ENDODONTICS

Endodontics commonly involves the procedure known as root canal treatment. Root canal treatment is the removal of the tooth’s nerves in the event they become inflamed or infected, which can happen due to deep decay or an extensive restoration. There are numerous reasons to need Root canal treatment such as a cracked or fractured tooth, excessive wear of enamel or dentine leading to exposure of the nerves, extensive restoration that involves the pulp or as a result of severe gum disease.

A tooth is made up of hard, white enamel and a thicker dentine layer, both layers protect the innermost soft tissues of the tooth called the pulp. The dental pulp contains blood vessels and nerves that extend from the crown to the tips of the root or roots. Root canal treatment is the removal of the pulp tissues from the tooth due to infection or inflammation.

Signs of pulp damage may include pain, prolonged sensitivity to heat or cold, discoloration of the tooth, swelling, tenderness of the overlying gums or a bad taste in the mouth. However, in some instances there are no symptoms at all. If pulp inflammation or infection is left untreated, it can cause pain, swelling and loss of the supporting bone.

WHAT ARE THE ADVANTAGES OF TREATMENT?

Root canal treatment saves teeth that would otherwise would need to be extracted. After root canal treatment, the tooth is pulp-less, i.e. it has no vital tissues within.

However, there are vital tissues surrounding the root (e.g. the gum, periodontal membrane and supporting bone) making root canal treatment imperative for dental health. A root canal treated tooth can function normally and can be maintained with routine dental care and oral hygiene measures.

HOW IS TREATMENT CARRIED OUT?

Removal of the infected or inflamed pulp is the first step in saving the tooth. Under local anaesthetic, an opening is made in the crown of the tooth to get access to the infected or inflamed pulp within.

Using small, specially designed hand or rotary files, the root canals are cleaned and shaped to a form that can be sealed. Debris within the canals is removed by flushing with an anti-bacterial solution.

The canals are finally filled with a permanent sealant material. The tooth should be restored to full shape and function by either a permanent filling or a crown, depending on how much of the tooth is left. This should be done as soon as possible as there could be a risk of tooth fracture due to biting forces.

All root canal treatment procedures are performed by isolating the tooth with a rubber dam to provide a clean and saliva-free environment. Root canal treatment may be done in single or multiple visits depending on the complexity of the tooth.

Often, X-rays are taken to determine the length of the root and to monitor the various treatment stages.

IS ROOT CANAL TREATMENT PAINFUL?

Root canal treatment procedures are relatively comfortable and often painless as the tooth is anaesthetised during treatment. After treatment, the tooth may be sensitive or tender for a few days due to inflammation of the surrounding tissues. This discomfort can be relieved by taking painkillers available over the counter at the pharmacy. However, if the pain persists and is severe, or a swelling occurs, you should contact your dentist.

AFTERCARE FOR YOUR ROOT-TREATED TOOTH

As far as possible, avoid chewing or biting on the tooth being treated until you have it permanently restored with either a filling or a crown. Excessive pressure at this stage may crack or fracture the tooth. Therefore, it is very important to restore the tooth properly as soon as possible. Most endodontically treated teeth last as long as natural teeth following permanent restoration.

Practise good oral hygiene, including brushing and flossing at all times, as root-filled teeth are as prone to decay as natural teeth. It is also important to have your treated tooth reviewed regularly by your dentist.

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