What is root canal treatment?

Root canal treatment or endodontic treatment is a procedure performed to help restore a tooth when there has been disease, infection or inflammation of the root canal system of the tooth.

The tooth consists of a crown (the part of the tooth that you can see in the mouth) and the roots (the part that sits beneath the gum line and secures your tooth to your jaw bone). The roots contain a blood and nerve supply, and if the health of this system is compromised by bacteria (through decay or trauma) or irritation (cracks and fillings) then the blood and nerve supply can start a process of disease or necrosis. This typically is very painful, and only two definitive treatment options are normally available-extraction or root canal treatment.

Root canal treatment involves:

1. Thorough assessment. This includes a clinical examination, x-rays and vitality testing (with ice pellets or using an electrical current).
2. If a root canal treatment is indicated, the dentist will give you local anaesthetic to numb the tooth.
3. A rubber dam is placed to help isolate the tooth from the rest of your mouth. This ensures that natural bacteria from your mouth cannot enter the tooth and that chemicals and tools used during the procedure are unable to enter your mouth or airways.
4. Using a drill, the dentist will remove decayed tooth or fillings and gain access to the pulp of the tooth.
5. Once the pulp has been accessed, he will locate the openings of the root canals, there may be between 1 and 4 normally.
6. Using a special meter called an apex locator, he will determine the length of the roots, normally we like to ensure that your root filling finishes within 0.5-2mm of the tip of the root visible on the x-ray.
7. The root canals are normally very narrow, and specialised tools are now used to widen and bore out the root canals to the previously determined length. This is termed mechanical preparation, and the aim is to form a well tapered shape and to debride the walls of the root canals to help eliminate bacteria.
8. Whilst the dentist is performing the mechanical preparation, he will also be using chemical solutions to help further disinfect the root canals and prevent clogging of the canals with debris.
9. At this point the dentist may place an antiseptic dressing for a few weeks prior to completion of your treatment to help further disinfect the tooth, or he may proceed to completing the root canal treatment.
10. The final stage is placement of a permanent filling in the root canals. The dentist normally takes an x-ray to confirm the length and size of gutta percha points prior to sealing them with a special endodontic sealer paste. He can seal the gutta percha in a few ways, but heated sealing is a popular method where the gutta percha is heated to allow it become more flowable and thus flow and fill any nooks and crannies. A final x-ray is taken to assess the quality of the treatment.
11. Once the root canal treatment has been completed you will still require a permanent filling or crown to seal the root canal treatment from the mouth and to give the tooth some more strength.