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Root Canal Treatment

What is root canal treatment? (RCT)

Root canal therapy gets you out of pain when your tooth starts to hurt, and doesn't stop.

Pain that is usually:

  • prolonged (for more than ten minutes at a time)
  • intense, so that strong pain killers are necessary
  • extremely sensitive to heat
  • does not need a stimulus to hurt
  • keeps you up at night
  • feels like it spreads up the side of the face to the ear area.

This pain is irreversible. The only way to get rid of the pain is to go to the dentist. Unfortunately antibiotics of prolonged use of painkillers will not work. They will only delay the return of the same pain.

How did my tooth get to this state?

Large fillings close to the nerve, a lot of decay, and trauma are the usual causes of irreversible nerve pain. To fix the pain we have to remove the neurovascular bundle in the center of your tooth. (A collection of nervous tissue, lymphatic tissue and blood vessels). Due to the closed off nature of the living tissue in a tooth, if the nerve becomes irreversibly inflamed then it often dies and becomes necrotic (rots).

Your pain may be the symptom of the dying nerve, or a pressure pain from the release of necrotic tissue from the apex (tip) of the tooth. (An abscess).

What's an abscess?

Dying tissue leaks out of the tip of the tooth and erodes the bone. The space formed fills up with inflammatory fluid and dead white blood cells. This is known as pus. The body is unable to clear the pus and it collects increasing pressure locally. It can also spread along tissue planes (the spaces between muscles etc) resulting in a cellulitis. This is a very serious state. If not treated the spreading infection can block a patients airway resulting in death. Usually the pain from an abscess drives the sufferer to see a dentist.

What happens?

Root canal treatment cleans out the infected nerve from the middle of the tooth and then cleans the space that the nerve lived in. Teeth are porous and some of the walls of the canal need to be removed before the tooth is properly disinfected and can be filled up. Maintaining a clear passage through the tip of the tooth and placing antibiotics at the tip of the tooth drains and prevents abscesses from forming. The first appointment is usually pulling the majority of the dying nerve out of the tooth and placing a sedative dressing in the tooth that will help remove the pain of the dying nerve.

The second involves properly disinfecting the root canal and preparing it for obturation (the last stage). This is done by filling the tooth, to increase the size and smooth the shape of the existing root canals.

In the third appointment the tooth is filled completely from the tip of the tooth (deep in the bone) to the crown, with an inert biocompatible substance that ensures there will be no residual infection and complete cessation of symptoms for the remaining life of the tooth.

If done correctly root canal therapy has a 97% success rate.

It allows you to keep a tooth that would otherwise need to be extracted.

Although expensive it is far less expensive than trying to replace a tooth that has been lost.

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