Root-Canal-Treatment-Conventional
Root canal treatment information

Conventional root canal treatment

We are a leading Endodontic Referral Practice providing pain free advanced Root Canal Treatment to patients referred to us by their dentists.  Please consult your dentist if you think that you require Root Canal Treatment.

What is root canal treatment?

A root canal is a treatment used to repair and save a tooth that is badly decayed or becomes infected. During a root canal procedure, the nerve and pulp are removed and the inside of the tooth is cleaned and sealed. Without treatment, the tissue surrounding the tooth will become inflamed and an abscess can form.

“Root canal” is the term used to describe the natural space within the centre of the tooth. The pulp (tooth nerve) is the soft tissue within the root canal space. Endodontics is a specialty of Dentistry that deals with diseases of the dental pulp and its supporting structures. Our dentists  have special post-graduate training in this field and are experienced at finding the cause of oral and facial pain that has been difficult to diagnose.

Although General Dentists can perform treatment patients are often referred to us when the case is complicated or more difficult than usual. We at Kentendo are experts in root canal treatment with state of the art facilities.

All the facilities required for such cases, including the operating microscope, ultrasonics and an electronic apex locator are routinely used at Kentendo.

In order to understand Endodontic treatment, it helps to know something about the anatomy of a tooth and the process involved in the treatment. This section is aimed at giving some basic information about the Anatomy of a tooth and basics of root canal treatment.

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Teeth have several layers. The outside layer of the tooth is composed of a hard layer called Enamel. Enamel is supported by an inner layer called Dentin, which has at its centre a soft tissue known as the Pulp.

The pulp contains blood vessels, nerves, and connective tissue that are responsible for forming the surrounding Dentin and Enamel during tooth development. The pulp receives its nourishment supply from vessels which enter the end of the root. Although the pulp is important during development of the tooth, it is not necessary for function of the tooth. The tooth continues to be nourished by the tissues surrounding it even after the pulp is removed.

A root canal treatment typically requires one or more appointment visits.

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Prior to root canal treatment a radiograph is taken to see the shape of the roots and to determine if there are any signs of inflammation in the surrounding bone. Local anaesthesia is used to numb the area.

Next, a dental dam is placed around the tooth to keep the area dry and free of saliva during treatment. An access hole is drilled into the tooth, this is typically done with the use of a dental operating microscope, to help locate all the root canals whilst keeping tooth removal to an absolute minimum.

This is followed by the removal of infected nerve tissue and related debris from inside the root canals.

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The cleaning out process is accomplished using root canal files and rotary instruments. The canals maybe as narrow as 0.05mm in diameter and so a series of these files of increasing diameter are each subsequently placed inside the root canals and worked down to the full length (determined by an electronic apex locator) in order to shape the canals.

The shaping facilitates irrigation with Sodium hypochlorite and other disinfectant solutions, which are used periodically to flush away the debris and to eliminate any bacteria that remain inside the canals. Once the tooth is thoroughly cleaned it maybe possible to have the treatment completed in a single visit, otherwise a medication is placed inside the tooth and a temporary filling is placed in the access hole to keep out contaminants (like saliva and food) between appointments.

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At the next appointment, to fill the interior of the root canals, a sealer paste and an inert root filling material called gutta-percha is placed using advanced thermal techniques. The entrance of the root canals are sealed with an anti-bacterial filling ensuring a good seal.

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To fill the exterior access hole created at the beginning of treatment, a temporary filling is placed and an appointment is made with your dentist for the permanent restoration. In some instances your dentist may request that we place the permanent restoration inside the tooth.

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For a significant number of teeth, in particular heavily filled posterior teeth, a crown, crown and post, or other such type restoration is required to protect the tooth, preventing it from breaking, and restoring it to full function.  The crown is a treatment that your dentist will be able to help you with.  We will always advise you if this is required at the consultation appointment.

On completion of treatment we will send a detailed report to your regular dentist who will then place the crown restoration – should this be required; and continue with your routine dental care.

Frequently asked questions

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 a tooth that has developed a crack. Occasionally, a healthy tooth may need root canal treatment to enable a crown to be retained (referred to as ‘elective root canal treatment’).
Success of the treatment may be influenced by the quality of the new filling or crown. If there is not enough tooth structure left, extraction of the tooth may be necessary. In this case, you will be referred back to your own dentist for further treatment.
Pain during treatment is a rare possibility, particularly when the nerve is inflamed. Under these circumstances, local anaesthesia is not so effective. A number of strategies are open to the dentist under these conditions. Some forbearance is required though to achieve immediate progress in treatment. Mild discomfort after treatment may be caused by one or a combination of several factors; local anaesthesia, rubber sheet placement or the treatment procedures, lasting between 12-24 hours after treatment. This is easily treated by over the counter pain killers. If you have severe pain that starts after three to four days of mild discomfort following root canal treatment, we would advise you to contact the practice immediately . You will also be provided with an out of hours emergency number. There is a common misconception that root canal treatment is very painful. There are certain situations, for example when a nerve is inflamed, that require a different approach to treatment. We have the skills and expertise to manage such situations with minimal discomfort.
The process of finding, placing instruments into, preparing and washing root canals is a highly skilful procedure and takes time and patience during multiple and longer than normal appointments (1 – 2 hours).
Following completion of the root canal treatment, the tooth will be filled with a white filling for front teeth or amalgam (silver) for molar teeth. In some cases, the use of a post is necessary to help build the tooth up before the crown is made. You will then be referred back to your dentist for an additional restoration such as a crown to protect the tooth from fracturing as well as routine care. However, the tooth is normally monitored periodically to make sure that the bone cavity around the root end is healing up. This requires an X-ray picture. The healing can take anything from six months to four years and sometimes longer. The first check-up is at 6 months and thereafter on an annual basis up to 4 years.
The number of risks are minimised by the high standard of care. However, sometimes unforeseen problems can occur and may include the followings; . Pain during treatment . Mild discomfort after treatment . Leakage of antiseptic agents into the mouth . Tooth fracture . Failure of canal location and negotiation . Blockage of root canals . Fracture of files in the canal . Root perforation . Extrusion of antiseptic through the end of the root into the surrounding soft tissue.
Failure despite adequate treatment is a possibility in a small proportion of cases and is usually due to persistent infections. The success rate in those cases where there is no inflammation around the end of the root is of the order of about 96%. The success rate for those teeth with inflammation around the end of the root is about 85%. In case of failure, either re-treatment, surgery or tooth extraction may be considered. The dentist treating you will provide you with an estimated success rate specific to your case.
Normally the alternative options to root canal treatment are extraction, with or without replacement with a denture, bridge, implant or space closure with orthodontic treatment (braces). You may opt to have no treatment at all but some of the risks may include: pain, swelling, pus discharge, fracture of the tooth and ultimately losing your tooth.
Repetition of an existing root canal treatment is undertaken when the previous root canal treatment has failed or is deemed to be inadequate. Common reasons for failure of previous root canal treatment include; sub-optimal treatment, re-infection e.g decay around filling, presence of cracks / fractures or presence of a cyst around the root end. Re-treatment may also be performed to improve the technical quality of the root canal filling prior to the placement of a new crown or bridge.