General Dentistry

Root Canal Therapy

Root canal treatment is a dental procedure that replaces a tooth’s damaged or infected pulp (‘nerve’) with a filling. The pulp consists of specialised dental cells, blood vessels, tissue fibres and some nerve fibres located in the hollow space in the central part of the tooth. The procedure is also known as endodontic treatment.

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Success rates for endodontic treatment are generally good. About 90 – 95% of patients who have root canal treatment can expect a functional tooth after treatment.

The treated tooth should last a very long time, provided that you maintain good oral hygiene and generally look after your teeth. Of course, no therapy or replacement will last as well as a healthy tooth.

After root treatment, the tooth becomes more brittle and important sense receptors are lost, thus the risk of fracture of the tooth is high. It is recommended to place a crown over root treated teeth for the long-term life of the tooth.

Causes of pulp infection or inflammation

  • Breakdown of a filling or crown
  • A deep cavity
  • Trauma
  • Gum disease
  • Crack or chip in the tooth
  • Extreme wear or erosion
  • Extensive dental work to the tooth

Signs and symptoms of pulp infection or inflammation

  • Unprovoked or spontaneous pain
  • Sensitivity to hot and cold drinks and foods
  • Pain when biting or chewing
  • Loosening of the tooth
  • Swelling of the gum near the affected tooth
  • Draining of pus which may look like a ‘pimple’ on the gum
  • Facial swelling

Complications of pulp infection or inflammation

If left untreated, pulpal infection and inflammation can become life threatening. Complications include:

  • Spreading infection Once the pulp becomes infected, it loses its ability to fight the spread of the infection. If bacteria find their way into the pulp chamber, the bacteria will multiply greatly. This can cause a severe infection or an endodontic abscess when it spreads into the surrounding bone. This can extend through the soft tissues and track to the cheek, chin or neck, restricting the airway.
  • Localised bone loss The infection may spread around the ends of the infected root canal and cause bone loss in the jaw.
  • Loss of tooth The tooth may have to be removed, which interferes with the person’s ability to bite and chew.

Root canal treatment

Root canal treatment usually takes 3-4 appointments, which are 2- 6 weeks apart to complete. It involves:

  • The decayed portions of the tooth and any affected filling are removed.
  • The pulp or pulp remnants are removed using a special drill and small instruments to thoroughly clean and shape the root canals and to remove bacteria, pus and debris. The canals are shaped to ensure a smooth surface.
  • The canals of the tooth are flushed with disinfectants and then dried.
  • If the root canal is medicated and the tooth sealed with a temporary filling material. If the dentist feels bacteria are still present at your next appointment, the cleaning procedure may be repeated and the tooth once again packed with medication. This stage will continue until the dentist feels the tooth is free from bacteria.
  • The infection-free root canal is then sealed with long-lasting barrier materials (the root filling), usually a rubber-based material called ‘gutta-percha’.
  • The tooth then undergoes restoration and the biting surfaces need protection – an artificial biting surface for the tooth is fashioned out of regular filling material.
  • Where there is considerable loss of the tooth structure, there may be a need for a crown made from porcelain or gold alloy or other materials.