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Why and when do 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 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’).

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.

What is involved in root canal treatment?

The treatment is carried out under local anaesthetic to ensure your comfort. Where a decision has been made to proceed with root canal treatment, the procedure 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.
  • Placement of a metal band around the tooth to protect it, if there is no pre- existing crown. The area around a tooth therefore requires additional care inhome cleaning.
  • Entry to the centre of the tooth (root canals) by drilling through the tooth, filling or crown. If the filling or crown is defective it may need to be removed and replaced with a temporary material.
  • Using specialised instruments to prepare the root canals for washing.
  • Taking x-ray picture 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 between appointments.
  • Placement of a root filling material to prevent the root canals from becoming re- infected.
  • A microscope may be used to make treatment easier.

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Will I experience pain during 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.

How long does the treatment usually take?

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).

What happens after my root canal treatment?

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.

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What are the risks associated with root canal treatment?

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.
How successful is the treatment?

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.

What are the alternatives to root canal treatment?

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.

Root Canal Re-treatment

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.

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