What You Need to Know About Root Canal Treatment

What is a Root Canal?

You’re not alone if you’re asking this. The treatment causes some confusion and is a mystery to many people. Also called endodontics, or RCT for short, it is needed when the tooth ‘nerve’ has been badly damaged through decay or injury/trauma (and usually, but not always, causing pain or other problems).

More accurately, the ‘nerve’ as patients will often call it is in fact the pulp. This normally contains healthy blood vessels, nerves and other tissue.  It lies in the center of a tooth and runs down little tubes or canals in the roots (hence the phrase ‘root canal’). The main purpose of the pulp is to give teeth nutrients as they grow. Once a tooth has fully developed, the pulp can be removed without harm.

"Graphic of the dental root canal procedure"

So this is a treatment whereby the dentist treats a damaged/diseased ‘nerve’, in order to save a tooth. This is done by a combination of cleaning out, shaping and then filling the chambers inside the tooth, as summarized in this chart:

 

"Dental Root Canal photo"

The pulp opening obvious in this molar; the canal opens at the black hole in the cavity

We continue this section with the causes for needing RCT and then link to answer some common questions about it.

 

Why Might You Need a Root Canal?

There are a variety of reasons why you may need a RCT, but the reasons generally involve damage to the nerve of the tooth. Sometimes mild nerve inflammation will heal itself, but in the case of needing this procedure, the damage is deemed as too severe for this.

In other words, you will need a root canal if the pulp nerve is damaged beyond repair.

"Image of teeth that are dark due to trauma and need root canal"

These teeth where knocked some years ago. The dark shade indicates nerve damage and the need for endodontics

There are a number of causes for this pulpal disease. They include:

  • A cavity that has been left untreated and has spread to the nerve.
  • Damage to the nerve from a knock, a cracked tooth, large fillings or from dental procedures.

There is a range of damage that can occur to the pulp, from increased blood flow which cause sensitive teeth and nerve pain (toothache), to a bad infection causing a tooth abscess…

 

 

Tooth Abscess

In general, an abscess is a collection of pus. This forms when the body is trying to fight off an infection. The pus contains the bacteria, as well as cells and fluids from the body’s immune system. The body will try to drain infections away but when it cannot, the pus collects to form an abscess.

"An image showing a root canal symptom of abscess on gum at a front tooth"

An abscess above a front tooth, which needs RCT

In dental terms, abscesses are a common condition. If bacteria enters the nerve from, say, a cavity, this can spread to fill the whole inside of the pulp. Antibiotics cannot get inside this chamber, and the infection will cut off the blood supply to the pulp. This will prevent the tooth from being able to heal itself.

If the infection spreads out from the bottom of the tooth into the surrounding bone, this will result in an abscess.  This can be dangerous if it spreads and must be treated immediately. See more on dental abscesses here and it’s treatment here.

 

RCT: “Does it Work?”

A lot of patients wonder if it is worth getting RCT done for fear that it won’t settle down their pain. ‘Better to get it out and be done with it.’

In actual fact, the success rates for this procedure are very high. This rate does depend on the state of your tooth, it’s anatomy and how badly it is infected. Success rates are also higher if the procedure is carried out by a specialist endodontist (read about them here).

Success rates will be in the region of 75-95 %. That is, after five years you can expect to still have the tooth. Success also depends on the tooth being properly restored after the endodontic treatment; often this requires a crown being fitted to avoid failure post-treatment.

 

Male dentist

Further Advice

Root canal treatment is termed endodontics by dentists, and those that specialize in the field are called endodontists. It is a common treatment needed to restore dental health in several circumstances, and one that is generally painless, despite common perceptions!

The remainder of this section will answer common questions about this procedure.

Click on the following links for answers to the questions:

 

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