What is a Root Canal and What can go Wrong
What is root canal treatment?
Root canal treatment is a procedure used to treat infection found in the centre of the tooth. It can also be called endodontics . The tooth is opened up and internal damage is removed. Most of the time the infection causes the network of blood vessels and nerves inside the tooth to swell and become painful.
Why is it needed?
The main causes of infection in the teeth are:
- Tooth decay
- Leaky fillings
- Damage to teeth as result of trauma, for example a fall
What does the treatment involve?
- The tooth, surrounding gum and bone is numbed by injecting anaesthesia. This can be a little painful.
- A dental dam, which is a thin sheet of rubber or vinyl, will be placed over the affected area and surrounding teeth. A hole is made in the dental dam so that only the damaged tooth pokes through. This creates a sterile environment for the tooth to be treated in, protected from bacteria found in the saliva and rest of the mouth.
- A small hole is drilled into the tooth so that the pulp chamber and root canal can be accessed.
- The infected pulp is removed from the tooth using a barbed broach:
- The canals at the bottom of the tooth are disinfected with antiseptic and antibacterial solutions.
- The canals are shaped and cleaned using something called a K-type file and a root canal reamer. The dentist will remove any leftover debris and shape the canal so it is ready to be filled and sealed.
- The canals are filled with a rubber-like material called gutta-percha. This is heated and compressed against the walls of the canal to get the perfect fit.
- An adhesive cement called a sealer is used with the gutta-percha to properly seal the canal.
- A temporary or permanent filling with be placed over the top of the root canal filling to seal the hole that was used to access the root canal.
- You may be prescribed an antibiotic to prevent further infection.
- You will be sent back to your general dentist, or will arrange another appointment to get a filling or a crown to finish the procedure and protect the tooth from further infection.
What can go wrong?
There are number of things that can go wrong during root canal treatment. These include:
- Bruising at the anaesthetic injection site.
- Breakages of files or other instruments inside the tooth. Sometimes these cannot be recovered from the tooth.
- Inability to complete procedure due to obstructions such as calcification or because of other unexpected findings such as a crack in the tooth.
- Development of secondary infection after treatment.
- A fracture to the tooth after the root canal treatment but before full restoration has happened. Sometimes this can be serious enough to mean the tooth cannot be restored.
- Defective or inadequate restoration, also known as coronal leakage.
How to tell if something is wrong:
If any of your symptoms persist then something could have gone wrong. A root canal treatment should stop any symptoms you had before the procedure. Likewise if you developed any new symptoms, such as pain or swelling, you should contact your dentist sooner rather than later.
Sometimes problems will not display any physical symptoms and they will only be detected via an x-ray.
Why can treatments go wrong?
The most common reason for treatments failing is because cleaning isn't done correctly, or the seal has not been secured correctly. It could be that the material itself was deficient from the outset or it has deteriorated in a way that it shouldn't have.