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Root Canal Therapy

Every tooth has its own nerve. When the nerve of a tooth becomes inflamed or infected signs can include: no pain, pain of long duration, use of painkillers, signs of infection, temperature sensitive, swelling or temperature. Root canal therapy (RCT) can save the tooth, by removing the offending nerve and cleaning the canals, yet leaving most of the good tooth behind. It is always better to save a tooth where there is a favourable outcome as missing teeth can cause problems.

Before                                                                                After

Benefits:

  • Stops pain
  • Prevents or cures infection
  • Saves the tooth
  • Retains tooth for normal function
  • Avoids consequences of missing teeth (see here)

What to expect:

How does a nerve get inflamed/infected in the root canal?

Deep cavities or cracks can allow germs to get into the pulp chamber and damage it. These germs cause infection, and the pulp fights (painful inflammation) then dies (no pain). The dead pulp makes pus from the infection eventually builds up at the root tip and makes a hole in the bone. This is called a tooth abscess and can swell locally or find an escape route to the surface of the gum, leaking out through a gum-boil that looks like a spot on the gum.

A blow to a tooth may also cause the pulp to die and then become infected later. An infected tooth will never heal on its own, and as it gets worse, it will continue to be a source of infection that weakens your body’s immune system. This can affect your entire body and even make you feel run down. This damage to the bone and the swelling inside the bone can also be excruciatingly painful, and possibly life-threatening if not treated. Years ago, an infected tooth would have to be extracted, but today, we can save the majority of teeth (6 out of 7) with root canal therapy.

What you should know:

  • The alternative to root canal therapy (RCT) is having the tooth removed and then replaced. Different options can be found here to replace missing teeth.
  • Sometimes, despite best efforts root canal therapy is unsuccessful. Success rates are about 68-98%, so about 1 in 7 fail and the tooth is lost if any re-treatment hasn’t worked either. Failure is often due to resistant infection, complex anatomy, canal blockages or narrowing, that cannot be overcome.
  • There is no guarantee how long the tooth will last. Average is 1-15 years.
  • Discomfort is common for a few days after treatment with a 7% chance of pain after treatment.
  • After RCT the tooth is considerably weaker and a final restoration will be required to provide additional strength to the tooth and ensure a tight seal is obtained. This is crucial for success.
  • If there is very little tooth tissue left a post, core and crown may be needed to rebuild the tooth into its original shape.

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