Root Canal Therapy
There are several scenarios that will indicate the need for the Root Canal Therapy (RCT). The most widely known is where bacteria reaches the nerve/pulp chambers of the tooth, an infection can occur, and abscess may form. Bacteria can reach the pulp through a cavity in your tooth (caused by decay) under old fillings or crown and enter via the gums around your tooth. An abscess can be very painful as it destroys the nerve in the tooth and the surrounding bone support on other occasions it may form a cyst/sinus without you or your dentist knowing, but it can be detected with an X-ray as the infection alters the density of the tissue (early tooth infection may not show on an x-ray picture) As subsequent nerve damage may also be caused by cracks in the teeth, large fillings placed close to the nerve and/or a heavy bite.
Principles of therapy
Removal – Reduce – Restore – Review
There are 4 stages to RCT treatment.
An x-ray or CT Scan of the specific tooth will be taken and then opening will be made to the pulp and nerve chamber to drain and clean out the infection/affected nerve, followed by cleaning the tiny canals in each root.
These canals can vary tremendously between patients and teeth. In some cases, it is impossible to clean out the canals successfully. The canals are then dressed in medicine and the opening will have a temporary filling placed until your next visit. This will start to heal the chamber/s that have cleaned.
Please be advised that the temporary filing may crumble away during the course of the week, as the material is soft and temporary.
On this appointment, we will remove the old dressings and clean the canals again, then reapply new dressing to the canals and temporary fill the tooth for the second time.
At this appointment, the old dressings will be removed and new permeant rubber points seal with medication will be replaced into the canals to fill and dress them, an x-ray will be taken, and a permanent restoration is placed to seal the access into the nerve chamber.
It is recommended to have a crown placed around a root-filled tooth once the root canal therapy is completed. As the success rate of the average root filling is about 75%. Our dentist will wait for up to 3 months before taking another x-ray prior to placing a new crown around your tooth to make it structurally strong.
In some cases, root canal therapy may not work, and the abscess can then be surgically removed in a process called an apicoectomy, or the tooth itself might need to be removed. This tooth can then be replaced with a denture, bridge or implant.