ROOT CANAL

What Is A Root Canal?

In the past, if you had a tooth with a diseased nerve, you’d probably lose that tooth. Today, with a special dental procedure called “root canal treatment,” your tooth can be saved.

When a tooth is cracked or has a deep cavity, bacteria can enter the pulp tissue and germs can cause an infection inside the tooth. If left untreated, an abscess may form.

If the infected tissue is not removed, pain and swelling can result.

This can not only injure your jawbones but is also detrimental to your overall health.

What Does Root Canal Do?

Root canal treatment involves one to three visits. During treatment, your general dentist or endodontist (a dentist who specializes in problems with the nerves of the teeth) removes the affected tissue. Next, the interior of the tooth will be cleaned and sealed.

Finally, the tooth is filled with a dental composite. If your tooth has extensive decay, your doctor may suggest placing a crown to strengthen and protect the tooth from breaking.

As long as you continue to care for your teeth and gums with regular brushing, flossing, and checkups, your restored tooth can last a lifetime.

Sign & Symptoms

How do I know I need root canal treatment?

During the early stages of infection, pain may be minimal or even non-existent.

As the infection develops you may get pain or swelling.
When there are no symptoms, it may only be visible to your dentist on examination.

In these situations, the dentist would normally see a small spot or opening on the gum (called a sinus tract) where the infection has created a path to come out of the bone. Sometimes the dentist can also see a shadow at the bottom of the root on the x-ray.

What are the signs and symptoms of a tooth infection?

The main symptoms of early infection are tenderness to bite on and/or pain to hot and cold that lasts more than a few seconds.
The longer you leave the infection to spread through the root canal system, the more painful it may become until you feel a constant toothache.
In serious cases or in advanced infection, a dental abscess may form which will present as swelling of the gum or even the face.

Treatment Options

What are the treatment options for a tooth infection?

A tooth infection can only be treated by either root canal treatment or removal of the tooth. Antibiotics are only a temporary measure until you can have the infection treated properly. Antibiotics will not remove the infection permanently.

What happens if you do not treat a tooth infection?

If a tooth infection is left untreated the surrounding bone will be affected and bone will be lost. A small infection may develop into an abscess or even a swelling of the face that may need urgent treatment in hospital.

Consultation

What happens during the root canal treatment consultation?

Before starting treatment it is important to see our specialist Endodontist, Dr. Dominique Laatz, for a consultation. At this appointment Dr. Dominique will assess your tooth and take some x-rays in order to diagnose and plan your treatment accurately.

In some complex cases, 3D Cone Beam CT imaging may be recommended for this as well, as the root canal system is a 3-dimensional network of canals and tubules that cannot always be visualized accurately on a 2-dimensional standard x-ray.

The consultation is an important and integral part of your root canal treatment. Every patient is different and unique, with different expectations, past dental experiences and levels of anxiety.

Dr Dominique will discuss all options with you and answer all your questions before commencing treatment. This way the treatment as a whole can be tailored specifically to you in order to achieve a positive treatment experience and a successful outcome.

How many appointments are needed for root canal treatment?

Depending on various factors, the treatment can be done in a single session start to finish or in multiple sessions. This will be discussed with you at your consultation.

Procedure

Is root canal treatment painful?

With the advanced approaches practiced by Dr.Dominique Laatz at German Dental Clinic, root canal treatment is almost always predictably pain free and comfortable.

Dr. Dominique uses a combination local anesthetic regime when required and ensures your comfort throughout the procedure. 

What happens during the root canal treatment procedure?

Once the root canal has been accessed via the crown (top) of the tooth, the microscope is used to investigate the canals further and to identify micro canals that extend off the main canals so that these are not missed. A full examination under microscope is also carried out to identify cracks and other complications.

The canals are thoroughly cleaned using precisely measured files and disinfected with antibacterial irrigants.
If carried out in multiple appointments, the canals will then be dressed with antibacterial medication and a temporary filling placed.

Once the canals have been thoroughly cleaned, they are shaped to receive the root filling material, a rubber based material called Gutta Perche, coated in an antimicrobial sealant paste. The root canal system is a very complex system with many fine asymmetric irregularities three dimensionally.

The Gutta-Percha is therefore compressed into the root canal system with heat so that it can shape itself and fit the root canal system most optimally in all three dimensions. The gutta percha then cools and solidifies forming the permanent root canal filling.
After the root canal treatment has been completed, the top part of the tooth is then sealed up with a core restoration. You will then be referred back to your dentist for the permanent restoration that goes on the top of the core restoration.

Complicated Teeth

Can root canal treatment be carried out on teeth with complications?

Some Endodontic Specialists with advanced skills like Dr. Dominique are also able to treat complicated teeth that would otherwise need to be extracted. If the root canal has a perforation from previous treatment, Dr Dominique can repair this.

If there is a fractured portion of instrument separated in the canal from previous treatment Dr Dominique will most often be able to bypass or remove this for you. If there is a post in the root canal, Dr Dominique can either remove it for you or provide root treatment from the other end of the tooth; known as an apicectomy or apical microsurgery.

An apicectomy is also useful if it is not possible to access the tooth from the crown (top). If a previous root canal treatment is perfectly filled but for some reason has still failed, Dr Dominique may carry out Endodontic microsurgery to treat the infection in our Chelsea practice.

If a tooth has multiple roots and one root has too many complications, Dr Dominique can carry out root resection surgery to remove the infected failing portion and thereby restoring the rest of the tooth.

After Treatment

What happens after the root canal treatment?

After root canal treatment, the tooth may become brittle as there is no longer a live blood supply within the tooth. It is important to prevent the tooth from future cracks and breakages so that you can increase the lifetime of the tooth.

The most effective solution is to place a crown or onlay over the tooth. This is more durable and stronger than a composite filling and reduces the risk of tooth fracture or re-infection of the roots.

What is the success rate for root canal treatment?

The success rate for root canal treatment can be high as 98% when carried out by a specialist. A successfully treated tooth will normally survive for years afterwards, in most cases for a lifetime.

Endodontic Specialist

Should I see a specialist for root canal treatment?

You should see a Specialist Endodontist for root canal treatment in order to increase the success rate of the root treatment and to have a better chance of keeping the tooth for the rest of your life.
At The German Dental & Dermatology Clinic, Specialist Endodontist Dr Dominique has the expertise to provide outstanding treatment and care for you. Dr Dominique uses state of the art equipment and technology to achieve optimum results. A dental operating microscope is used to view the root canal system under high magnification allowing a more thorough and complete treatment of the canals. In addition to this, further state of the art technologies and materials are used during your treatment to ensure superior results.
The German Dental  invests in the latest research, materials and technologies to provide you with the best root canal treatments whilst staying at the forefront of the endodontic world.

Do I need to be referred to an Endodontist?

You can book directly with the Endodontist and do not need to have a referral to see them.
Many dentists do however refer their patients to Dr Dominique at German Dental & Dermatology for better continued care and communication. Dr Dominique is then able to send reports of the consultation, investigation and treatment back to your dentist and can advise them on the best follow-up care required for long term results.

Cost

What is the cost of root canal treatment?

The cost will vary on a number of things; the number of root canals present, whether a root canal treatment has previously been performed on the tooth, and whether there are other complicating factors.

Frequently Asked Questions:

Why do I need a root canal treatment?

If the pulp tissue inside the root canal becomes acutely inflamed or infected because of decay or injury, the tissue needs to be removed and the canal to be disinfected to saving the tooth and stopping the infection from spreading into the surrounding area of the jaw.

Is there any alternative to root canal treatment?

A tooth extraction should always be considered as a last resort, rather than an alternative to saving a tooth through a root canal treatment or another conservative procedure. Root canal treatment is one of the best-established procedures in dentistry and comes with a high success rate (over 90%). Saving teeth can prevent other troubles typically associated with tooth loss, such as bite problems, teeth shifting their position, difficulty eating, and loss of bone volume and density due to atrophy of the jaw.

What is a root canal treatment?

The term “root canal” describes the tiny, narrow passageways within a tooth through which contain the tooth nerve and accompanying vessels (called the pulp). The term can also be used as an acronym for “root canal treatment” – a procedure of shaping, cleaning, disinfecting, and filling the root canal space hermetically to save the tooth if the pulp becomes acutely inflamed or infected as a result of dental decay or trauma for trauma example.

What happens during the root canal treatment?

After administering local anaesthesia, the doctor will drill a small hole into the top of your tooth to access the root canal system and pulp. The infected or diseased nerve tissue is then removed, with gentle filing and rinsing until the whole root canal system is finally clean and disinfected. Our skilful and experienced endodontist will measure the exact length of the root canal system in the process to perform the actual filling of the canal from top to bottom to exactly the measured length. We at the GDDC work with an inert, biocompatible material, for all root canal fillings. In the end, the access hole will be sealed with a filling as well, to prevent any chance of leakage.

What happens after the root canal treatment?

Your tooth typically though not necessary, may feel a little sensitive on biting (especially hard and chewy food) for a few days after root canal treatment, but this possible discomfort can usually be relieved with anti-inflammatory pain medication such as Ibuprofen, Diclofenac, or Paracetamol to name a few. Please avoid chewing on that tooth until it receives its permanent filling or crown, which can be placed soon after

Is the root canal treatment a painful procedure?

Root canal treatment may have a bad reputation, but it is not the procedure that causes pain. Pain is just the result of the inflammation or infection caused by injury or dental decay. To manage the pain efficiently our Endodontist works with a special and gentle injection technique for strong local anaesthesia. The Root canal treatment itself is often the quickest way to relieve your pain.

How can I avoid the need for a root canal treatment in the future?

You can avoid root canal treatment by, Keeping your teeth clean by brushing and flossing them to prevent dental decay, which is the most common cause of tooth nerve infections. We at the GDDC recommend a healthy natural diet and you should avoid sweet and acidic beverages such as most soft drinks. We also recommend and offer regular professional cleanings and check-ups.