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Home / General - Root Canal Treatment

• Root treatment is the removal of nerve tissue from inside the crown and roots of the tooth and then filling the space completely
• Root treatment is often the only way to save the tooth and to relieve pain

Root Treatment or root canal therapy or endodontics is the removal of nerve tissue (pulp) from the inside of the tooth crown and root. The nerve is removed from the tooth when it has become inflamed and is causing extreme pain with hot and cold stimuli, when it is throbbing and is diagnosed to be dying (necrotising), or when there is an abscess (pus) at the top (apex) of the root as a result of pulpal death and the dead tissue has become infected, which may cause pressure around the top of the root pushing the tooth slightly out of the socket and stretching the retaining dental ligaments around the tooth making the tooth extremely sensitive to touch or pressure. The tooth feels longer and is struck first when closing the mouth.

The root treatment is done by opening a hole into the pulp chamber in the crown of the tooth and then removing all the pulpal tissue from the crown up to the apex of the root. All nerve tissue, dead or alive and all infected dentine lining the root canal has to be removed and the walls of the root canal have to be filed smooth. This needs to be done under strictly sterile conditions. Amputation of the pulp relieves the pain in the case of pulpal injury or pulpal inflammation. Opening the root canal allows the pus to drain out of the apical tissues and removes the cause of the abscess.

Filling the root canal with medicaments, gutta percha, or resin or a combination of these completes the root treatment. This is done meticulously as the whole root canal up to the apex has to be completely obliterated.

Advantages: Root treatments prevent and alleviate pain and infection resulting in the ability to save the tooth simply and effectively.

Disadvantages: The procedure can be time consuming, especially where there is a resistant or entrenched apical infection. The procedure may be initially painful, but this is normally less of a problem than public perception allows and is usually transient and is usually easily managed. There may be postoperative pain that may last a short time. After treatment the tooth may darken or discolour slightly. Root treated teeth become brittle and may fracture or break, so it is recommended that these teeth be crowned once the root treatment settles down.

Endodontics is time consuming and expensive. Complex cases are often referred to a specialist endodontist. Once endodontics treatment is initiated, the patient must understand that they will have to complete the treatment or the tooth may become abscessed.