Root canal treatment is a procedure that repairs and saves an infected tooth. The root of the tooth is the part on the tooth that is inside your gums.
Toothache is often caused by a root infection. The inside of your tooth (the pulp) is normally a sterile environment, meaning that there are no bacteria in there. The pulp also contains blood vessels and nerve fibres, which is why you often experience pain in your tooth when it becomes infected. If the surface of your teeth becomes compromised (for example after trauma, tooth cracking or tooth decay) then bacteria can enter the tooth, infect the tooth and can cause pain.
If left untreated, you may experience pain; the areas surrounding the tooth may become infected, you may lose the tooth altogether and the infection may spread to other parts of your body.
During root canal treatment, your tooth’s infected pulp will be removed; the infection inside is cleaned out; the tooth is treated with antibiotics; and then the hole is filled.
It is important to have a good discussion with your dentist about the prognosis for any infected tooth, so an informed decision can be made about whether the tooth should be kept and treated, or extracted.
If you have a toothache, don’t delay in seeing your dentist, as pain can be the first sign of a major tooth infection.
A tooth can be compromised in a number of ways:
If your tooth is hit by something, such as in a sporting injury, or you bite down on something that causes the tooth to split, bacteria will be able to enter the tooth.
Bacteria can enter the tooth if there is a large decay in the tooth, which can also be caused by things like sugary food and drink, or acidic soft drinks.
This can cause the gum to detach from the tooth, creating a gap. Bacteria can then become trapped between the tooth and gum, which can lead to infection of the tooth.
Fillings usually keep bacteria out of the inside of the tooth. If a filling cracks, then bacteria can get down the crack and into the pulp of the tooth.
Treatment of an infected tooth is called root canal treatment. The infected material is removed from the inside of the tooth and antibacterial medicine is used to kill the infection. Once the infection has been killed, the tooth can be filled to prevent further entry of bacteria into the tooth. Effective root canal treatment may result in the tooth being saved and not extracted.
Root canal treatment enables your natural tooth to be retained, having both cosmetic and dental benefits. If your tooth was extracted, leaving an empty space, the teeth around it will begin to shift, causing your teeth to become misaligned, crooked, or crowded, or even causing gum and jaw problems from changes in your bite.
Replacement teeth, bridges and implants can be more expensive than root canal treatments and may require even more treatment time and additional work on adjacent teeth.
Nothing is better than having your natural, healthy teeth in place.
If you experience some, or all, of the following symptoms, you may have a tooth infection:
Severe and continuous pain, or pain experienced during biting or chewing.
Swelling and redness can develop in the gum area surrounding the infected tooth as well as swollen upper or lower jaws and neck glands.
In some cases, a fever can develop. In these cases, antibiotics may be needed as the infection may have spread to surrounding tissues, especially where pus is present.
Sometimes, an open and draining sore (like a pimple) will form on the gum near an infected tooth. This is called a sinus tract. A sinus tract is your body’s way of trying to drain pus (a mixture of dead tissue and bacteria) from an infected tooth. If you have a sinus tract you should seek treatment from a dentist as soon as possible.
However, it is also important for you to understand that these symptoms are not always conclusive. If the pulp or the nerves inside a tooth die from an infection that was not properly treated, your toothache (pain) may subside even though the infection is still active – you just no longer feel it. Left untreated, an infection like this can spread to other parts of your body.
A chronic periapical abscess is an infection right at the base of the tooth, infections may lie undetected for years, and toothaches may not be experienced at all as there are no surviving nerves in the tooth to cause you pain. These abscesses may only be discovered when an x-ray is taken of your mouth.
One way to fix an infection is with root canal treatment.
Root canal treatment usually involves a series of visits to the dentist.
The aim of the first appointment is to expose the infection and to start removing the bacteria from inside the tooth.
Once the majority of the bacteria, dead nerve tissue and any other debris are removed, then antibiotics and anti-inflammatory medicine can be applied to the inside of the tooth, which will help to kill any remaining bacteria. A temporary filling can then be put in the tooth, to keep the medicine in and any new bacteria out of the tooth.
At the next appointment, the tooth will be checked for any remaining signs of swelling or infection. If necessary a second round of medication and temporary fillings may be required to kill any infection that is still there.
If the pain and swelling are gone and the tooth has become painless again, then the tooth is ready to be filled with a permanent filling which will keep any bacteria from entering again.
Further restoration of the tooth may also be needed such as a crown or a crown and post. This may be essential to strengthen the tooth and protect it from breaking. Until a permanent filling or crown is in place, chewing on the affected tooth should be minimised.
During the first few days or weeks post-treatment, you may experience some pain, sensitivity or discomfort from your tooth, due to remaining inflammation. This can usually be managed with over-the-counter pain medication. Sometimes, your dentist will also prescribe antibiotics (depending on the circumstances).
The pain and tenderness should eventually subside after the completion of root canal treatment.
Even though ‘best practice’ techniques are adopted during the treatment, in some cases complications may emerge.
Breakdown of the final filling can also occur in some cases and this can lead to re-infection of the root canal system, thus the importance of regular check-ups is emphasised.
Depending on the complexity of your root canal system, a decision may be made that your case should be handled by an Endodontist (a dental specialist that specialises in root canal treatment).
If the tooth becomes infected again, a second root canal treatment may be made which may resolve the issue. Other endodontic procedures such as apicoectomy can also be considered.
As with any dental procedure, surgical or invasive procedures on teeth carries inherent risks. At Dentist Mandy, we will discuss all aspects of root canal and endodontic treatment with you prior to the commencement of any treatment. A consent form will need to be signed by the patient, or the guardian of a patient, to indicate that he or she fully understands the procedure, risks and complications involved.
For more detailed information about root canal treatment, you can visit Australian Society of Endodontology http://www.asensw.org.au, or read this article http://www.asensw.org.au/wp-content/uploads/2014/11/m68351_v1_what-is-endo-combinded_final.pdf