What is root canal treatment?
Root canal treatment (RCT), also known as endodontic therapy, is a dental procedure that replaces unhealthy pulp tissue (nerve) with an artificial substance to prevent the spread of infection.
Why could it happen?
Nerve and pulp possibly become irritated, inflamed and infected due to deep decay; repeated dental procedures and/or a large filling; veneer, crown or bridge preparation; and a crack or trauma affecting the tooth.
What are the signs that I need an RCT?
- Severe toothache upon chewing or application of pressure.
- Prolonged sensitivity or pain to heat and cold temperatures (that remains after the stimuli has been removed).
- Discoloration (darkening) of a tooth.
- Swelling and tenderness in the nearby gums
- Pimple on the gums.
- Periapical lesion seen in x-ray examination.
What happens if I do not get the treatment?
Infection will spread down along the root canal and reach the end of the roots, leading to the development of a painful dental abscess (a pus-filled swelling). The swelling may extend to other areas of the face, neck or head. A pimple on the gum (called gumboil) near the tooth can emerge. If the damage continues and RCT is not performed, the tooth may have to be extracted.
How long will the procedure take ?
An RCT may require 2-5 visits depend on difficulties of the case. Every visit requires around 1 hour.
Will RCT be painful?
On the first visit, endodontist will use local anesthesia to make the surrounding area numb. Anesthesia may not be necessary on the following visits or in the case of dead (necrotic) tooth, but sometimes it is still used to make you more comfortable.
Who should I see for this treatment?
RCT is best performed by an endodontist, who has undergone 2-3 years extra special education in advanced techniques and procedures of root canal treatment. This is the type of dental work that needs finesse specialized skills and a gentle hand.
What will I feel after undergoing an RCT?
After an endodontic visit, you may feel a slight discomfort while biting or chewing. But any discomfort usually subsides in a couple of days and an improvement will be felt gradually. If necessary, endodontist will give you medication(s).
What is next after RCT done?
Final restoration is a must to achieve long term successful result. It could be a direct filling, onlay (stronger and longer lasting alternatives to traditional fillings) or even a crown depends on the remaining tooth structure. Sometimes a post is also needed.
Onlay
Crown / post-core crown
Root Canal Re-treatment / Repeat RCT
Re-treatment is an RCT that is carried out on a tooth that previously has been completed an RCT. For this reason it is also called "repeat root canal treatment".
The initial RCT may fail due to re-infection for many reasons:
- Untreated or undetected canal/s at the initial treatment.
- Unproper canal obturation and/or shortening of working length.
- Leaking from the filling or crown creating a new decay and exposing root canal filling materials, thus causing new infection.
What are the alternatives to repeat RCT?
The only alternatives to repeat RCT are having the tooth treated surgically or having it extracted. Endodontist will discuss your options and recommend the appropriate treatment.
Is RCT / repeat RCT the best choice for me?
An endodontic treated tooth can serve well for years, even for a lifetime. It is always best to save the tooth if your endodontist believes that RCT / repeat RCT is the best option for you, since nothing can be as good as your natural tooth.
If you are experiencing any of those signs and you think you might need an RCT / repeat RCT, talk to your endodontist today.