Endodontics

Endodontics or "root canal treatment" as it is more commonly known, is required when the blood or nerve supply the pulp of the tooth is infected through decay or injury. The aim of the treatment is to preserve the tooth by removing all traces of infection and then filling the root to prevent further infection.

What to expect:

  • An x-ray can show the number and shape of the root canals, and also signs of infection in the surrounding bone. Teeth can have a number of roots and some roots are easier to fill than others because of their shape.
  • To keep root canals dry during treatment the dentist may stretch a sheet of thin rubber around the tooth, on a frame outside the mouth; this is called ‘rubber dam’. Having this fitted makes the treatment more comfortable.
  • You will be given a local anaesthetic, and then an opening is made through the top of the tooth, down into the pulp.
  • The dentist then uses narrow files to remove the dead pulp from the core of the tooth and from the root canals.
  • At this point the dentist will put medicaments into the canals and seal the tooth with a temporary filling. You will have to return at a later date for the dentist to complete the treatment.
  • At the next stage, the dentist fills the root canals. A filling is then placed in the remaining cavity in the top of the tooth.  If necessary, at a later date, a crown can be placed on top of the tooth, supported by a post placed inside the filled root canal.
  • Root filled teeth can become darker than other teeth over time, but bleaching can be used to make them look lighter.

Benefits:

  • Pulp damage can cause server  toothache but the pain will usually end very quickly when the root canal is cleaned out.
  • Without a root filling a tooth with a dead pulp would probably have to be taken out. There is also a possibility of infection spreading beyond the tooth itself.
  • Root fillings are usually successful (about 90% of the time) and can last many years, but re-treatment is also possible if infection recurs. Occasionally, if inflammation persists at the tip of the root, surgery can be carried out to remove part of the root, clean the area and put in a filling. This is known as an ‘apicectomy’.

Warnings:

  • Roof fillings are successful in about 90% of cases, but that means that there will be some failures (the only 100% predictable option is to remove the tooth).
  • Very fine flexible files are used to clean the canals. Very occasionally, a file may separate leaving a minute amount of the file in the canal. Depending on how much and where the broken file is, will decide on how it will be dealt with. Often the separated piece is left in the canal.
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