Root canal treatment unfortunately has such a bad reputation. In most cases root canal treatment causes very little pain. The procedure is carried out under local anaesthetic and the area may be a little tender for a few days. With today’s technology, most patients come away impressed with how fast and easy the procedure is. And most importantly, how pain free they are, both during and afterwards.
It is very likely that the dread around having a root canal is more related to the pain in the tooth that caused it. In most cases, the symptoms that point to a root canal is a very painful tooth ache.
If you have a very infected or abscessed tooth, when you bite down on it, it will hurt like crazy. So even thinking of a dentist touching the tooth, much less drilling on it, would be the last thing a patient would want. The reality is that infections are usually handled with antibiotics before the root canal and anesthetic virtually ensures a pain-free procedure.
Despite their bad reputations, our patients are often so relieved to have had the root canal therapy, because their tooth pain went away. Root canal treatment is highly successful; the procedure has more than a 95% success rate. Many teeth fixed with a root canal can last a lifetime.
What exactly is a root canal?
Your teeth have ‘roots’ that anchor them into your jawbone. Inside each of your teeth there is a mixture of blood vessels and nerves called pulp. Pulp sits inside a space called the pulp chamber and this extends down into the roots of the tooth. The pulp chamber within the root is called the root canal.
Why might I need root canal treatment?
If your tooth is damaged, bacteria can get inside it. This causes irritation, pain and swelling. If the pulp inside the tooth becomes infected, this can spread into the pulp inside the root canal. The aim of root canal treatment is to prevent your tooth from being taken out by removing the damaged pulp and treating the infection.
You may need root canal treatment for a number of reasons, including:
- Severe tooth decay
- Repeated dental treatment on the tooth
- A cracked tooth
- A broken crown
- Cracked or loose fillings
- Gum disease
- An injury, such as a blow to your mouth
If an infection isn’t treated, it can spread further and cause an abscess, which is a collection of pus. This can be painful, tender and can cause swelling around your tooth and jaw.
Sometimes your tooth may look darker in colour than your other teeth, which means that the nerve inside your tooth is dead or dying. Without treatment, the infection may spread further into your jawbone and you may need to have your tooth removed.
Preparing for root canal treatment
Your dentist will examine you and ask about your symptoms, including any pain you’re having. They may also ask you about your medical history and any previous treatment you’ve had on your teeth. Your dentist will take an X-ray of your tooth. This can help to show which tooth is causing your pain and needs treatment, and how far any infection has spread. These examinations are necessary for your dentist to make sure that the tooth is not too badly damaged for root canal treatment.
Although some root canal treatments can be completed within one appointment, most are done over two or more sessions with your dentist. Root canal treatment is usually done under local anaesthetic. This completely blocks pain from your tooth and jaw area, and you will stay awake during the procedure.
What are the alternatives to root canal treatment?
Sometimes, damaged teeth can’t be repaired with root canal treatment. This is usually if your tooth is badly damaged or if you have severe gum disease which prevents your tooth from healing or being well supported after treatment. If this happens, your dentist may suggest you have the tooth removed (extracted).
What happens during root canal treatment?
Once the area is numb, your dentist will place a thin rubber sheet inside your mouth. This is called a dental dam and covers everything except the tooth being worked on. It helps to keep the area around the tooth clean and stop the spread of any infection.
Using a drill, your dentist will make a hole in the top of your tooth and remove the pulp. They will clean out the empty hole using small instruments and a liquid to irrigate and disinfect the inside of the tooth. The instruments help to make the canals a more regular shape to enable the tooth to be filled and cleaned more precisely. The irrigating liquid makes sure that all infected material is flushed out.
Once the tooth is clean, your dentist will fill and seal it. Unless the dentist is sure that all infection has been removed, they will put in a temporary filling. You then have a second appointment to have the tooth permanently filled.
If your tooth is badly worn or is at risk of further damage, your dentist may suggest having a crown fitted. This is an artificial cap that fits over your tooth. You’re more likely to need a crown if you’re having one of your back teeth treated, because these are used for chewing.
Having root canal treatment can be uncomfortable because you have to sit still with your mouth open for longer than you’re used to. Your dentist will make you as comfortable as possible before the procedure starts.
What to expect afterwards
After a local anaesthetic, it may take several hours before the feeling comes back into your jaw and face. Take special care not to bump or knock the area. You may need pain relief to help with any discomfort after the anaesthetic wears off and for the next couple of days. You can take over-the-counter painkillers such as paracetamol or ibuprofen. Always read the patient information leaflet that comes with your medicine and if you have any questions, ask your pharmacist for advice.
Recovering from root canal treatment
When you next need to see your dentist in Bulleen will depend on the reasons for your treatment and how the procedure went. Your dentist may ask you to have further X-rays and check-ups to make sure that the tooth is secure and you’re healing well.
Some people need to have further root canal treatment if the tooth cracks or more decay develops.
After your treatment, it’s important to take care of your repaired tooth. These tips will help to keep your mouth, teeth and gums healthy:
- Brush your teeth twice a day using a fluoride toothpaste
- Rinse your mouth with a mouthwash, if your dentist recommends it
- Clean in between your teeth every day, either using floss or inter-dental brushes
- Don’t smoke
- Try to limit sugary foods and drinks and only have them at mealtimes
- See your dentist regularly for check-ups
Side-effects of root canal treatment
You may have some slight tenderness around the tooth that has been treated, but usually this lasts for only a short time. If you have severe pain or any pain or discomfort that gets worse, see your dentist. The area around your tooth may also be swollen and bruised. This should get better within two weeks of your treatment.
Complications of root canal treatment
Complications are when problems occur during or after treatment. All medical and dental procedures come with some risk. But how these risks apply to you will be different from how they apply to others. Be sure to ask for more information if you have any concerns.
Most root canal treatment is successful, but sometimes further problems can occur. Possible complications include:
- Damage to the root canal or the tissue surrounding the tooth
- Infection
- Damage to the nerves around the tooth
If your root canal treatment doesn’t work, you may be advised to have more treatment. This is called re-treatment. You might also need re-treatment if your symptoms return years after you’ve had root canal.
If you have any oral health concerns and you would like to speak with one of our friendly dentists, please call our Bulleen clinic on 03 9852 2234.