Root canal treatment – what’s that all about?

Today I’m writing my blog on my favourite branch of dentistry: Endodontics, or root canal treatment (RCT).

I’ve been receiving referrals for root canal treatment from local dentists since 2013, and in this time, I get asked the same handful of questions. Number one, by far, is “Does a root filling hurt?” The short answer is no, almost never! Very occasionally you might need extra local anaesthetic to make it comfortable, and if you want more numbing all you need do is ask. Sometimes you’ll need to take painkillers afterwards, but paracetamol and ibuprofen usually does the trick.

“What is a root filling?” That’s where the dental pulp, or “nerve” as it is sometimes (wrongly) called, is removed from the middle of the tooth, the root canals cleaned and disinfected and sealed with a rubbery filling material called gutta percha. It’s usually best to do this in one visit, but sometimes it can take 2 or even 3, depending.

“How long does a root filling take?” is another FAQ. Depending on complexity, it’s usually done in one to two hours. If you have a favourite kind of music or a preferred radio station, then you can listen to that to keep your mind relaxed and occupied. We can also provide you with a comfortable mouth prop to prevent your jaw from aching.

If the RCT tooth is a molar or premolar, then it will need a crown or onlay afterwards, and the sooner the better. This can be done at the same visit using CEREC same day crown technology, or it may be more financially prudent to wait until symptoms subside.

“Why do root canals at all?” you may ask. Your options are usually (a) attempt to save the tooth with RCT, (b) extract the tooth or (c) do nothing and let the infection spread, so really you need to weigh up if is it better to have RCT or your tooth extracted. If you lose a tooth then it might affect your appearance or ability to chew, and it might cause other changes to your bite. If it’s a useless tooth with poor chance of success, then it’s usually best to extract.

“Do root fillings work?” RCT is highly successful but not 100%, and due to the complex nature of the procedure it cannot be guaranteed. Typically, there’s a 90% to 95% chance that the tooth will be healthy and comfortable for the next 5 years and more.