Root canal treatment (also known as endodontic treatment) is all about saving your tooth. Its aim is to:
Remove the infected, inflamed or dead dental pulp tissues (nerve and blood supply in the tooth)
Clean and disinfect the root canal space
Seal this space to prevent further spread of bacteria to or from this space
There are times that the nerve in the tooth becomes sensitive or infected and needs to be treated. If the tooth has enough sound structure to be restored, this is our treatment of choice, as no artificial tooth will feel like your own tooth.
Each tooth has an internal space known as the dental pulp, which provides blood and nerve supply to the tooth. Presented below is a 3D model of an upper molar tooth. Using the mouse or touchscreen, you can turn the model to see this space in the middle of the tooth.
3D model – Use mouse or fingers to rotate
At times, this space can become inflamed or infected.
The main reasons for the pulp to become infected or inflamed are:
Deep cracks in the tooth
Trauma to the tooth. (e.g. from an accident)
Some of the signs of an infected/inflamed pulp tissue are:
Severe pain on pressure
Extreme sensitivity to hot and cold
Most of the time, these are the signs of a dental pulp disease, but that is not always the case and thorough examination is critical to make a correct diagnosis. Sometimes the diagnosis of dental pulp disease is simple and straightforward. However, at times, it can be very complicated and specific attention to detail is needed, that is when effective treatment relies heavily on the knowledge and experience of the clinician.
When it is confirmed that the pulp space is infected or inflamed and the tooth has an acceptable long-term survival rate, the only way to save the tooth is to perform a root canal treatment.
What is root canal procedure?
The aim of root canal treatment is to remove the infected/inflamed dental pulp tissue and to clean the pulp space and seal it. Ultimately, this will lead to a pain-free tooth. To achieve this, a sequence of procedures will be followed:
Establishing access and identifying the pulp space
This step is very important. Extreme care must be taken to ensure a minimal amount of tooth structure is removed to establish access to the pulp. This generally means more tooth structure will be left in order to restore the tooth.
At Trusted Dental, we utilize the latest technology, including a dental microscope, to make sure we can identify the pulp space and the root canals with extreme precision and minimal access preparation. Our aim is to have a restorable tooth that will last you many years, and no matter how good a root canal treatment is, if the remaining tooth structure is too weak the whole tooth is compromised.
Cleaning the pulp space
At this stage we will utilise different mechanical and chemical techniques to clean this space as much as possible. Again, our aim is to retain as much tooth structure as possible while achieving a clean dental pulp space.
Sealing the dental pulp space
Once the dental pulp space is cleaned, we will seal this space (canals obturation) and the tooth will be ready for the final restoration.
Frequently asked questions about root canal treatment:
Is root canal treatment painful?
We will always ensure that you are fully numb for this procedure and can always increase the level of numbness through the procedure in order for you to have a comfortable experience.
How long will it take to perform a root canal treatment?
The treatment time depends on the number of canals and complexity of the tooth receiving this treatment and generally takes about one to two hours.
What is the success rate of a root canal treatment?
Based on many studies if root canal treatment is performed by a skilled clinician the success rate is about 90-95%.
How many visits are required to perform the root canal treatment?
At Trusted Dental we perform most of our root canal treatments in a single visit however based on the complexity of the treatment or the state of each individual tooth multiple visits may be required.
Will I have pain after the endodontic treatment?
Some discomfort can be present following a root canal treatment which normally goes away within a few days. This can vary depending on the immune system of each person and the amount of infection in the tooth. If discomfort is present it can normally be controlled using over-the-counter painkillers. Your dentist will explain this to you in detail.
How much does root canal treatment cost?
The cost of the treatment depends on the number of canals treated and the complexity of the treatment and generally ranges from $1098 for a single canal tooth to $1830 for a tooth with three canals.
At Trusted Dental we will provide you with an accurate treatment plan prior to start of the root canal treatment. After the treatment the tooth needs to be restored and your dentist will also discuss the cost of restoration and options available prior to start of your treatment.
What is a rubber dam and why should it be applied to the tooth during the treatment?
The success of a root canal treatment heavily relies on keeping the tooth as isolated as possible so that no new bacteria (i.e. from saliva) enters the canal.
A rubber dam is a piece of rubber sheet that significantly helps with isolating the tooth from oral environment and saliva and at the same time protects you.
What is a cone beam CT scan (CBCT) and how is it useful for root canal treatment?
A Cone beam CT scan (CBCT) is a form of x-ray that is done in 3D. Unlike old x-rays that only provide a two-dimensional image the CBCT scan allows your dentist to see the tooth from every dimension which is extremely helpful to see the anatomy of the root and the number of root canals present in each tooth. This is specially important in multi canal teeth like molars which can often have complex anatomy. Below you can see a 3D reconstructed model and cross section of the teeth on a CBCT scan showing the root canals.
AT trusted dental we are privileged to have one of the most advanced and highly accurate CBCT machines on the Gold Coast which not only provides scans with high quality but also significantly reduces the dose of exposure by the ability to confine the scan to only a small area of teeth which are required to be assessed for root canal treatment.
What is the optimum restoration for the tooth which has received a root canal treatment?
This depends on the amount of structure lost and the status of the tooth receiving the treatment. A dental crownis a very good option to restore teeth which have lost most of their structure however in many instances a simple direct resin (tooth coloured) restoration will be sufficient.
What is a root canal retreatment? (Endodontic retreatment)
An endodontic retreatment is performed when a tooth with previous endodontic treatment becomes symptomatic or shows signs of root canal failure and infection. The main reasons that a tooth may not respond to previous root canal treatment are:
Inadequate cleaning of the canals
Inadequate restoration or failed restoration (i.e. cracked filling) which can lead to leakage of saliva and bacteria to the sealed canals leading to failure
Missed canals in the tooth that did not receive treatment
New decay starting that can lead to leakage of bacteria to the canals system
Generally, the treatment is similar to a normal root canal treatment with some modifications and unique approaches based on each individual tooth situation and happens through two or more visits.
What is a dental microscope and how does it help during endodontic treatment?
A dental microscope is a device that helps magnify the tooth and will significantly help the clinician to see fine details and small areas in the root canal system which ensures nothing is missed.
One of the main success factors of the root canal treatment is the ability to see all the anatomy and inspect the root canal system inside the tooth which at times can be a very complex structure.
While normal dental loupes (magnifying glasses worn by most of the dentists) provide some magnification typically about 2.5 – 6 times, a dental microscope takes this to the next level providing magnification levels of more than 30 times.
The role of microscope is even more significant in endodontic treatment of more challenging teeth such as multi rooted molars and canals with blockage or diagnosis of cracks.
At Trusted Dental we utilise a dental microscope for our root canal treatments to make sure you receive the highest standard of treatment.
At Trusted Dental, we are experts in root canal treatments (including retreatment of previously root canal treated teeth). Our principal dentist Dr Omid Salar has performed more than 3000 root canal treatments and has a good understanding of the dental pulp tissues. He will take the time and necessary measures to make sure the diagnosis is correct. More importantly, our focus is on the long-term survival of the tooth.
We will always have the big picture in mind rather than focusing on the root canal treatment on its own. We will explain the tooth situation in detail, so that you are an active part of the decision making. For example, sometimes a painful tooth can easily be treated by root canal treatment, but the extension of the cracks is not favourable. The long-term survival of the tooth may be questionable, and the endodontic treatment is possibly not the best option for this tooth. It all comes down to establishing the facts and making an informed decision.
There is so much more to root canals, and the best way to gain an understanding of your unique situation is to have a complimentary consultation at Trusted Dental.
If you want to know more about root canals or get a second opinion, book a complimentary root canal consultation with Dr Omid.