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A root canal treatment is performed if you have an infection in the center of your tooth. Root canal treatment is not painful and can save a tooth that might otherwise have to be removed completely.
If you have any of the following symptoms, you may have an infection in the center of your tooth – the pulp:
This infection cannot be treated by antibiotics so it is recommended that you visit your dentist for an accurate diagnosis of the problem. In some cases you may need root canal treatment.
The root canal refers to the space at the center of your tooth that holds the pulp. The dental pulp consists of blood vessels and nerves and it can become infected. An infected pulp can be very painful and the infection can spread through the root canal out into the bone. Having the infected pulp tissue removed is the most effective way to stop the infection. While it can be worrying to hear that a nerve is being removed, the function of the tooth will not usually be affected by removing a nerve.
Although all dentists carry out root canal work, if your tooth provides a particular challenge then you may be referred to an endodontist. An endodontist is a dentist with specialist status after extensive training in treatment of the dental pulp.
Before the treatment you will need a dental examination, followed by an X-ray to get an idea of the severity of the infection and to see how many root canals the tooth in question has. This should allow the dentist to tell you exactly what will be involved in your case, talking you through the procedure in detail. They will do this to put you at ease and allow you to make an informed decision about going ahead with the procedure.
Firstly you may need a local anaesthetic to stop you feeling any pain in the area being worked on, but you will stay awake throughout. To prepare the tooth, your dentist will separate it from the rest of your mouth using a sheet of plastic known as a rubber dam, which stops any germs (bacteria) from re-infecting the tooth after it has been cleaned. The dentist will then drill a hole in the tooth to remove any decay and access the infected pulp, which they will remove. They will disinfect the space using a special antiseptic fluid. In order to fill the root canal system properly it will have to be widened using special files. As this process can take time, you may have to come back for one or more sessions before a permanent filling can be placed within the root canal. If so, your dentist will use a temporary filling to seal the tooth from further infection. Once the permanent root filling has been fitted, the dentist may fit you with a crown (if they consider your tooth to be at risk of becoming damaged further in future).
A lot of people are afraid of root canal treatment because they fear it will be painful. Actually the procedure is not usually more painful than having a regular tooth filling but it does take longer. You may find that your jaw muscles ache a bit from having to keep your mouth open wide during the treatment.
Shortly after the treatment, you may find your tooth feels a little bit tender to chew on but this usually only lasts for a couple of days. Any soreness can be reduced with a soft diet and, if necessary, the use of painkillers. To ensure that the root canal treatment is successful and the root is healing, regular check-ups and X-rays should be taken by your dentist over a period of several years.
If you have an infected pulp but opt not to have a root canal treatment, you risk having to have the tooth taken out and, more seriously, the infection spreading inside your mouth or across your face and neck. It could also result in several tooth extractions.
In the center of each tooth, under the outer layers of enamel and dentin, is a collection of nerves and blood vessels called the dental pulp. The vessels of the pulp enter the tooth through a hole in the root tip, or root apex, and run along the root canal to a space in the center of the tooth crown called the pulp cavity, or chamber.
Your dentist may suspect that you have a dead or dying pulp if you have a combination of any of the following symptoms:
1. Discoloration: a front tooth with a dead pulp will often turn grey or brownish, possibly over the course of several years.
2. An abscess or a small persistent small hole on the gum: it may look like a pimple.
3. Signs or symptoms of a spreading dental infection: high temperature (fever), tender or swollen lymph nodes under the lower jaw or upper neck area, or swelling of the soft tissues of the face and under the lower jaw.
4. Recent toothache: severe throbbing tooth pain of irreversible pulpitis and/or pain on biting. When the pulp has died the throbbing toothache may stop completely.
5. A history of trauma to the tooth: the dental pulp of front teeth is more likely to die from trauma while for back teeth, tooth decay or deep fillings are the more likely cause.
6. Pain which lasts more than three days after dental treatment: especially if it involved dental work close to the pulp.