What is root canal treatment?

Root canal treatment or endodontics is the micro-surgical treatment to remove the pulp (nerves and blood vessels) from within the root systems of teeth. The removal of this material is necessary if it becomes infected or is likely to become infected, following either previous decay or trauma. Once the root system is cleaned it is then shaped to receive a permanent root filling, in the form of flexible rubber points called gutta percha.

When is root canal treatment necessary?

When the inside of the tooth, commonly referred to as the root canal, pulp or nerve, is infected it can lead to pain, abscess or swelling. An infected tooth can cause pain characterised by a constant pain, pain on biting or touch. It can also be diagnosed from radiographs (x-rays).

There are two treatment options available. The infection can be removed by root canal treatment or the tooth can be extracted. Thus root canal treatment can save an infected tooth from removal.

How is root canal treatment performed?

The dentist has to remove decay and infection from the root canal by the use of disinfectants and special shaping tools. Once infection is removed, the cleaned and shaped root canal system is filled with flexible rubber points called gutta percha.

Root canal treatment can be very difficult because the canals are very fine, often difficult to access and may contain awkward curves. Some teeth, dependant on position within the mouth, will have one, two, three or even four canals that must be cleaned and filled. Treatment is usually performed over one or two visits depending on complexity. Considerable dental skill and time is needed to properly clean and seal these infected canals. To isolate the mouth from disinfectants rubber dam is placed. This is a sheet that covers all the teeth apart from the tooth involved.

If during treatment, it becomes difficult to locate the canals, referral to an endodontist (a dentist who specialises in root canal treatment) may be necessary. They will have the aid of magnification equipment to help them locate the canals.

What are the outcomes following treatment?

The outcome, prognosis and cost of root canal treatment are variable dependant on the complexity. This will depend on the underlying condition of the tooth. For example if the infection is diagnosed early and the canals are straightforward to prepare, then the prognosis can be over 85% at 5 years. Most treated teeth will go on to last much longer than this. Where the anatomy is complex, the canals are difficult access or a larger infection is present, then the prognosis will be reduced. However, a prognosis is an estimate and patients will report individual experiences.

Root canal treated teeth can become brittle, discoloured and weak; therefore, the treated tooth may require a further restoration, such as a crown, to strengthen it. The cost for this would be in addition to the costs of the root canal treatment.

Post operative care