Root canal treatment is a very common treatment and our specialist dentist Dr Matthew Gahan has heard all the questions that patients usually ask beforehand. We’ve compiled some of the most frequently asked questions with his answers so you know what to expect before you book in…
What is root canal treatment?
Root canal treatment (RCT) involves removing the nerve tissue (called pulp) located in the centre of the tooth and its root or roots (called the root canal).
Treatment involves creating an opening through the biting surface of the tooth to expose the remnants of the pulp, which then are removed.
Medications are used to disinfect the root canal space to prevent further infection and it is then filled.
Why and when might I need root canal treatment?
Root canal treatment is undertaken to treat or prevent an infection occurring inside the tooth. Treatment may be required after extensive decay in a tooth, a deep, fractured or leaky filling or crown, repeated replacement of fillings, extensive gum disease and its treatment, tooth injuries or in a tooth that has developed a crack.
How successful is the treatment?
It is a common and very successful procedure. The success rate in those cases where there is no inflammation around the end of the root is about 96%. The success rate for those teeth with existing inflammation is about 85%.
Although RCT has a very high success rate as with all medical and dental procedures, it’s results cannot be guaranteed. The success depends on a complex dental-biological interaction and relies on the body removing the infection once the tooth is disinfected and filled. Failure despite good treatment is a possibility in a small proportion of cases and is usually due to persistent infections. In cases where treatment has not been successful either re-treatment or root tip surgery can often be considered to still keep the tooth. If the root canal filling fails in the future, either in the following days or years, then the full fees for our time are still applicable and no refund will be offered.
We can’t guarantee of success, but we do promise you that we will give you our utmost care and professional attention in treating you.
Will I experience pain during treatment?
Generally, no. Pain during treatment is rare. If the nerve is very inflamed local anaesthesia is not as effective. Don’t worry, we have a number of strategies to overcome this so that progress can be made.
The tooth may feel sore after treatment, lasting for 3-4 days but for some it may be a few weeks. This is treated by taking mild pain killers. About 1-5% of people experience a flare up immediately after treatment with increasing pain or swelling 3- 4 days afterwards – if this is the case please contact your dentist as you may require a short course of antibiotics.
What is involved in root canal treatment?
The treatment is carried out under local anaesthetic and will involve:
- Placement of ‘Rubber Dam’ (an isolation technique) that enables the tooth to be kept dry and prevents it from becoming infected from your saliva.
- Entry to the centre of the tooth (root canals) by drilling through the tooth, filling or crown. The filling or crown may need to be removed and replaced with a temporary material.
- Using specialised instruments to prepare the root canals for disinfection. A microscope may be used to make treatment easier.
- Taking X-rays to check the length of the root canals and the quality of root filling. • Use of disinfectants to wash the root canals.
- Dressing of the tooth temporarily if more than one appointment is necessary. • Placement of a root filling material to prevent the root canals from becoming re infected.
- On top of this a new filling, crown or onlay may be required. This is usually provided by your own Dentist. The success of the root canal treatment will be influenced by the quality of the new filling or crown providing a seal to stop bacteria getting back into the tooth.
Is root canal treatment always possible?
If there is not enough tooth structure left, extraction of the tooth may be necessary. In this case, we will discuss what options are available for replacement and you will be referred back to your own dentist. In addition, it may not be possible to negotiate or fill the canal due to blockages, curves or inability to find the canal.
We make as full an assessment before treatment starts as possible, however occasionally we can only make a full diagnosis when we have opened the tooth up and assessed the tooth internally. Sometimes at this stage, we may need to advise you that the tooth cannot be saved, and extraction will be necessary, and performed either at that appointment or at a later planned date. Please note that the full fee may apply.
How long does the treatment usually take?
The appointment may be 1 ½ – 2 hours, and more than one appointment may be necessary for more complex teeth. The process of finding, placing instruments into, preparing and washing root canals is a highly skilful procedure and takes time and patience.
Please feel free to bring in some headphones to connect to your phone. Music, audiobooks or Podcasts help to make it more comfortable for you!
What are the risks associated with root canal treatment?
While a root filling is a very common and successful procedure we like to make you aware of any risk so that you are fully informed. The risks are minimised by the high standard of specialist care we provide. However, even though they are uncommon, unforeseen problems can occur and may include the following:
- Mild discomfort after treatment, rarely pain during treatment
- Incomplete healing with the need for additional procedures (root-tip surgery, retreatment or tooth removal)
- Failure to find and negotiate the root canal or canals
- Blockage of root canals, fracture of files in the canal
- Risk of tooth or root fracture (afterwards as the tooth is weaker)
- Fracture, chipping, or loosening of existing crown or veneer
- Root perforation (extra openings) of the tooth/canals with instruments
- Leakage of antiseptic agents into the mouth, extrusion of antiseptic or filling through the end of the root into the surrounding soft tissue
- Phoenix abscess: this is an acute flare up of a previously dormant infection and can occur when a chronically infected tooth is root treated. This can occur in 1% to 5% of cases and requires antibiotics
What happens after my root canal treatment?
Following completion of the root canal treatment you will be discharged back to your own Dentist for an additional restoration such as a crown to protect the tooth from fracturing. Failure to have the tooth properly restored in a timely manner significantly increases the possibility of failure of the root canal treatment or tooth fracture. The tooth is normally monitored by taking an x-ray periodically to make sure that the bone cavity around the root end is healing up. Healing can take anything from six months to four years and sometimes longer.
Alternative treatment choices
The following treatment options might be possible:
- No treatment at all. The risks include pain, swelling, infection, cyst formation, loss of bone around teeth and premature loss of teeth. Resulting in teeth drifting, change in bite, altered smile and reduced ability to chew
- Waiting for more definitive development of symptoms
- Extraction: to be replaced with either nothing, a denture, a bridge or an implant
If you have more questions about your tooth pain, or would like an assessment of your dental health, call us on 01977 682 200 or book online.
