Root canal treatment is the procedure which removes the injured or infected tissues from within the central core of the tooth, known as the pulp chamber and root canals. This is then followed by disinfecting and reshaping the canals before sealing them off from the rest of the body using an inert material and cement. Unlike fillings or crown which repair tooth structure, the objective of root canal treatment is to stop pain and infection. As the canals are fine and require careful manipulation, the use of a special microscope to ensure adequate visualisation during treatment is useful.
What is the procedure like?
Root canal treatment usually requires two 1-hour visits to complete though it can sometimes be combined in a single session. On the first visit, the contents of the pulp chamber and root canals are removed and cleaned. A disinfectant is used and if there is an infection, a medication is placed and the cavity sealed for a week to allow the infection to clear. At the second visit the canals are cleaned once again and shaped to receive the sealant which is a type of rubber which is lightly heated and placed together with a cement to create a barrier between the tooth and the rest of the jawbone.
What to expect
A local anaesthetic injection is required and the dentist will place a rubber sheet around the tooth. This is to reduce the risk of the disinfectant entering the mouth or irritating the surrounding gums. There is no pain after the anaesthesia though some patients may find it uncomfortable to keep the mouth open for the full hour with the attached rubber and frame over their lower face. If the tooth affected is a back tooth, the procedure is usually longer as premolars have 2 roor canals and most molars have 3 root canals.
How will I feel after the procedure?
There may be some discomfort when biting on the affected tooth for the first 2-3 days after the procedure but the discomfort should be far less than before the treatment. If necessary take the painkillers prescribed. Root canal treated teeth are weaker and will eventually darken in colour over time even though the pain may have gone. It is recommended that a crown be used to protect the root canal treated tooth. This will also help restore appearance though it should be noted that the tooth will eventually still get darker.
What is Root Canal Surgery
Root canal surgery is an alternate method of treating an infected tooth by directly approaching the affected tip of the tooth through a minor surgical procedure. A small incision is made and the infected root tip removed. The end of the tooth is then filled with a biocompatible cement to achieve a seal. This approach is favoured if a crown has already been placed over a root canal treated tooth as it is difficult to access the affected root tip through the usual approach. The medical term used is apicectomy or apex resection surgery.
Success Rates of Root Canal Treatment
In competent hands, the success rate exceeds 90%. However if the infection is extensive, or in back teeth where the canals are much narrower and curved, the success rate lowers. It is also more difficult to redo a previously root canal treated tooth and success rate drops to around 70% regardless of whether a conventional or surgical approach is used. It should be noted that the lifespan of a root canal treated tooth is usually shortened as it is usually compromised structurally by decay, cracks or by the need to remove the internal core of the tooth in the process of saving it.