Endodontics is the branch of dentistry most commonly known as Root Canal Treatment.

What is Root Canal Treatment?

Root canal treatment is a technique which involves treatment to the inside of a tooth. It is a time consuming and technique-sensitive procedure that can save a tooth which may otherwise need to be extracted.

Why is Root canal treatment needed?

Every healthy tooth contains within it a living tissue called the pulp (often known as ‘the nerve’). This tissue occupies narrow spaces inside the tooth called canals. The pulp can be damaged by a number of factors, the main ones being decay and trauma (e.g. a blow to the tooth or cumulative forces from biting). When the pulp is damaged it becomes inflamed and an infection can occur. Because there is inflammation in a confined space, the pressure increases and there can often be pain associated with the tooth. If there is infection of the pulp, it can pass out of the root canal at the end of the tooth, or even to the surface of the mouth or skin to give rise to a swelling or gum boil.

What does the treatment involve?

The aim of the treatment is to clean the inside of the tooth, removing any infected, inflamed or dead tissue. The tooth will be anaesthetised before treatment with a local anaesthetic and isolated with the aid of a thin rubber sheet to keep the tooth free of bacteria from the saliva. The canal or canals inside the tooth are then disinfected and carefully shaped before filling and sealing the cleaned spaces, thus preventing re-infection. Small X-rays are taken during the treatment to enable the procedure to be carried out correctly. A temporary filling is usually placed after each visit. Some treatments can be carried out in a single visit but often two visits are necessary, or occasionally more in unusual cases.

What about re-treatments?

Unfortunately not all roots canal treatments are successful. If a tooth that has had previous treatment, often many years before, gives problems again, then one option to try to save the tooth is to re-do the root canal treatment. As the problem usually stems from re-infection inside the tooth, re-treatment involves removing the old root canal filling and disinfecting and then re-filling the canals.

What happens after the treatment is finished?

Often there will be mild discomfort after each treatment session and appropriate painkillers will be recommended. After root canal treatment is complete the tooth will need a permanent filling to seal the top of the tooth. A crown (‘cap’) may be recommended to protect the tooth from future breakage, especially if the tooth already had a large filling before treatment.

How successful are root canal treatments?

When carried out thoroughly and carefully, root canal treatments for certain types of teeth can be expected to give long-term success in 90% or more of cases. For other types of teeth, for example where infection has been established over a long period, success rates are lower as the infection can be more difficult to remove. It should be possible to give an estimate of the likely prognosis of treatment after looking at the tooth in the mouth and at an X-ray of the tooth.