Endodontics, more commonly known as root canal therapy, is the treatment of a diseased or injured dental pulp and its supporting tissues.
You may be suffering from dental decay or your tooth may be fractured. In either case the pulp of the tooth has been exposed to bacteria, which over time has led to infection. The inflammation or infection can have a variety of causes including deep decay, repeated dental procedures on the tooth, faulty crowns, or a crack or chip in the tooth. In addition, trauma to a tooth may cause pulp damage even if the tooth has no visible chips or cracks. If pulp inflammation or infection is left untreated, it can cause pain or lead to an abscess.
Every case is different and, depending on the complexity, you may need more than two appointments, which is the norm. At the first appointment, we will assess your condition and ensure there is sufficient tooth available to make treatment viable. During this first appointment the pulp is usually removed and any abscesses are drained, giving you immediate relief from pain. We will clearly outline your treatment following our initial assessment of your case.
Under normal circumstances, root canal treatment is not painful. A local anaesthetic is given to numb the area and, following this, you should experience no more pain than with a normal filling.
Again, this will depend on the case, but one option is to have the tooth extracted. Although some patients prefer this, we always recommend keeping as many of your natural teeth as possible. We will inform you of all your options at your initial consultation.
As occasionally happens with any dental or medical procedure, a tooth may not heal as expected after initial treatment for a variety of reasons, or a new problem can jeopardise a successfully-treated tooth:
- Narrow or curved canals were not treated during the initial procedure
- Complicated canal anatomy went undetected in the first procedure
- The placement of the crown or other restoration was delayed following the endodontic treatment
- The restoration did not prevent salivary contamination to the inside of the tooth
- New decay can expose the root canal filling material to bacteria, causing a new infection in the tooth
- A loose, cracked or broken crown or filling can expose the tooth to new infection
- A tooth sustains a fracture
Whenever possible, it is best to save your natural tooth. Retreated teeth can function well for years, even for a lifetime. Advances in technology are constantly changing the way root canal treatment is performed, so we may use new techniques that were not available when you had your first procedure. We may be able to resolve your problem with retreatment but, as with any dental or medical procedure, there are no guarantees. We will discuss your options and the chances of success before beginning retreatment.
If nonsurgical retreatment is not an option, then endodontic surgery should be considered. This surgery involves making an incision to allow access to the tip of the root. Endodontic surgery may also be recommended in conjunction with retreatment or as an alternative. We will discuss your options and recommend appropriate treatment.
Though endodontic procedures are intended to help save your tooth, this is not always possible. The only other alternative is extraction of the tooth. Missing teeth can make you self-conscious, affect your ability to bite and chew, cause other healthy teeth to shift and have a negative impact on your overall health. For these reasons, the extracted tooth should be replaced with an artificial one.
The way implants are placed depends on the patient, the type of implant and the tooth being replaced. Some implants can be fully placed in one day. Most involve two or three steps. First, the implant is placed into the jaw and the gum is secured over the implant. Over the next three to six months the implant will fuse with the jawbone, a process called osseointegration. Then we may attach an extension, called an abutment, to the implant, although in some cases, the implant and abutment are a single unit placed during the initial surgery. Once healed, the implant and abutment act as the foundation for the replacement tooth.