Insightful and informative dentist blog, covering a wide range of dental topics alongside new treatment & clinic announcements.
If the dental pulp at the centre of a tooth becomes infected or damaged, you will probably need a root canal treatment in order to relieve the pain, get rid of the infection and save the tooth.
What is a root canal?
The tooth is made up of three parts. The white enamel which is the hard substance that covers the tooth and protects it. The bulk of the tooth is made of dentine, which is a similar composition to bone and makes up the structure of the tooth. The root of the tooth is the section that is secured inside the gum, and there are long cavities inside the roots that house the nerves and blood vessels which are protected and nourished by dental pulp. Root canal treatments are needed when the pulp becomes infected.
What is endodontics?
You may have heard of the word ‘endodontics’ which is concerned with diseases of tooth pulp. A root canal specialist is called an endodontist.
What causes root canal problems?
Problems occur for the root canal when the pulp is infected with bacteria, usually as the result of an untreated cavity, or as the result of the tooth becoming damaged through trauma to the tooth.
How do you know if you need a root canal?
There are many signs that you may need root canal treatment:
- Tooth pain – any pulp infection is likely to cause constant throbbing pain deep within the tooth, and will become more painful the longer you leave it. The pain can be more pronounced if you put pressure on the tooth, such as when you’re eating. The infection may also get into your gum and cause an abscess (a pocket of pus), and the pain could spread to your jaw, face and adjacent teeth, leaving you unclear where the tooth pain is coming from.
- Sensitive teeth – if a tooth becomes very sensitive to hot and cold and the pain lasts for more than a few seconds, it may be an indication of a root canal infection.
- Gum swelling – if you have developed an abscess, it is likely that the gum area will become swollen and tender. Your jaw may also become swollen.
- Spots on the gum – another sign of an abscess is the development of a pimple or boil on your gum. If the boil drains, you may notice an unpleasant taste and smell.
- Discolouration – an infected tooth can have a darker appearance because of a poor blood supply.
- Loose tooth – the longer you leave it, the more likely it is that the infected tooth could feel looser because the pus from the infection can soften the supporting bone.
- Damaged tooth – if you have a cracked tooth, or it has been chipped or damaged in any way, it could allow bacteria to get into the pulp and infect it. Therefore, if you damage a tooth, it is always best to make an appointment with your dentist as soon as possible.
How to avoid a root canal infection
Looking after your teeth is the best way to prevent a root canal infection as well as promote good oral health. This means brushing twice daily, flossing every day, and regular check ups and treatments with the dental hygienist to remove plaque. It is important to treat any damage early, so as soon as you notice any cavities or there is any damage to your teeth, make an appointment with your dentist.
Reducing the amount of sugar in your diet will lessen the risk of getting cavities which lessens the risks of root canal infection.
If you smoke, you are at a higher risk of gum disease because of the nicotine content in cigarettes, which can lead to infections of the root canal; preventing dental problems is another good reason to quit smoking. It is also a good time to give up vaping – although less nicotine is used, the vaping ingredient propylene glycol can cause irreversible damage to your tooth enamel and gums, as can the combination of vegetable glycerin and flavouring agents which can double the formation of plaque and reduce enamel hardness.
If you play contact sports, use a mouthguard to minimise the risk of damaging your teeth which can lead to infection.
What happens in a root canal treatment?
Your dentist may want to take X-rays of your affected tooth before beginning treatment in order to assess the extent of the damage and to make sure root canal treatment is the most appropriate course of action.
You will always be given a local anaesthetic before commencing root canal therapy to numb the tooth and the surrounding soft tissue. The dentist will place a small rubber sheet around the tooth to keep it dry throughout the treatment.
The dentist will then drill through the crown of your tooth in order to expose the pulp. They will then remove the infected pulp and, if there is an abscess, they can drain that too.
Once the root canal has been drained and the infected pulp is removed, it will need cleaning and filling. Root canals can be extremely narrow which makes it difficult to fill. Your dentist will therefore need to enlarge the canals and make them into a more regular shape so they can be successfully and permanently filled. This may have to be carried out over more than one visit depending on the natural size and shape of your root canal.
If you need multiple treatments, the canal will be filled with medicine and a temporary filling put in. At your next visit, the filling and the medicine will be removed and replaced with the permanent root canal filling. The tooth will be sealed with a permanent filling or sometimes your dentist will suggest sealing it with a dental crown. A tooth with a root canal filling will be more prone to damage, so a crown will help to protect it, preventing fracturing.
How many root canals do teeth have?
The time it takes to treat a root canal depends on the tooth. Your incisors and canines usually only have one root canal, whereas your molars and premolars could have two or three roots that each contain one or two root canals. The more root canals that need to be treated, the longer the treatment time will take.
How successful is root canal treatment?
Root canal therapy has a high success rate with the majority of treatments lasting for at least 8 years. With good oral hygiene, it’s possible for natural teeth with root canals to last a lifetime. If necessary, the root canal procedure can successfully be undertaken a second time, prolonging the life of the tooth.
It is possible to experience discoloration of a tooth that has had a root canal, but it is something that can be whitened. Fortunately, with modern endodontic techniques, there is less likelihood of the tooth becoming discoloured.
What happens if you don’t do anything?
The need for a root canal is not going to go away. That’s why you always need to see your dentist if you develop a toothache. If the pulp inside your tooth becomes infected, it cannot heal itself, so the longer you leave it to seek treatment, the worse it will get.