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Root Canals

Root canal treatment refers to treatment of the root canal/s of the tooth, where the nerves and blood vessels extend down from the pulp chamber in the crown of the tooth. The treatment is usually necessary when bacteria enter the pulp from a cavity or a crack, or from severe gum disease. Sometimes it is necessary when a tooth has been subject to trauma or knocked out, damaging its blood supply.

Very simply, the aim of root canal treatment is to eliminate the bacteria from the roots and to restore the crown of the tooth (the part above the gum) in such a way that the bacteria from the mouth can no longer find a way in, and that the tooth is protected from breaking. A combination of mechanical debridement with metal files and irrigating with disinfectant solutions is used. Usually, two or three appointments are necessary.

Because a tooth in need of a root canal treatment is usually heavily-filled and/or badly decayed, it is already quite weak. The process of doing a root canal treatment will weaken it further, as more tooth structure needs to be removed. This is why root canal-treated teeth often require crowns as a long term restoration. In the meantime, it is often necessary to place a temporary stainless steel band around the tooth, to prevent possible fracture.

A root canal-treated tooth is not a “dead” tooth, it is a non-vital tooth; it still has blood supply to the ligament which holds it to the jaw bone.

Root canal treatment should not be painful. Occasionally, when a pulp is extremely inflamed, it can be difficult to get it anaesthetised at the start of the first appointment. This may mean that pain may be experienced for a very short time, until the tooth can be anaesthetised.

The decision on whether or not to do a root canal treatment depends on a few factors, such as the restorability of the tooth, the usefulness of the tooth, the likely success expected, the physical difficulty of actually performing the treatment, the consideration of other treatment options (eg bridge or implant) and the cost.

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