gutta percha root filling in place (pink)
1. Assessment and Diagnosis: We examine your tooth and assess the problem. We might use 2D or 3D x-rays, special tests to determine if the pulp is infected and review what you tell us about the history of the symptoms. Symptoms that may tell us you need root canal treatment include severe toothache, sensitivity to hot or cold, or signs such as swelling around the tooth. Sometimes a pimple-like bump on your gum will tell us this is a long-standing infection.
2. Control of pain: Root therapy is a delicate procedure that requires your absolute co-operation. Because of this, before starting the procedure, we will use local anesthesia to make you sure your tooth and the area around the affected tooth is really numb. We’ll also monitor your discomfort levels during the treatment to make sure you do not have any pain.
3. Pulp Removal: This is the first third of the treatment. When you are numb, we’ll make a small cavity in the biting surface of your tooth to get access to the pulp chamber and to the root canals. We use rubber dam to ensure your tooth is isolated. We use small instruments to carefully remove the infected or damaged pulp tissue from inside the tooth. This leaves the inside of your tooth clean and eliminates bacteria and debris.
4. Canal Shaping and Disinfection: The middle third of the treatment is done by shaping smoothing the root canals, to create space for filling material. This process also thoroughly disinfects the inside of your tooth to kill any remaining bacteria.
5. Filling and Sealing: The final third of the process is usually done during a second appointment. The root canals are filled them with biocompatible material called gutta-percha (link to window[below]), to replace the removed pulp tissue. You tooth is sealed with a temporary or sometimes permanent filling material to prevent recontamination.
6. Restoration: If your tooth was damaged by trauma or decay you may require a dental crown to provide strength and protection. The whole process of root therapy is necessary to preserve a tooth but it also might leave your tooth structurally weaker. Crowns restore function and appearance to teeth, and make the whole root therapy process worthwhile.
After Root Therapy - Frequently Asked Questions
How soon can I eat?
You can eat or drink straight away but it would be safer to wait until the anaesthetic wears off so you don’t accidently chew your lip. This is especially a problem for young people, so please keep an eye on children while they are numb.
Are there any special precautions with my temporary filling?
Remember it isn’t as strong as a definitive restoration. Don’t try to pull floss up out of the space between this tooth and an adjacent tooth until your final restoration is completed. Brush normally, and avoid things like Minties™.
Is endodontic therapy completed in a single appointment?
Endodontic treatment normally takes more than a single appointment.
What sort of filling do I need after endodontic treatment is complete?
Today, there are more than 20 different materials and techniques available for restoring teeth . We will discuss the best option with you.
Do I need antibiotics?
Unless you have a ‘cellulitis’ infection, or a swelling and a raised temperature, antibiotics are ineffective in treating dental pulp infections.
What happens if I don’t do anything about this tooth?
You may develop a more serious infection which can’t be easily treated. Your tooth may fracture, or decay without you being aware of a problem. Because of this, you may lose your tooth. However, with appropriate and timely treatment your tooth has an excellent chance of lasting a long time.
Is my tooth dead?
No. The periodontal ligament surrounding your tooth-root is alive—this is what makes root therapy possible. Teeth after endodontic treatment are best described as ‘non-vital’.
Will my tooth go black?
Colour change in non-vital teeth is extremely variable. If treatment is started and completed within a reasonable period, there is a good chance teeth won’t discolour. However, some colour change in the short term may be unavoidable. Dark or discoloured teeth can often be whitenend and there are other excellent techniques for remedying this problem.
Do I need to obtain a specialist referral?
‘Endodontists’ are dental specialists in endodontics or root therapy. I sometimes determine that treatment is too complex to be completed in this office and I may refer you for completion of treatment. If you would like a second opinion about your tooth I am happy to provide a referral–please ask. AQ
Alternative care
If you do not wish to keep your tooth I will discuss the most appropriate way to manage this process. It may involve a referral for tooth removal.
After trauma
If you have had splinting and stabilisation applied, this needs to be monitored and further treatment to remove the splinting will be required.
You will also need regular review appointments.
For teeth involved in a traumatic incident, this is usually at 1 week, 2 weeks, a month, and then every three months for a year. Yearly review appointments may also be necessary. These appointments can include dental pulp vitality testing, radiographs and monitoring of colour change. All of these are important in ensuring the continued health of your teeth. After trauma, dental pulps may lose vitality and the root of your teeth may start to dissolve in a process called external root resorption. It is important to catch this condition early and treat it appropriately.
