An infection in the nerve (or pulp) of a tooth is a painful condition that cannot be treated with antibiotics. If left untreated, it can spread to the jaw bone and cause potentially serious complications.
This kind of infection can be treated by a procedure known as root canal treatment, or root canal therapy. The tooth is drilled into, the pulp is removed and the roots are then cleaned and filled, with the aim of preventing reinfection.
During treatment the root must be internally accessed with very fine instruments and measuring devices, then disinfected. Due to their minute size, the root canals can only be properly viewed with the aid of extremely large magnifying technology (enlarging up to 24x).
This dental treatment is therefore slow, requiring extreme skill. Depending on the number of canals and their shape, and the complexity of the case, the entire treatment process can require up to three visits for any one tooth.
There are also risks associated with the use of such delicate instruments in spaces invisible to the naked eye. Occasionally a file can fracture inside the root canal, especially if the shape of the canal is complex. The fracturing of a file is due to the characteristics of the case at hand and is not a reflection on the expertise of the clinician; but the separated fragments should not be removed by other than a highly qualified, experienced clinician using a purpose-designed tubular device.
Root canal therapy is not a stand-alone treatment. After your tooth has been root filled, its crown structure will need to be restored. In many circumstances, including when the treated tooth is a back tooth (which always carries more loading than a front tooth), you may need to have a dental crown, which requires a core substructure. Otherwise, the restoration may take the form of a veneer or a white filling.
Who can perform the necessary treatments?
Root canal treatment is sometimes carried out by a general dentist. However, given the high degree of specialisation involved in this kind of surgery, you are advised to seek out the services of a specialist endodontist.
In Australia these practitioners have sub-specialised after completing their general dentistry degree, receiving a Masters or a Doctorate degree in the field of endodontics (usually three years of full-time university study), during which they undertake original research and build their practical skills in the management of difficult and complex root canal treatments. They are required to be registered with the Dental Board of Australia and are strictly regulated.
The cosmetic enhancements that follow endodontic treatment are carried out by a specialist prosthodontist – an expert in the restoration of teeth. Like all dental specialists in Australia, prosthodontists must be registered with the Dental Board of Australia and you can verify their details on the AHPRA dental register.
Are there any options for saving the affected tooth?
If you suffer an infection in the root of one of your teeth, the only safe alternative to root canal therapy is to have your tooth extracted and replaced with an implant. But you should always consider root canal therapy as the first option. Not only will it preserve your natural tooth but it will be less than half the price of an implant (with the exact cost depending on how many roots the tooth has – multiple for molars, single for front teeth – and the shape of the canals, among other things).
You are strongly advised to obtain the opinion of a specialist endodontist before you commit to any tooth extraction. You do not need a referral to seek the opinion of an endodontist, a consultation that usually costs between $100 and $150. Their professional reputation depends largely on the success rate of their treatments, so they will be perfectly honest in advising whether or not your tooth can be saved.
You can expect to pay anywhere from $1,700 to $2,700 for the actual root canal procedure, which will be carried out by a specialist endodontist, and $200 to $450 after the root canal is complete to have the tooth filled.