Root canal treatment

Root canal treatment

Endodontist

An endodontist is a dental surgeon whose speciality is the diagnosis and treatment of diseases of the root canal. An example of this is root canal treatment.

The root canal

The root canal is a channel which runs the length of the tooth and contains a soft substance or pulp. The pulp consists of tissue, nerves and blood vessels which are sensitive and prone to infections. A single tooth may contain several canals.

If a tooth becomes decayed, the infection can spread through the enamel (outer layer) and the dentine (inner layer) before it reaches the pulp. Once there, the bacteria continue to multiply, releasing substances, endotoxins and pus, which along with the bacteria, travel down the root canal and exit at the end. An x-ray of the tooth will usually show this damage in the surrounding bone. Often the patient finds it hard to eat on the infected tooth and it becomes tender to tapping/percussion.

This causes the tissues at the base of the tooth to become red and inflamed, causing a great deal of pain to the sufferer. In some cases this causing an additional swelling in the side of the face and the formation of an abscess. An abscess can be treated by Dr Monica Bijlani in this Clinic. If root canal treatment is not carried out, the infection will spread and the tooth may need to be taken out.  In some instances, it is recommended that you see an Endodontist if the posterior tooth anatomy is complex or always as an option open to you.

Root canal treatment

Dr Bijlani will treat the abscess and prevent the infection from spreading around the rest of the body, by removing the infected areas of tissue inside the root canal, allowing the surrounding areas to heal.

If a dental abscess is present it will be drained at the same time.  She will clean out the root canal, increasing its size and shape to prepare it for the filling. A small amount of medication may be inserted into the root canal to kill any bacteria before the insertion of a temporary filling, referred to as a root dressing. This treatment may take place over several visits.

A temporary filling is inserted to allow the tooth to fully heal before the insertion of a permanent root canal filling. This effectively seals the tooth root. A crown is also fitted as a protective measure, a short while later. This crown prevents the fracture of the tooth as root-filled teeth tend to be brittle, as they are non-vital.

Root canal surgery can be performed under a local anaesthetic. This is an effective form of treatment and less painful than often assumed.
Infact, patients often fall asleep during this treatment as Dr Bijlani is very gentle and the patients feel so relaxed. We actually have to wake them up and inform them that the treatment has been completed.

Root fillings are usually successful and can last many years, but re-treatment is also possible if sadly the infection recurs.  The tooth can become discoloured and or mobile. It is best to retreat a persistent inflammation at the tip of the root by cleaning out and disinfecting the tooth and refilling the root to seal its apex. Sometimes on anterior teeth, a surgical procedure called an apicectomy is needed, in order to prevent tooth loss.

Approximately a month after treatment, in order to ensure the tooth is asymmptomatic, the tooth should be crowned. This is to protect the tooth from fractures, which can lead to loss of the tooth.