Treatments · Root Canal Treatment
Root Canal Treatment
Root canal treatment removes the inflamed or dead nerve tissue (pulp) inside the tooth, cleans the canals and seals them with a filling material. The aim is to keep the tooth in the mouth rather than extract it.
Root canal treatment saves a tooth whose nerve is inflamed or dead by cleaning and sealing the canals instead of extracting it. It is done under local anaesthesia; front teeth usually need one visit, back teeth 1–2. A crown afterwards prevents fracture. The success rate is high; biting sensitivity for a few days is normal.
When is it needed?
- Pain that lingers with hot or cold, starts on its own or wakes you at night
- Pain on biting, darkening of the tooth
- Swelling of the gum, a "pimple" that drains
- Inflammation at the root tip on an X-ray (sometimes with no pain at all)
- Deep decay or a fracture reaching the nerve, trauma
Step by step
- Diagnosis: X-ray, cold/heat and percussion tests determine the vitality of the tooth and the extent of the inflammation.
- Anaesthesia and isolation: local anaesthesia; the tooth is isolated from saliva with a rubber dam.
- Access and cleaning: the canals are reached through the top of the tooth, their length is measured electronically, they are shaped with rotary files and washed with disinfectant solutions.
- Filling: the canals are sealed with gutta-percha and sealer; a control X-ray is taken.
- Restoration: a permanent filling in the same or the next visit; for back teeth and large losses, a crown or onlay.
Duration and visits
- Single-rooted front teeth: 1 visit, 45–60 min
- Multi-rooted molars: 1–2 visits, 60–90 min
- Teeth with abscess or large lesions: 2–3 visits (with medication in the canal between)
- Re-treatments: 2–3 visits
Healing
Biting sensitivity and mild throbbing for 2–7 days are expected and decrease daily. Swelling, fever or increasing pain need a check. Do not bite hard things with the tooth until the crown is fitted; root-treated teeth are brittle, so a crown is recommended especially for back teeth.
Re-treatment
If a previous root canal treatment leaks or the inflammation returns, it can be redone (re-treatment). If that is not possible, root-tip surgery (apicoectomy) is considered.
Alternatives
The only alternative is extraction, after which an implant or bridge is needed. Keeping a natural tooth that can be saved is usually the first choice for both function and cost. If the root-tip inflammation does not heal despite treatment, apicoectomy is an option (oral surgery).
- Teeth with a vertical root fracture or insufficient bone support may not be saved by root canal treatment; extraction is considered.
- Using the tooth before the final restoration carries a high risk of fracture.
- Limited mouth opening can make treatment of back teeth difficult.
FAQ
Root Canal Treatment
Is root canal treatment painful?
It is done under local anaesthesia and no pain is expected during the procedure. Severely inflamed teeth can be harder to numb, in which case additional anaesthetic techniques are used. Sensitivity afterwards settles within a few days.
How long does a root-treated tooth last?
With a well-done root canal and a suitable restoration the tooth lasts for years, often for life. The most common cause of loss is fracture, which is why a crown is recommended.
Wouldn't extraction be better?
Your own tooth functions more naturally than an implant. If root canal treatment is possible, the tooth is kept; extraction and implant are considered for teeth that cannot be saved.
Will the tooth darken afterwards?
The darkening seen with older techniques is rare with today's materials. If it happens, it can be corrected with internal whitening or a veneer.
Are antibiotics needed?
In most cases no; the real treatment is cleaning the canal. If there is widespread swelling, fever or general illness, the dentist may prescribe antibiotics.
Appointment
Examination appointment for Root Canal Treatment
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