Root canal treatment, or root canal therapy (RCT) is required to treat a tooth with a dead, dying or inflamed pulp, more commonly known as the ‘nerve’.
Endodontology, or endodontics, is the art and science of root canal treatment. Endodontics is one of the dental specialities recognised by the Dental Board of Australia, which also maintains the register of specialist endodontists, all of whom have had a minimum of three years post-graduate training.
Endodontic treatment is required when the pulp of a tooth becomes inflamed or if it becomes necrotic, ie; it dies! The presence of a necrotic or dead nerve leads to the formation of an abscess. Inflammation of the pulp, or indeed pulp deaths, can be caused by trauma, such as a blow to the mouth or tooth, by deep dental decay (dental caries), the presence of a crack or split in the tooth, or in some cases, simply a reaction to a very deep filling or the placement of a new crown on a compromised tooth.
Endodontic problems often present in an acute phase, with pain and swelling, but in many cases the patient is symptom free and the presence of an endodontic problem is diagnosed via a routine radiograph, or x-ray.
Endodontic treatment is carried out over one or two visits and involves the endodontist, or dentist, creating a small hole in the top of the tooth and removing the dead or dying pulp with a series of fine files. Once the canals have been shaped to allow filling, they are soaked with a strong antibacterial solution to make sure all the bacteria is rendered ineffective.
Following this antibacterial irrigation, the root canals are dried with small, sterile paper cones, and then filled with a soft rubbery like material, called Gutta Percha.
The final step in the management of the root filled tooth is the placement of a permanent restoration. In some cases this may be a simple filling, but more commonly a crown or complex restoration is required.
Root canal treatment is totally pain free, as local anaesthetic is used at all stages.
There is generally minimal post-operative discomfort, which can be controlled with analgesics for a day or two.
When RCT is carried out by an endodontist, the success rate is very high, and the outcome quite predictable.