What does Root Canal Treatment mean?
Root canal treatment is the dental procedure to remove the tooth’s pulp tissue.
An opening is made by using a tiny drill to remove the cavity and expose the pulp to remove it from the canals. Each canal is cleaned and shaped using instruments. Disinfecting solutions are used to clean the root canals. After the initial cleaning if the dentist feels there is still some infection persistent in the tooth a medicament is placed in the tooth to eliminate any residual bacteria. Antibiotics may also be given to treat and prevent infection when needed. The canals are sealed and filling placed. A crown is mandatory to be placed after a root canal procedure unless specified otherwise by your dentist.
When is it recommended?
Root canal treatment is recommended to save teeth damaged by severe tooth decay, trauma to tooth leading to its fracture, large fractured restoration, excessive wear of teeth exposing the pulp, severe gum disease infecting the pulp.
What does it do?
A properly executed root canal procedure prolongs life of a dead/ infected tooth against an alternative of extracting it and replacing the missing one with either a denture, a dental bridge or an implant. Long term success rate of root canal is 85-93% whereas of re-root canal is 50-75% at best.
Reasons for failure
Missed extra canal beyond the expected normal
- Poor oral hygiene maintenance leading to secondary cavities or gum diseases
- Restoration leakage or breakdown over time
- Crown not placed
- Fracture of tooth due to overload or overuse
- Difficult/Unusual anatomy of tooth
- Difficult access to tooth with instruments especially back teeth or with reduced mouth opening
- Accidental instrument breakage in tooth
- Anaerobic bacterial infection that does not get resolved
What to do if root canal fails?
Re-root canal can be performed. A specialist in root canal: an endodontist is the best person to treat such cases. Sometimes a surgical intervention might be needed called Apicoectomy/ root resection of infected/ fractured root.
Despite chances of failure, should one do it?
The success of the treatment depends on many factors including patient compliance and condition of tooth before treatment begins. Case selection should be done carefully based on clinical scenario, X-rays and history of complaints. The alternative to root canal treatment is removing the tooth and replacing it with either a denture, a bridge or an implant; all of which are substitutes to the existing natural teeth. Priority should always be given to save natural teeth as much as possible.
What can one do to avoid failures?
- Avoid overusing that tooth alone and fix other teeth that might have troubles
- Maintain good oral hygiene to prevent cavities and gum diseases
- Keep regular follow up visits
- Place crown immediately after root canal procedure to avoid tooth/ filling fracture and re-infection
- Follow all instructions given by the dentist, take all medications exactly as prescribed without modifying or stopping mid course.
- Report to your dentist in case of discomfort/ unease without waiting for obvious symptoms to occur.