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Root Canal Treatment - Endodontics

This dental procedure is carried out when the inner part of the tooth, the nerve (we call it the “pulp” because it is nerves, blood arteries and veins and support tissues as well) becomes irreversibly damaged or infected. If left untreated, the tooth becomes very painful and infected. The pain can be so bad that all you want is to extract it! However, usually it is possible to save the tooth but it will require significant treatment to do so. The infected pulp needs to be removed and the infection eliminated. Any abscess associated with it will heal. In dental terms this procedure is called ‘endodontics’.
 
The reason the pulp would die
• Decay (caries) – If decay is left, it will travel deep into the pulp area and infect it.
• Trauma – A severe knock will affect the pulp.
• Severe Gum Disease - The gum detaches itself from the tooth creating a gap between the tooth and the gum, bacteria then gets trapped causing an infection which can infect the pulp.

The symptoms

Pain is variable from a dull pain on biting to intense pain. Pus or a boil can appear on the gum in the area of the infected tooth. This is where the
collection of pus from the root tip is draining which will leave a bad taste in your mouth. Swelling in the gum area surrounding your tooth.

As mentioned, the treatment to save the tooth is significant and there are many variations on how to complete this treatment. Regrettably, treatment itself is damaging to the tooth and leaves it in a weakened condition which needs to be managed as well. We will advise you fully of what your specific treatment will be to restore the tooth back to a long term health.

The mechanics of root canal treatment starts with the access in to the pulp chamber. This is a hollow part inside the tooth with narrow canals running down the roots. In a healthy tooth, this has the pulp or nerve of the tooth and its supporting tissue. When the pulp is irreversibly damaged or infected, this infected tissue needs to be removed from the root canal system. Once removal is completed, the canals are cleaned and disinfected. A root filling is put inside the canals to block up the space from the now removed, pulp tissue. By providing a seal at the root tip, stops any inflow of any material back in to the tooth which may cause re-infection. Equally so, it is important to seal the mouth end i.e. the crown of the tooth to ensure that both ends of the canal is sealed.

Core fillings/posts

Usually the tooth is severely damaged and the root canal treatment damages the tooth further and leaves it in a weakened condition which needs to be managed as well. A core filling is built up in the tooth, often using part of the root canal space, so as to form a post-type retention. The crown part of the tooth is also rebuilt in the filling material so that the core filling acts as a link between the root and the crown of the tooth. A proper crown is required for all rear teeth as the biting loads are so much greater and the crown braces the tooth together. The main cause of failure for root canal treated teeth is fracture and the crown goes a long way to prevent this!

In some circumstances, a cast gold post is used where the amount of damaged tooth is much greater, again followed by a crown.

We will also explain the financial implications of the treatment because they are significant and you need to be aware before you start the treatment. The alternative can be an extraction but is that really what you want?

At your consultation appointment we will locate the offending tooth, and confirm the diagnosis with special tests including x-rays. Antibiotics are rarely used because the best emergency treatment is to start the root canal treatment (RCT).
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Harley Dentistry
344 Otumoetai Road
Otumoetai, Tauranga  3110
Phone: (07) 576-3104
New patients: (07) 576-3109
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