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Root Canal Treatment

Know more about the Root Canal Treatment procedure

What is Root Canal?

Root canal treatment is done to treat the infection or inflammation of the pulp or the Root canal space. It is best summarized as the disinfection and cleaning of the root canal space and filling up the canals to prevent re-infection. The procedure itself can be done in one visit or over several visits. The choice of the number of visits depends on the status of the infection. Several x-rays are required before, during, and after the procedure to ensure that the root canal treatment is performed in accordance with standards.

Root Canal Treatment Procedure

The root canal treatment starts off with adequate anesthesia. For a painful tooth, usually, the achievement of anesthesia can be more challenging. Experienced endodontists or root canal specialists will explain what is needed for proper anesthesia.

Afterwards, a rubber cloth will be placed so that the tooth can be isolated from the tongue, cheeks, lips and saliva.

This would follow up with an access opening into the root canal space of the tooth by using rotary burs. After there is access to the root canals, there would be cleaning and shaping of the canals using small files. Copious irrigation with a disinfecting solution would be done concurrently. After the canals were adequately cleaned and shaped, the canals are filled up with a filling material that is usually gutta-percha (a rubbery material) and biocompatible cement.

The tooth will then need a final restoration. It serves as a final seal over the tooth to prevent root canals from infection/reinfection. For posterior teeth, a full-coverage restoration such as a crown will be required to prevent the tooth from fracturing.

root canal treatment procedureInsertion of the files to confirm that the canals were cleaned and shaped along the whole length of the canals

radiograph image of a tooth with root canal fillingRadiograph of root canals with root canal fillings

Signs and symptoms that indicate the need for root canal treatment

There would be preceding signs before root canal infection or toothache. These can be large decay, fracture or severe gum disease.

Another indicator would be the presence of pain. As mentioned earlier, toothaches are a result of pulpitis (inflammation of the pulp). In the mild form of pulpitis, the tooth may be sensitive to cold temperature (eg. cold drinks). There is a substantial chance that this may heal and the pain will subside with appropriate and timely treatment.

In a more severe form of pulpitis, the tooth can be painful to thermal changes and the pain can linger up to several minutes. There can be a spontaneous or sudden pain in the evening which can cause disruption of sleep.

Obvious signs will emerge once there is an infection of the root canal space. These can involve swelling and sometimes pus discharge from the surrounding gums.

However, not all signs and symptoms listed here will be observed in patients themselves. A dentist/dental surgeon or an endodontist (root canal treatment specialist) will be the best person to make the best judgement and diagnose your condition.

Benefits of root canal treatment

Having the root canal treatment procedure can help patients save their teeth from extraction. Patients can preserve the well-being of their teeth without having to resort to extraction which can be a painful and time-consuming process.

Root canal treatments get rid of the pain caused by inflammation in the pulp of the tooth. By removing any abscess, the treatment also helps to reduce the risk of infection in your mouth which can result in unwarranted pain and bleeding.

Risks and Complications of Root Canal Treatment

The root canal treatment procedure is commonly practised and generally safe. However, like any delicate procedure, there are risks involved. Most of the possible complications are limited to the well-being of the tooth or its supporting structures. 

Some of the common complications are listed below.

  1. Sometimes after completion of root canal treatment, though there might be no signs of infection or inflammation, the patient may feel that the tooth may not be as it used to be (eg. Feels sensitive when biting or touched).
  2. There are aberrations of the tooth anatomy that result in a higher chance of procedural complications. These complications include:
    • Calcification of the root canal can render the root canal space undetectable or too small for ease of cleaning. Without proper cleaning of the root canal space, persistent infection may occur.
    • Curved canals can cause a higher chance of instrument fracture which may render further cleaning of the canals impossible.
    • Premature tooth or tooth with limited tooth structure may fracture during treatment.

When such complications occur, the success rate may be affected and additional follow-up treatment may be required.

Curved and long canals shown in the radiograph can cause procedural errors

Calcification causing narrow canals can increase the chance of procedure errors

Overall, complications to a patient’s general health due to root canal treatment are rare. If these complications do arise, it is usually due to the patient’s pre-existing medical condition. If he/she is allergic to certain medications or materials or has any health condition that requires special care, the dentist or endodontist should be informed before the start of the treatment.

Courtesy from Society of Endodontists, Singapore website for the radiographs