Root Canal Treatment
Specialists / Endodontist
What is it
Root canal treatment (RCT) is performed to treat the inflammation of the tooth pulp (“pulpitis”) or the infection of root canal space. Simply put, it is the disinfection and cleaning of the root canal space and filling up the canals to prevent re-infection.
When do we need RCT
Toothache
A toothache is a common term for pulpitis, the inflammation of the tooth pulp. The pulp is protected from bacterial infection by the encasing tooth structure. In the presence of decay, fracture, cracks or gum disease, the pulp tissue will be inflamed resulting in pulpitis/toothache.
If pulpitis is allowed to progress, the bacterial infection will cause the pulp to degenerate and there will be an infected space within the tooth, giving rise to inflammation of the bone tissue around the tooth root.
Dental Trauma/ Tooth Fractures
Other situations requiring root canal treatment include dental trauma, which usually refers to fractures of the tooth structure and/or loosening of the tooth within its socket.
How it works
Root canal procedure itself can be done in one or several visits. X-rays are required before, during, and after the procedure to ensure that the root canal treatment is performed in accordance to standards. It is routinely done with the placement of a rubber cloth so that the tooth can be isolated. Several anaesthetic procedures can be used to numb the tooth before root canal treatment proceeds.
The treatment involves:
- Drilling the tooth to gain access to the pulp
- Cleaning and shaping the canals using small files
- Inserting the files to confirm that the canals are thoroughly cleaned and shaped
- Filling the canals, usually with gutta-percha (a rubber base material) and biocompatible cement
Care Tips
A tooth that is root canal-treated has a greater tendency to fracture, so patients are advised to not chew on hard foods before the tooth can be crowned or restored.
Otherwise, the tooth should be maintained with brushing and flossing in the same way as the other teeth to prevent tooth decay or gum disease.
Risk Factors
Sometimes, even when the treatment has been carried out correctly, the patient may find that the tooth is sensitive to touch. This may be the result of complications in the procedure due to unusual structure of the teeth, such as:
- Calcification of the root canal space
- Very curved canals
- A premature tooth or tooth with a limited tooth structure that may fracture during treatment
When such complications occur, the success rate may be affected and other follow-up treatment may be required.
When Further Treatment is Necessary
Root canal treatments usually have good success rates but depend on the pre-existing condition of the tooth.
When the treatment fails, there is usually persistent inflammation of the bone and sometimes swelling and pus discharge.
Redoing root canal treatment can be complex as it can be complicated by the presence of materials that are difficult to remove.