Your dentist or endodontist will examine the tooth and take a radiographic (X-ray film). A local anaesthetic will usually be given to block pain. A thin sheet of latex, called rubber dam, is used to isolate the tooth and keep it clean and dry during treatment.
To reach the pulp, an opening through the tooth is made with a dental drill. Using special instruments called files, your dentist or endodontist will remove the inflamed or infected pulp.
Each root canal is cleaned, enlarged and shaped. Anti-inflammatory and anti-bacterial medicines may be put inside the root canal to help stop the inflammation and infection. If a severe abscess has formed as the root tip oral antibiotic tablets may be needed to help treat the infection.
You may need to make several visits to the dentist or endodontist to complete the treatment. A temporary filling will protect the inside of the tooth between visits.
Pain or discomfort, if any, usually lasts no more that a few days, and will not be experienced by every patient. Some people may want to take a mild pain reliever such as aspirin, ibuprofen or paracetamol.
Your dentist or endodontist may take several radiographs to check the shape and length of the root canals and the success of the treatment.
After the pulp has been removed, the tooth is not “dead”. The tooth can survive without the pulp because it is nourished mostly by tissues around it.
Removal of the root end: in a small number of cases. The end of the root may need to be removed to help treat an abscess. This is called a root-end resection or apicectomy. Rarely, a major portion of the root may need to be removed, which is called a root resection.
If you need a root-end resection or a root resection, your dentist or endodontist care provide more information about this treatment.
Completion of root canal treatment
To protect the inside of the tooth and prevent further infection, the root canals are filled, and the pulp chamber is sealed.
A post may be inserted inside the tooth if it lacks enough structure to support an artificial crown. As the jaw bone surrounding the treated tooth takes some time to heal completely, Follow- up visits may be needed to see whether healing has been satisfactory. This is usually checked by examining the tooth and gums and by talking a radiograph. To help the healing process, you should continue to practice good hygiene, including brushing, flossing and regular check-ups.
Fitting an artificial crown: if the treated tooth needs to have an artificial crown, your endodontist will recommend that you return to your dentist. Usually an endodontically treated tooth is at increased risk of fracture without the protection of an artificial crown, so one should be fitted soon after treatment.
Usually made of porcelain or gold, the artificial crown is needed to:
- Protect, strengthen and further seal the tooth.
- Restore normal occlusion ( the way the upper and lower teeth contact each other during biting and chewing)
- Restore an acceptable cosmetic appearance.
Possible side effects of root canal treatment
As with all dental medical treatment, root canal treatment has risks. The following list of possible side effects is intended to inform you about some of the potential problems. As other uncommon complications may occur, the list in not complete.
- If you have any concerns about possible risks or complications, always ask your dentist or endodontist.
- Loss of tooth: while root canal treatment can save most teeth, your dentist or endodontist cannot guarantee that it will be successful in every case. It is possible to predict how long the treatment will last, but it should last for many years.
- Success may depend on a patient’s general health. Age, capacity to heal, oral hygiene, and many other specific factors affecting the tooth, particularly the amount and strength of the remaining tooth structure.
- A very important factor in the final restoration. Be certain to have your tooth restored completely. Otherwise, bacteria can re-enter the tooth and cause another infection.
- Infection: infection in the damaged tooth is likely to resolve completely once treatment is undertaken. The risks of re-infection are low. However, if the infection occurs again, the tooth may have to be treated again or removed.
- Discolouration: in some cases, the treated tooth may lose its original whiteness and become darker. If a front tooth is affected, the person may feel unhappy about the tooth’s appearance. Discolouration can be treated by bleaching, or an artificial crown or veneer can be fitted.
- Pain or discomfort: some people may continue to have pain or discomfort around the tooth during and following treatment. Your dentist or endodontist may recommend a pain reliever. If the pain is severe or lasts more that a few days. Tell your dentist or endodontist. Additional treatment to the tooth may be needed.
- Weakness: and endodontically treated tooth may not be as strong as durable as a normal tooth. This is especially true for the back teeth (molars), and this is why a crown is usually recommended.
- Altered feeling: During and after treatment, the tooth may feel slightly different from the other teeth. This should disappear gradually. If the difference in feeling persists, inform your dentist or endodontist as further treatment may be needed.
- File fracture: special metal files are used to clean the inside of the root canal. These instruments are very fine and occasionally may break during use. Special procedures may be needed to remove the broken portion of the file, or you may be referred to a specialist. In some cases, it may not be possible to remove the fractured portion of the file: the long-term effects of this will depend on many factors. Such as whether the canal was infected and whether it had been cleaned before the fractured. Your dentist will discuss this with you in more details if a file feature occurs.
- Re-treatment: pain or infection may occur months or years after a tooth has been treated. This is usually due to further deep decay, trauma, a cracked tooth or a cracked filling that allows bacteria to enter the tooth and cause the infection. More endodontic treatment may be needed to save the tooth.