Endodontics (Root Canal Therapy)

This is done when a patient wants to keep their tooth though the nerve in the tooth has

• been exposed due to trauma(accident) or due to decay
• died and is giving them toothache
• an abscess formed
• become infected but before actually abscessing
• discoloured due to one of the above but treatment at the time was not sought and the tooth has given no signs or symptoms

Under most circumstances we try and remove the offending dead nerve and the associated bacteria. The idea is to thoroughly clean the tooth root canal of all material and under strict conditions sterilise it and then seal it up so no further invasion of the canal system an occur during it's life time.

Then after a period of time a permanent restoration is placed on it that protects the remaining tooth, this is usually a type of crown as a dead tooth is a brittle tooth and can fracture later.

Procedure:

At all times we place an anaesthetic and anaesthetise the tooth (sometimes there can still be feeling though the tooth is "dead")

Then we place a rubber dam on the tooth thus separating it from the rest of the mouth.

This seals the rest of the mouth from instruments possibly falling into the mouth also protects the tooth from the patient mistakenly putting saliva which contains bacteria into the tooth and reinfecting it.

We then open up the centre of the tooth and locate the canals we then use a computerised machine to measure exactly how long these canals are and then we prepare them to that length ready to accept our sealants. This is an important stage as too short and we leave material still in the canal system. Too long and if you push the sealing point through the end of the tooth you get irritation by the surrounding jawbone. There may be a number of dressings required, as there can be many different types of bacteria in this system, which may be more difficult to remove than others.

Finally when there are no further problems we can restore the tooth with a normal restoration or go straight into crowning or overlaying it. This is necessary as root filled teeth do become brittle and can break under load.

The tooth is dead and as such cannot feel anything. But it still sits in a socket so you can still feel pressure on it and it feels normal. It is like a fingernail, that is a dead piece of body that though sits in a live nail bed so if you cut the nail no pain but if you pull it too hard or bend it etc. it still will give pain in the surrounding tissue.