Root fillings, or root canal treatments, are needed when a large cavity in a tooth reaches the nerve chamber, or in some cases when a tooth breaks. The decayed nerve needs to be removed and the root space filled. A root filling will often allow you to keep a tooth which would otherwise have to be extracted and replaced with a bridge, denture or implant.
Within every tooth is a nerve chamber and a blood supply in the root canal. In a healthy tooth, these nerves will be alive. Front teeth will normally have one root holding them in the jaw bone, but back teeth can have two, three or four.
If a large cavity in a tooth reaches the nerve chamber, or if a tooth breaks, bacteria can cause the nerves to die. The root canals can become infected and an abscess may form beneath the root(s) of the tooth, in the jawbone. Pain (occasionally severe) may occur at any time during this process, and the infection can spread.
Treatment is usually carried out over one or two visits. The purpose of the treatment is to remove the bacteria or dying tissue from inside the tooth and to clean and disinfect the root canals. This is achieved by making a small hole through the tooth into the nerve chamber, locating and measuring the root canals, then cleaning and widening them using fine instruments. Local anaesthetic is used throughout the procedure to avoid any discomfort.
To aid the instrumentation of these intricate channels to the tooth, magnification may be used and, if possible, the tooth will usually be isolated to keep the area dry and clear.
Once clean, the canals are filled to seal them off from re-infection. In most cases, infections will start to heal at this point.
Most patients only experience mild discomfort following treatment, but it is common to experience none at all.
Root Canal treatments fall within an area of dentistry known as Endodontics.
What is a root canal?
The root canal is the area inside the centre of the tooth that houses the nerve and blood supply. This becomes a larger space towards the top of the tooth known as the ‘pulp’. Some teeth have only one root canal whilst larger teeth towards the back of the mouth can have up to four.
When would I need root canal treatment?
Root canal (or endodontic) treatment is needed when the pulp becomes affected by decay or trauma. In these situations, it can become infected leading to inflammation and pain. In more severe cases the tooth can become ‘non-vital’, which means that it loses its blood supply altogether. Once the pulp becomes infected, the bacteria can spread through the root canal system and lead to the development of an abscess.
What does the treatment involve?
Root canal treatment aims to remove all infection and debris from the infected tooth. It is a skilled and time-consuming procedure that usually requires two or more visits. This treatment is complex because the dentist is working inside the tooth to very small tolerances. Root canal treatment consists of the following stages:
- Removing the remains of the infected pulp and, if an abscess is present, allowing it to drain
- Cleaning and shaping of the root canals ready for filling
- Putting in a temporary filling
- Checking the tooth at a later visit, to ensure that the infection is cleared and if so, filling the canal/s permanently
- Restoring the rest of the tooth
Do root treatments always work?
Root canal treatments are usually successful and the infection is eradicated. If infection recurs, the treatment can be repeated. In rare instances it is possible to lose a tooth.
Are root canal treatments comfortable?
As with all modern dental techniques, local anaesthetics make root canal treatments comfortable. Your experience of having this kind of treatment should be little different to that of having a normal filling. Sometimes the treated tooth can be tender to pressure, such as biting, for a day or two after the treatment. This usually subsides quite quickly.
Will root canal treatment change the colour of my tooth?
A tooth that has had root treatment can darken in colour over time. This used to happen more frequently than it does today since modern techniques have improved the process. If there is any discolouration, there are several treatments that can be undertaken to give the tooth a more natural appearance. For example, it is possible to lighten root treated teeth, or alternatively your dentist may suggest that the tooth should be crowned or veneered.
Will my tooth be weakened by the treatment?
It is generally thought that root treated teeth are not as strong as normal ones. Whether this will necessitate further treatment to strengthen the tooth will depend upon its position in the mouth and the amount of damage or decay that led to the root canal treatment in the first place. Your dentist will advise whether it is necessary to have a crown or other restoration fitted for extra strength.
Is there an alternative to root canal treatment?
Once the tooth has become non-vital and an abscess has developed, the only alternative to root canal treatment would be to have the tooth extracted. This is because pulp is unable to heal and it is inadvisable to leave an infected tooth in the mouth.
How do I care for my teeth after root canal treatment?
There are no special precautions after root canal treatment. You can eat quite normally and brush or floss your teeth as usual. As always, you should avoid holding hard objects such as pins or nails between the teeth.
Regular check-ups with your dentist and hygienist are essential to maintain the health of your teeth and gums.