Root Canal Treatment

Root canal treatment is also known as a root filling or an RCT.

If a tooth is infected or badly damaged by trauma, a root canal treatment is necessary unless the patient decides to have the tooth out.

Root canal treatment is removing the tissue from the inside of the tooth and replacing it with a filling.

When do I need a root canal treatment?

If decay is left untreated, it reaches the pulp inside the tooth and damages the pulp tissue (that consists of nerves, blood vessels, lymphatic vessels and other tissues), causing an infection.

The infection can develop with or without pain. If not treated, an abscess can form around the root of the tooth in the jawbone causing pain and swelling.

The abscess can be treated temporarily with antibiotics. But to get rid of the abscess and save the tooth, a root canal treatment is necessary.

A tooth does not have to be infected to have a root canal treatment.

For example, if a tooth is badly broken and not sufficient to put a crown on, a root filling is performed. A post or a screw is placed inside the tooth to form the foundation that is used to put the crown on. This extensive treatment is referred to as a post and crown.

Are root canal treatments always successful?

There is always a risk of the root canal treatment failing and the abscess returning. An abscess can return months or years after a root canal treatment is completed.

Some reasons for failure are:

  1. Extremely resistant infectious bacteria.
  2. Complicated root canal system in the tooth.
  3. The dentist's skills.
  4. The choice of tools and materials used to perform the root canal treatment.

Your dentist may decide to perform the root canal treatment or to refer you to a specialist, endodontist.

Do I need to have a crown after root canal treatment?

In order to get access to the nerve room inside the tooth during root canal treatment, your dentist has to remove a considerable amount of tooth substance. This can weaken the tooth and make it more vulnerable to pressure if the tooth is rebuilt with conventional filling materials. Therefore your dentist may recommend a crown to be put on top of the rootfilled tooth after the root canal treatment has been completed to protect the tooth from cracking.

Why did my tooth discolour after root canal treatment?

Some rootfilling materials can discolour teeth. This matters more when the treated teeth are in the front. This may happen within months or years after the root canal treatment. To get rid of the discolouration, the tooth is whitened from the inside.

In certain cases where the tooth is heavily discoloured, the internal whitening (internal bleaching of teeth) needs to be repeated. If the tooth does not respond to internal whitening, a crown may be the choice of treatment.

Discoloured Tooth After Internal Whitening

 

 Questions and Answers

 - Why did I get an abscess in the jaw after a root filling?

 - Some bacteria species can be very aggressive and not easy to get rid of. Dentists can decide to clean the canal and fill it with a potent medication to make sure all the bacteria is killed before filling the canals. Even this does not work all the time and an infection might return. Getting an abscess straight after a root filling could be due to missed canals. Some canals can be difficult to find because of size or different anatomy. 

 - Why do I have sensitivity after a root filling?

Sensitivity after root fillings is relatively common. If the tissue around the root in the bone is injured by the thin files used during the root canal treatment you might experience some sensitivity till the tissue is healed. It can also be due to excessive filling material leaving the apex of the canal. This can also subside with time. If the sensitivity persists or gets worse with time consult your dentist for best advice.

- Is an abscess the same as a tooth infection?

If bacteria start leaving the root of an infected tooth and spread into the surrounding tissue, an abscess is a result.

- Do dentists remove a crown on a tooth before performing a root canal?

Sometimes a dentist can perform a root canal treatment through the crown. If the canal is difficult to find, the dentist might decide to remove the crown completely to get better access and hence a better root filling.

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