.

Occasionally RCT is undertaken in a previously root filled tooth in which the treatment is inadequate or has failed. The outcome for such cases can be very favourable and result in complete resolution and healing of large infections.

Endodontics? Same as above Procedure

At Sunrise Dental Clinic, your dentist will take an X-ray image of your tooth and employ some specific cold and hot test to identify your individual dental requirements and decide if a Root Canal Treatment is required. The X-ray image will reveal the extent of the decay (if any) and presence of any abscess as well as number of roots attached to your tooth has spread, if there is an abscess and how many roots your tooth has.

If you have a dead tooth or one with severely damaged pulp, root canal treatment may be the only treatment option. Your dentist will discuss the X-ray results and treatment option to help you make the right decision to restore the health of your tooth.

If you do need to have root canal therapy, your dentist will give you a local anaesthetic, which will block all sensation within the treatment area whilst you stay awake during the procedure. It may not be necessary to have an anaesthetic if your tooth is dead but your dentist will discuss this with you before starting the procedure.

During the procedure, your tooth will be separated from the rest of your mouth using a thin sheet of rubber called a “rubber dam”. This keeps your tooth dry and protects your airway. It also allows effective cleaning of the root canal system and prevents recontamination.. Your dentist will first make a hole in the top of your tooth through which the dead or diseased pulp is removed. The empty pulp cavity is then cleaned and your dentist may also put in some medication to treat the bacterial infection. If more than one visit is required to treat the affected tooth, your dentist will put a temporary filling on your tooth to keep it sealed until your next visit (However, your dentist may decide to fill the cavity immediately if the root canal infection hasn’t caused you any serious problems). If you have had a temporary filling, your dentist will remove this during your subsequent visit and then fill the root canals with a suitable material. This is likely to be a putty-like substance. A permanent filling or crown is then placed over the top of the tooth to protect your filled root canal and the vulnerable tooth structure. Your dentist will help you chose between a gold or porcelain crown. If your dentist thinks it’s necessary, he or she may also place a metal or plastic rod inside the canal to help support the crown.

What other treatments are common in Endodontics

Traumatic injuries

The management of accidental traumatic injuries, particularly in children, is an important aspect of endodontic practice. The front teeth (incisors) are often involved and sustain fractures or chipped crowns. Such teeth require careful monitoring to ensure that the teeth remain healthy and develop naturally. A decision may have to be made to perform Root Canal Treatment to avoid pulp death and infection. Such teeth can be restored to normal appearance and function.

Bleaching

Endodontically involved or treated teeth may discolour over time. Where appropriate, bleaching of the tooth can restore the tooth to its original colour and normal appearance.