| Sometimes
a tooth can become infected or inflamed – it may be
very sensitive to temperature, there may be swelling in the
area or the tooth may be very painful to bite on. When this
happens a dentist can offer two solutions – either
extract the diseased tooth or provide root canal treatment.
Root canal treatment or endodontic treatment, as dentists
call it, involves cutting an access cavity into the tooth,
so that the dentist can clean out the hollow space within
the centre of the tooth – the pulp chamber. The
dentist then finds the root canal(s) – fine can als
which run down from the central pulp chamber to the ends
of the roots. There can be just one or many root canals
depending on the tooth, and they must all be found and
treated for the root canal treatment to be successful.
Once inside the tooth the dentist will clean out the dead
and dying material and then clean and shape the root canals.
In order to complete this part of root treatment correctly
it is essential for a dentist to take x-rays of the tooth
or use an electronic device, which determines how long
the root canals are. Once all the measurements are taken
and the root canals prepared, then the dentist places the
root filling which runs up to, but not beyond the end of
each root canal. This root filling will fill the canal
completely and produce a tight seal at the end of the canal.
The dentist will then take a final x-ray to check that
the root filling is correctly positioned.
The length of the procedure varies. Straightforward cases
may be completed in ½ to 1 hour. More demanding
teeth may take considerably longer - sometimes over two
hours. Such cases (and very infected teeth) will frequently
necessitate more than one visit before the procedure
is completed.
The symptoms associated with root canal treatment will
depend on the complexity of the case, but with adequate
local anaesthetic the procedure itself should be painless.
It is normal to have some slight discomfort for 2 or
3 days after treatment. The pain however, can usually
be controlled with over-the-counter analgesics.
A root treated tooth should feel the same as a healthy
tooth, but it will be more brittle than the same live
tooth and it is important to have a strengthening restoration
placed soon after root treatment, otherwise the teeth
can split and be lost.
Unfortunately sometimes root filling material is not positioned
at the correct length – either too short or too
long, and the tooth infection can return. Alternatively
sometimes the root canal cleaning instruments can perforate
through the side of the root causing infection around
the tooth. In all cases where root treatment has failed
immediate attention should be provided by a dentist,
and treatment thereafter may involve referral to a specialist
in root canal treatment, known as an endodontist.
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