Endodontics

What is involved?

Root canal treatment involves 1-2 visits, lasting around one and a half hours each. Depending on the complexity of the case, additional visits may be needed due to technical or anatomical difficulties. The treatment involves several steps, which should be followed to ensure an appropriate result:

1. Preoperative radiograph
A small x-ray is taken before starting treatment to assess the anatomy of the tooth and diagnose.

2. Isolation of the tooth
A rubber sheet called a ‘rubber dam’ is held over the the tooth by a frame to isolate it from the rest of the mouth to prevent reinfection of the tooth.

3. Chemomechanical cleaning of root canals
The infected root canals are cleaned with precision made instruments and files, and high strength anti-bacterial agents are used to chemically disinfect the area to kill any remaining bacteria.

4. Obturation
The prepared root canals are then filled with a durable and long standing rubber type material called ‘gutta percha’. A special sealer is applied to coat the surface of the gutta percha and this is placed into the root canals to fill the prepared areas.

5. Placement of a core/temporary filling into the tooth
After obturation, a strong filling is placed over the root canal filling to prevent any reinfection. This is used to build up the tooth and ensures that the tooth remains durable until a long term permanent restoration can be placed.

6. Permanent Restoration
After root canal treatment, a tooth requires a permanent filling to protect it from fractures and reinfection. This is usually a crown or restoration that covers the biting surfaces of the tooth. If the tooth has not been restored to full function in this way, it is likely bacterial leakage can occur and the root canal treatment will be ineffective.

Root Canal Re-Treatment

On occasions, a tooth that has been previously root filled can develop a further infection (chronic apical periodontitis). The tooth may have been filled many years ago, and can become painful or tender to bite on. Teeth may also develop underlying inflammation without giving any pain. Such teeth are commonly detected when a routine dental x-ray is taken. Root canal re-treatment aims to give the tooth a second chance; the only other option is to take this tooth out.

Endodontists are specially trained dentists who undertake additional years of post-graduate training in order to provide non-surgical and surgical root canal retreatments. Instruments such as microscopes, ultrasonic units and other advanced technology are used in this treatment.

What if root canal treatment alone does not work?

In specific cases, root canal treatment (re-treatment) is not enough to save the tooth. Certain teeth that have complex anatomy or a very severe infection may require a procedure known as root end surgery to be carried out. Root end surgery involves the endodontist removing the inflamed or infected tissue around the tip of the root, by removal of a small portion of the root apex (tip). A subsequent small filling is placed to seal the apex and the gum is closed around the site to allow for healing. On some occasions, a root canal treatment and root end surgery are required on the same tooth in order to save it.

Is the treatment painful?

Infected teeth are anaesthetised prior to treatment ensuring that the procedure is as comfortable as possible.