Root canal treatment, properly called endodontics, is required when tooth decay is so far advanced, or damage to the tooth so severe, that the pulp – the blood vessels and nerve supply at the heart of the tooth -have become infected. The infection may spread through the root canals, channels which run through the centre of each root carrying blood vessels and nerves from the jawbone to the pulp chamber. This may eventually lead to a pus-filled abscess, an inflamed area which causes swelling of the surrounding tissues and can be extremely painful.
If left untreated the infection will continue to spread and the nerve of the tooth may die; the pain will continue and if extensive loss of tooth structure occurs then it may no longer be possible to save and restore the tooth. Extraction of the tooth would then be the only option.
The aim of your dentist should always be to try to save as many of your natural teeth as possible; removing natural teeth leaves gaps which then causes the other teeth to compensate, affecting your bite. The missing teeth may cause a problem from an aesthetic point of view; the missing root also causes a problem since the bone surrounding the hole where the root used to be will gradually shrink and disappear.
For these reasons root canal treatment is the preferred option.
Root canal treatment is a skilled and time-consuming procedure since a tooth may have more root canals than expected, and they may be unusually shaped and so difficult to clean and fill perfectly. Most courses of treatment will involve two or more visits to your dentist.
At the first appointment, the infected pulp is removed. Any abscesses which may be present are drained and the root canal(s) cleaned and shaped ready for the filling. A temporary filling is put in and the tooth is left to settle. During treatment the tooth is 'isolated' with a device called 'rubber dam', which seals the tooth from the other teeth and protects the mouth and throat from the instruments and solutions being used.
The tooth is checked at a later visit and when all the infection has cleared, the tooth is permanently filled, usually with a type of latex which shows up on X-rays, so your dentist can check that all the root canals and spaces inside the tooth have been completely filled.
A local anaesthetic is used and it should feel no different to having an ordinary filling done. The fearsome reputation of the treatment probably owes more to the pain of the inflammation and abscess making the treatment necessary than to the treatment procedure itself, although in severe cases your dentist may prescribe antibiotics and perform preliminary treatment to relieve the pain of the condition.
The tooth after treatment will be "dead", having no nerve or blood supply. It will be more brittle than before and so your dentist may fit a dental crown or onlay to add extra strength and support.
In the past, a root-filled tooth would often darken after treatment. However, with modern techniques this does not usually happen. If there is any discolouration, there are several treatments available to restore the natural appearance.
The procedure is often complicated and may involve multiple visits over a period of weeks so the cost will reflect this. A simple root treatment on a front tooth can cost between £200 and £400, however a back tooth with three to four roots may cost as much as £1000. The cost of the dental crown or onlay will be in addition to this. It is advisable to get a written estimate and treatment plan before beginning any dental treatment.
Root-treated teeth should be treated just like your other teeth once the final crown or onlay has been placed. Always maintain good oral hygiene and have them regularly checked by your dentist.
Depending upon how well you look after them, they can last for several years.