What is root canal surgery?

Root canal therapy or root canal treatments is a procedure used to treat infection or pain/discomfort within a tooth. The pain or infection is mostly caused by bacteria.

Bacteria can progress into a tooth via many ways including deep decay, previous deep fillings, to even dental trauma. Eventually, bacteria get into little pipes in the tooth called the root canals, where they can live easily, hidden away from our bodies natural defences and immunity. The root canals contain the tooth nerve, responsible for giving us sensations like sensitivity to cold drinks/food.

Once the bacteria get into the root canals, the nerve can become very painful, leading to toothache we all fear, and eventually progress into a dental abscess. 

At this point, the bacteria is hiding in the root canals, hidden away from antibiotics and the body’s immune system. Root canal treatment aims to remove the bacteria from the tooth, and therefore allowing the tooth to heal reducing pain and discomfort from the tooth.

Why do I need it?

If the root canals are infected, or the bacteria is getting into the root canals causing pain, then simples measures such as antibiotics or filling replacements will rarely solve the issue, for the problem only to return. The treatment options other than monitoring the tooth, is either removal of the tooth via extraction, or root canal treatment to try and save the tooth and keep a functioning tooth in your mouth for as long as possible. Most patients opt for root canal treatments to try and save their tooth.

Sometimes root canal treatments can fail, and infections can return due to many reasons including new dental decay or fractures to the tooth, then the root canal treatment can be redone to eliminate any old or new bacteria in the tooth.

When do I need root canal?

The symptoms of root canal problems include increased pain when eating or drinking hot or cold food and drink which lingers, pain when biting or chewing, or swellings associated with the tooth. As the infection worsens, these symptoms often disappear as the nerve in the tooth dies. This may seem like the tooth has healed, but intact the bacteria is still inside the tooth, multiplying until a dental abscess forms.

Correct diagnosis with myself or your dentist, including dental x-rays, to assess all the symptoms of the tooth and to decide whether the best option is root canal treatment to save the tooth, or other treatments which may be beneficial for this tooth at the time. If symptoms do all point to the tooth requiring root canal treatment, and the patient wants to save the tooth, it is always better to treat the tooth as early as possible, rather than to let the bacteria progress deeper into the tooth over time making it harder to treat.

How do you perform root canal treatment?

Majority of my cases are treated in a single appointment. We gain access into the root canals via a small hole, we open the root canals up to clean them effectively, and once disinfected over the appointment, the root canals are sealed with a special root canal filling material, then a final permanent filling is placed back in the tooth.

Sometimes, if the infection has been there a while, and there is a strong infection when opening the root canals, I may place some medicine inside the tooth covered by a filling and do the treatment over two appointments.

Sometimes, I will recommend a crown to be placed over the tooth, this will protect the tooth and root canal filling from potential infection trying to return, and prevents the tooth from breaking.

Is root canal painful?

This is a question we get a lot, and understandably so.

Before having root canal treatment, you’ll usually be given a local anaesthetic. This will numb the entire area. Once the tooth is numb, we will perform the root canal treatment, which is pain free thanks to the anaesthetic.

What's recovery like?

Until the treatment is complete, it’s best to avoid hard foods, especially if I have advised the tooth to be crowned, always be gentle on the tooth until the crown has been placed.

As I mentioned, the procedure is not sore, but the area can be tender for up to 2 weeks after the anaesthetic wears off, which can be managed with painkillers if required.

In the future, keeping your teeth clean including flossing or tepe brushing and not eating too much sugary food are the best way to prevent dental decay and thus reducing the chance of needing root canal treatment in the future.