A tooth is made of enamel, (the outer coating), and dentine which makes up the inner part and the root. Deep inside the tooth lies the pulp.
The enamel and dentine are hard but the pulp is soft and fleshy and contains the blood vessels and the nerve which gives the tooth feeling. The root canal is the narrow hole in which the pulp lies. Front teeth have only one root canal. Back teeth (molars) have three or four.
Root canal treatment means removing the pulp and then replacing it with a root filling.
This is done by making a hole through the outer layer of hard tooth into the pulp, and using special files to first of all remove the fleshy nerve and then to file the root canal from an often uneven and awkward shape into a smooth conical canal into which it is possible to place the root filling. The root filling is made of an inert rubber material and is cemented in place to make a tight seal.
Why is root canal treatment necessary?
There are many reasons why root canal treatment may be necessary.
Tooth decay (dental caries) is tooth which has been softened and invaded by bacteria. If the decay gets close to or into the pulp, it can become very painful, especially with hot and cold. Removal of the nerve (and the tooth decay) by root canal treatment removes the pain.
Sometimes a nerve can die painlessly without you ever being aware. The root canal is then filled with dead, rotting nerve and bacteria. The bacteria multiply, causing an abscess inside the tooth. The bacteria then spread to the outside of the tooth around the end of the root. This can sometimes be painless and go unnoticed, but it can also make the tooth very painful especially to bite on, and the abscess can cause a painful swelling around the tooth.
The root canal treatment sets out to remove the source of the infection inside the tooth, and the body’s immune system can usually overcome the bacteria which have leaked out of the root.
Is root canal treatment painful?
We will use a local anaesthetic to make the tooth numb so that it does not hurt. Sometimes, if the nerve is already dead, it is possible to do root canal work painlessly without having an injection.
How long does it take?
A root filling is different from an ordinary filling and it takes much longer. As back teeth have more root canals than front teeth there is more work involved in thoroughly filing these teeth and the time required is quite variable.
It will usually require two or three appointments of up to forty minutes each. After this, an ordinary filling and maybe, later, a crown will be required.
Does it always work?
No. Root canal treatment has a good success rate (approximately 90%) in leaving your tooth pain and infection free. However the treatment is unsuccessful in a minority of cases. This means that one in ten people who attempt to save a tooth by having root canal treatment will ultimately have the tooth extracted.
It can fail for many reasons of which the most common is reinfection of the tooth. Sometimes the bacteria which colonise a root canal can be very resistant to the measures which we use to try to kill them and continue to infect the tooth making it painful. This can occur in between the appointments but it can also occur months or even years after the root canal treatment has been finished.
Is it not easier just to have it extracted?
Yes. Extraction is quicker, simpler and cheaper. However, afterwards you would be left with a gap which can cause problems, such as poor appearance, the inability to chew evenly and the tilting of the teeth either side of the gap.
Filling such a gap with implants, bridges or dentures can be a difficult, time consuming and costly procedure in itself
How much will the treatment cost?
The fee is from £125 to £455, depending on the number of root canals in the tooth as well as the complexity of the procedure.
There will be a further fee for the restoration in the crown of the tooth We will be able to give you an estimate of the expected fee payable for both the root canal treatment and the ordinary filling. A crown maybe recommended at a later date.
