Root Canal treatment
Root canal treatment or endodontics is designed to save an infected tooth from extraction. This treatment aims to save a tooth in which the blood or nerve supply has been infected by decay or dental trauma. If you are experiencing moderate to severe tooth pain you may be in need of a root canal treatment.
Root Canals: What are they?
There is a lot of confusion and concern about this procedure, which is really a very simple, painless and common procedure in dentistry. A root canal is actually the part of the tooth: the living chambers and tubes inside the roots that contain blood vessels and nerves. When you need a root canal treatment, it means that this chamber has become infected by bacteria, and needs a mini course of antibiotics to get rid of the infection.
If you had a similar infection anywhere in your body, a doctor would simply prescribe a course of antibiotic tablets; the antibiotics spread through your bloodstream to the source of the infection, and the bacteria are killed. Unfortunately, teeth are a uniquely shaped part of your body: they have live tissue in the middle, and only a pin point where the blood vessels enter on the tip of each root. When the tooth becomes infected, the blood vessels inside die, so no antibiotic flowing in your bloodstream can actually get inside the tooth. So a root canal treatment aims to open up and disinfect the chamber inside the tooth, and place antibiotic cream directly where the infection is. The dentist will place a sheet of rubber (called a rubber dam) over the tooth to keep it dry and sterile, like a surgeons sterile green drapes. It will allow you to swallow comfortably, and the spray from dental drills will not go into your mouth. The dentist will remove any decay with normal dental drills, but where dental drills will not reach deeper in the roots, sterile files will be used to clean and shape the canals. The canals are rinsed with disinfectants, and then antibiotic cream is placed in the empty chamber. A temporary filling is placed on top. The cream should be left to kill the bacteria for about 4 weeks (just like a full course of antibiotics would be taken over a couple of days).
Root canal treatment must be followed with a root canal sealant. This is a follow up appointment that involves removing the antibiotic cream, drying the now sterile (bacteria and infection-free) canal inside the tooth, and placing a rubber-like or resin based material. This is to create a water-tight and bacteria-proof seal, with the aim of stopping infection from coming back again.
Bacteria may have entered the deepest part of the tooth via decay (most common), cracks, or through a traumatic hit or fall.
Root canals… do they hurt?
This is a question I often get patients asking me. There has been a lot of misconceptions about root canal treatments, which really are a modified filling preperations to treat an infection. Root canals should not hurt. Like an ordinary filling, the dentist numbs the tooth beforehand so you do not feel anything. In the past, it is possible that dentists did this procedure without numbing, just like a lot of dentists did fillings without numbing- so some people believe this is always a painful process. Not so- modern dentistry aims for you to be comfortable, and out of pain . The dentist will always ask you if you do feel any discomfort at any stage to let them know- this for your benefit in case you do need more anaethetic, and you don’t just put up with it because you expect that it should hurt!
Occasionally patients will arrive in pain at the clinic because a tooth is badly infected and needs a root canal. The dentist will quickly do some tests to work out which tooth is causing the problem. One the causitive tooth is isolated, the dentist will numb you up ASAP so you are out of pain!