Q. What is root canal treatment?

Root canal treatment includes the removal of a nerve from a tooth through drilling a hole in the upper surface of the tooth. Using instruments which resemble a needle, the interior of the root canal are cleaned with disinfectants. Then the canals are dried and tightly sealed, inserting a special filling inside.

Q. Does it hurt?

Mentions of “root canal treatments” is often associated with severe pain. Technological progress and the experience of our professionals, allows for root canal treatments to be carried out with much less pain that their reputation might suggest. Ironically. root canal treatment is designed to minimise the ache of an infected tooth, and not to cause pain.

Q. When is root canal treatment necessary?

Root canal treatment is needed, when the teeth pulp becomes infected. The pulp is a soft tissue inside the tooth, containing connective tissue, blood vessels and nerves. The pulp stretches from the crown of a tooth all the way down to the tip of the verve in the jaw bone. Normally, a tooth protects the tooth pulp, but if it is damaged by a chip, crack or a problem stemming from multiple repairs, bacteria may enter the pulp. Then the bacteria propagate from the crown towards the root, puss collects at the ends of the roots, and the mouth becomes painful and sensitive to hot and cold.

Not all pulp infections cause pain. Sometimes it spreads so slowly that the patient does not feel it.

Q. How is root canal treatment done?

Root canal treatment is done over three stages. First thing is the correct diagnosis. Next, it is the turn for appropriate root canal treatment, during which an endodontist (a dentist who specialises in treating the inside of a tooth) will remove the pulp (and also the infection) and will clean out the inside of a tooth in preparation for a filling, sometimes using antibiotics to prevent further infections.

A temporary filling is applied at this stage to seal the tooth. Finally, during a subsequent visit, the treated tooth receives a crown or inlay/onlay, which will seal and protect the tooth against further damage or infection.

Q. What results are to be expected?

After successful root canal treatment, the tooth will no longer ache. However, as the tooth no longer has nerves, thus it is not sensitive to temperature or sweets, which are the signs of tooth decay. Thus a patient must undergo regular dental check-ups including X-ray imaging in order to prevent further tooth problems. A tooth that has been through a root canal treatment should function for ones entire life, however, as time goes by, the filling or crown may be ground off, which will need replacing. Excellent mouth hygiene after a root canal treatment should prevent further infections.

Retention of natural teeth should always be the goal of a patient. It should be remembered that tooth pulp will not heal itself, and will not regenerate, thus untreated infections will only get worse as time goes by. Without root canal treatment, the patient may eventually lose a tooth, and the next step will require a bridge or another expensive renovation.

Q. What complications could I expect?

Symptoms after an unsuccessful root canal treatment:

  • Mild to severe tooth ache
  • Mild or severe swelling of the gums around the tooth

Factors influencing unsuccessful treatments

  • Shape of the root canals
  • If there are many root canal passages they may be difficult to detect, and missed during treatment
  • Unexpected number of root canal passages
  • If the tooth has very thin root canal passages, these may be missed during treatment
  • Missed cracks of the root
  • Faulty or defective reconstruction which allows bacteria to infiltrate the tooth and its re-infection
  • A deterioration of tooth seals over time allowing for a bacterial re-infection
  • Structure of the tooth damaged during treatment requiring repair in order to stabilise it
  • Not maintaining particular mouth hygiene, which may lead to teeth loss
  • Resistance of some bacteria to root canal treatments

Q. What are the complications associated with root canal treatments?

  • Breaking of dental tools in the root canal during cleaning of the pulp chamber. It can be removed at a later date, but only by a specialised endodontist with the use of an endodontic microscope.
  • Infection as a result of an incomplete filling of the root canals or missing root canals undetected by an X-ray image
  • Resistance of some bacteria to root canal treatments

Q. What is a post?

A post is inserted into the core of the root, which was previously subject to a root canal treatment. The volume previously taken up by the tooth nerve is now filled with the post, which is cemented in to reinforce tooth structure. Based on such a core of a tooth, now a crown or bridge may be applied. The post is usually fixed to the tooth independently of the crown.

Q. How does a dentist insert the post?

In preparing of the post, the dentist removes part of the plastic ensuring that 2,3 millimetre are left at the end allowing for a sealing of the root end. This is necessary to correctly fix the post in the root. Different types of dental posts exist. The type will depend on many factors. Dental post may be 1) prefabricated or 2) may be cast in the laboratory. In both cases the method for fixing a crown based on a dental post is the same. Despite the fact that dental post are recommended if there isn’t sufficient support for the crown, they are not always required. The use of dental post is agreed upon based on individual needs.

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