Your teeth have a core of blood vessels and nerves at their centre called the pulp. From this pulp there are canals which go into the root. These are called the root canals. The number of root canals a tooth has varies. Your front teeth often have just one root canal, whereas your back teeth can have up to four canals.
If your tooth's pulp becomes damaged, the blood vessels may die. This results in a 'dead' tooth, which is more likely to get infected because it's no longer protected by your immune system (the system that defends your body against bacteria and other harmful substances). There are a number of ways that your tooth's pulp can be damaged. These include:
All of these conditions can lead to bacteria getting trapped in your teeth. There is then the possibility that your tooth pulp will become inflamed or infected, causing blood vessels and nerves to die.
Without treatment, a collection of pus (an abscess) can form at the root tip. This can lead to pain and swelling and may cause damage to the bone around your tooth.
The aim of root canal treatment is to get rid of the damaged pulp and the bacteria that are causing the infection. It involves removing inflamed or dead nerves and blood vessels from the centre of your tooth. This is done by drilling a hole through the top of your tooth to the root canal and removing the dead tissue. The empty root canal system is then cleaned, filled and a permanent seal is put over the top of your tooth.
The procedure may be carried out over one or two visits.
Our dentists will take an X-ray of your tooth to see whether you need root canal treatment. This can help to show how far any decay has spread, if there is an abscess and how many root canals your tooth has.
If you have a dead tooth or one with a severely damaged pulp, root canal treatment may be the only way to repair it.
Your dentist will give you an injection of local anaesthetic. This completely blocks pain from the area and you will stay awake during the procedure. You may not need to have an anaesthetic if your tooth is dead. Your dentist will discuss this with you.
Your dentist will separate the affected tooth from the rest of your mouth using a thin sheet of rubber called a dam. This will keep your tooth dry and protect your airways. It also allows your root canal system to be cleaned and stops it becoming contaminated again, which can cause infection later.
Your dentist will make a hole in the top of your tooth, and remove the dead or diseased pulp through this hole. He or she will then clean the empty pulp cavity and may put in some medication to help get rid of bacteria.
This may be all your dentist does at your first visit - if so, he or she will put a temporary filling on your tooth to keep it sealed until you go back for further treatment. However, your dentist may decide to fill the cavity immediately if the infection has been totally removed.
If you had a temporary filling, when you go back to your dentist he or she will remove this and then fill the root canal with a suitable material. This is likely to be a putty-like substance called gutta percha. A permanent filling or crown is then placed over the top of your tooth to protect your filled root canal and your tooth. Your dentist may recommend a crown made from gold or porcelain. If your dentist thinks it's necessary, he or she may also place a metal or plastic rod inside the canal to help support the crown.
No. A local anaesthetic is used and it should feel no different to having an ordinary filling done.
You will be able to go home when you feel ready. After a local anaesthetic it may take several hours before the feeling comes back into your mouth. Take special care not to bump or knock your mouth or bite your tongue, particularly when you're speaking, drinking or eating.
You may need pain relief to help with any discomfort as the anaesthetic wears off. If you need pain relief, you can take over-the-counter painkillers such as paracetamol or ibuprofen. Always read the patient information leaflet that comes with your medicine and ask your pharmacist for advice if you have any questions.
You may find that the tooth that was treated changes colour slightly. If your tooth does change colour, you may be able to have treatment to correct it.
After your treatment, it's important that you take care of your repaired tooth as you would any other. Brush your teeth at least twice a day and visit your dentist and hygienist regularly.
Your root canal treatment should be assessed by your dentist after six months and reassessed at regular intervals after this.
Root canal treatment is commonly performed and safe.
It's unlikely that you will have any further problems after root canal treatment. If your tooth does become infected again, your dentist can repeat the procedure. However, repeated treatments are generally not as successful.
Very occasionally after root canal treatment, you will still have inflammation at the tip of your tooth. You may need to have a surgical procedure called an apisectomy to remove the root tip.
The exact risks are specific to you and differ for every person. Ask your dentist to explain how these risks apply to you.
In the past, a root filled tooth would often darken after treatment. However, with modern techniques this does not usually happen. If there is any discolouration, there are several treatments available to restore the natural appearance.
Root canal treatment is usually very successful. However, if the infection comes back the treatment can be repeated.
The alternative is to have the tooth out. Once the pulp is destroyed, it can't heal and it is not recommended to leave an infected tooth in the mouth. Although some people would prefer an extraction, it is usually best to keep as many natural teeth as possible.
Yes. However, the root canal treated tooth may need a crown to provide extra support and strength to the tooth.
Root-treated teeth should be treated just the same as any other tooth. Remember to clean your teeth at least twice a day, preferably with a fluoride toothpaste. Cut down on sugary snacks, and keep them only to mealtimes if possible. See your dentist and hygienists for regular check-ups and hygiene treatment.
