Root Canal Therapy
This can also be called 'Endodontic Treatment' or 'Root Filling'. Root canal therapy is carried out to teeth that have died, i.e the live part sometimes called the 'pulp' or ‘nerve’ is no longer alive, or the tissues is irreversibly damaged. This treatment is often the only way to save a tooth from extraction due to the infection. Not every tooth is possible to root treat and some do not respond to treatment, success rates fall with teeth further back in the mouth and with increasing age of the patient. It is necessary to take x-rays during root canal treatment to assess progression and success.
During root canal therapy the inside of the tooth is cleaned right to the tip of the root to remove dead and infected tissue. A dressing is usually left in place at the end of the first visit to promote healing and disinfection. Sometimes it is possible to perform the treatment in a single visit. Particularly difficult teeth may need referral to a specialist 'Endondontist' for root canal therapy. These specialists have operating microscopes, specialist techniques and years of experience, but even so some treatment may be unsuccessful.
Problems of root canal therapy:
- Root treated teeth tend to discolour over time necessitating whitening of the tooth or placing a crown or veneer.
- Root treated teeth are no longer alive and have no blood supply so no defence against infection and therefore secondary infection necessitating removal of the tooth can occur.
- These teeth dry from the inside becoming more brittle so are more liable to fracture and are often protected by crowns.
- Root treatment often demands the removal of considerable tooth substance to access the hollow space or 'pulp chamber' inside the tooth further weakening it.
- A complication of treatment is fracture of the fine files used to clean the tooth in the canals. Everything is done to avoid this but it still sometimes occurs. If this happens it may be impossible to remove the instrument. This may lead to referral to a specialist or even removal of the tooth.
- Perforation of the root may occur. Again this is fairly uncommon but it may lead to referral to a specialist or removal of the tooth.
After the first stage of root canal therapy some mild discomfort is common. The feeling of increasing discomfort may signify a developing infection. This is a rare event but it is important to contact the practice if in doubt.
Permanent treatment to the tooth, i.e crowning is often avoided until one or two months after treatment to allow healing and show resolution of symptoms.