What is a Root Treatment?
if you have been told by your dentist that you need ‘root canal treatment’ you will obviously want to know what is involved and what the pros and cons are.
Root Canal treatment is treatment to the root or roots of the tooth in order to clean out any infection or inflammation that may be there and which may be causing you pain or discomfort.
The PROS are that you will get to keep your tooth and that you will be removing the infection/inflammation from your tooth and mouth. Also root canal treatment doesn’t hurt. Your tooth
will be numb and it doesn’t feel much different than getting a routine filling.
The CONS are that it is a complicated treatment that will take some time in the dentists chair and that can be expensive. Also a tooth that has been root treated has no live nerve and therefore is much weaker than before. In some cases a crown is required to strengthen the tooth.
Why do I need root canal treatment?
If you have toothache it sometimes means you have infection or inflammation in the root of the tooth. This will not heal by itself and you will need root treatment or if you prefer you could have the tooth extracted.
Why do I have toothache?
Dental pain is caused by infection or trauma that has affected the nerve inside the tooth. The chamber which is under the enamel and dentine leads on to small canals that run down the roots and in this space we find tiny blood vessels and nerve tissue. The nerve tissue exits the tip of the roots at the root ‘apex’ and joins the main nerves outside the root.
If you have a dental cavity that is deep there will be bacteria and toxins reaching the nerve chamber in the crown of the tooth and this is what causes toothache. At this stage there will be symptoms of lasting moderate pain and sensitivity which is more severe and long lasting than just ‘sensitive teeth’. Teeth can be ‘sensitive’ for various reasons like a filling that is too big or high, hairline cracks or exposed root surfaces usually combined with gum disease, or due to clenching or grinding your teeth.
Real toothache from infection of the dental nerve is much more sever and lasts for hours rather than seconds. This is when you know you are likely to need root canal treatment.
Why has my toothache gone away by itself?
After a period of infection the dental nerve usually dies and then the tooth can be symptom free for a long time. However this doesn’t mean that the infection has gone away. Unfortunately it is just dormant and building up to an even bigger infection which will strike again!
The acute phase of infection is now over and the chronic phase is setting in, the infection spreads along the tooth and out through the tip of the root, the apex, causing infection of the bone around the tooth. After some time this will cause new pain which is more deep and dull compared to the pain of a newly infected nerve. ThIs pain usually sets in at night and is triggered by hot things like
tea/coffee etc. it also may gradually cause a swelling that can develop into an abscess.
There can often be a long time between these two stages, sometimes many years but whatever the stage the treatment is the same. Root canal treatment!
What happens during Root Canal Treatment?
During root canal treatment the dentist has to get access to the infected nerve chamber of the tooth and from there, the root canals have to be cleaned out as well. The aim is to access all areas containing dead tissue and infection, clean out the whole root canal structure , irrigate with an antibacterial solution and finally fill the root canals.
When this is done the access cavity, ie. the entrance to the root canals, will be sealed to prevent any new infection getting in.
Before all of this you will get an anaesthetic to make sure you don’t feel any pain. There will be a little bit of drilling to begin with, to remove the old filling or the decay, and then the cleaning of the roots begins. Some patients have reported that this feels like the dentist is poking the tooth but that there is no pain. This is also the boring bit as It can take some time to clean out the canals
properly. Some patients have even been known to fall asleep at this stage!
Why do I need more than one appointment?
Root canal treatment is usually done in 2 stages. When you have pain the tooth has to be opened to let the pressure out, and this will take away the pain immediately or after a few days. This appointment doesn’t take long. The second stage takes longer as finding and cleaning the canals can be tricky especially on back teeth where it is hard to reach.
“I don’t like sitting in the dentist’s chair for a long time”
The long term outcome of root canal treatment is generally very good but it does require that the patient has to sit in the dentist’s chair for a long time.
The treatment could be divided up into shorter appointments but this introduces the risk of further superinfection. ie every time the tooth is opened up again there is the risk of new bacteria gaining access to the tooth. There will be a chance to take some time out if the treatment is taking a long time and after a cup of tea and a break you will find it easier to last until the end of the appointment.
What happens next?
After you have had your root treatment you may experience a general ache in the area for a couple of days. If you get sustained pain it can mean that the filling or crown is high and needs to be adjusted. A root treated tooth is weaker than a non root treated tooth so the most common complication is a broken tooth or in some cases root fracture. Your dentist will know how best to restore your tooth to avoid these complications but nonetheless it can happen. A broken tooth can usually be fixed with another filling or a crown. A root fracture unfortunately is non restorable and the tooth will need to be extracted.
Another potential complication is reoccurrence of the infection. This is more likely to happen in a tooth that has had a longstanding infection before root treatment and where the infection has spread to the bone outside the tooth. In these cases the tooth can be re root treated or extracted.
Re root treatments can be more difficult and many dentists like to refer these cases to a specially experienced dentist especially if it is a ‘strategic’ tooth. ie. If it is being used to support a bridge or a crown.
At Andersson dental care ltd, Dr Per Andersson receives many referrals for complicated root canal treatments. If you would like to refer to us please call us or use our ‘Refer To Us’ page.