Endodontics

Endodontics is the branch of dentistry that treats the diseased nerve tissues inside the teeth.

Endodontic treatment or root canal treatment is usually the last resort treatment to save a tooth where the nerve and blood vessels inside the tooth become damaged either due to a bacterial insult, infection or trauma.

Root canal therapy often gets bad press however when done with meticulous precision, under magnification and with adequate local anaesthesia it should be a painless comfortable procedure with success rates in the region of 90-95%.

The types of procedures associated with endodontics:

• Root canal therapy
• Apecitomy: Removing an infected root tip via a surgical approach, cleaning out the surrounding infection and placing a filling to seal off the new end of the tooth.
• Rehabilitation of badly broken down teeth.
• Removal of separated instruments.
• Treatment of complications to do with root canal therapy.

Frequently Asked Questions

What is a root canal?

Inside the tooth, under the white enamel and a hard layer called the dentine, is a soft tissue called the pulp. The pulp contains blood vessels, nerves and connective tissue and creates the surrounding hard tissues of the tooth during development. The pulp extends from the crown of the tooth to the tip of the roots via root canals.

What is Root Canal Treatment?

Endodontic treatment is necessary when the pulp, the soft tissue inside the root canal, becomes inflamed or infected. Root canal treatment (RCT) is one type of endodontic treatment.

The inflammation or infection can have a variety of causes such as:

• Deep decay
• Repeated dental procedures on the tooth
• Cracks or fractures in the tooth
• An injury to a tooth (such as dental trauma) may cause pulp damage even if the tooth has no visible chips or cracks

What are the signs and symptoms?

Common signs or symptoms may include:

• Severe pain while chewing or biting
• Pimples on the gums
• Prolonged sensitivity to hot or cold, even after the sensation has been removed
• Discoloured teeth
• Swollen or tender gums
• Deep decay
• A chipped or cracked tooth
• Sometimes there are no symptoms but can be identified by your dentist following clinical and radiographic examinations.

What does the treatment involve?

Endodontic treatment can often be performed in one or two visits and involves the following steps:

1. Local anaesthetic is administered to ensure the area is numb and that treatment can be carried out comfortably.
2. Then a protective sheet called “rubber dam” is placed over the area to isolate the tooth and keep it clean and free of saliva during the procedure.
3. An opening is made in the crown, and fine instruments and disinfectants are used to clean and shape the root canals.
4. Following cleaning and shaping, the root canals are usually filled with a rubber-like material called gutta-percha.
5. The access cavity is then restored to seal the root canals.
6. Sometimes after the completion of the root canal procedure, your tooth will need an additional restoration e.g. an onlay, overlay or crown to help protect it. Failure to have the tooth properly restored in a timely manner significantly increases the possibility of failure of the root canal procedure or tooth fracture.

If the tooth lacks sufficient structure to hold the restoration in place a post may be required inside the tooth.

Will I feel pain during or after the root canal?

Many procedures are performed to relieve the pain from toothaches caused by pulp inflammation or infection. Modern techniques and anaesthetics allow the vast majority of patients to be comfortable during the procedure.

For the first few days after treatment, your tooth and surrounding gums may feel sensitive or tender. Over-the-counter medications, such as Ibuprofen or Paracetamol are usually enough to manage this.

Your tooth may continue to feel slightly different from your other teeth for some time after your endodontic treatment is completed. Of course, if pain persists or if you experience severe pain, you can call us for further advice.

Can all teeth be treated endodontically?

Most teeth can be treated. Sometimes a tooth can’t be saved if the root canals are not accessible, the tooth/root is severely fractured, the tooth doesn’t have adequate bone support, or the tooth cannot be restored.

What are the alternatives to Root Canal Treatment?

No treatment or active clinical monitoring may leave you susceptible to repeated episodes of pain and infection. Sometimes active clinical monitoring may be appropriate if the diagnosis is unclear.

Another alternative is the extraction of the tooth, which may be replaced.

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