Endodontics is the dental specialty concerned with the study and treatment of the dental pulp, the living connective tissue and cells in the middle of the tooth that bring it nourishment and keep it alive. The pulp can become infected or diseased and has to be treated to save the tooth.
The most common causes of disease are tooth decay, failing restorations like a defective filling, crown or bridge, tooth trauma from a blow to the tooth, cracks in teeth or fillings and gum disease. In all these cases, bacteria find their way into the pulp and this leads to “devitalisation” of the pulp. If left untreated, this can cause an abscess at the tip of the root and even start destroying the bone supporting the tooth, leading to eventual loss of the tooth.
Dentists perform a number of different procedures, the most common of which is root canal treatment. During this treatment, the dentist isolates the tooth to be treated with a protective cover called a rubber dam. They then expose the tooth root and remove the infected pulp tissue, clean and disinfect the inside of the root to make sure no infection remains and then fill it up with root filling material to seal it and protect the root canal from reinfection.
Occasionally a tooth requires more specialist treatment, in which case, we can offer referral to an Endodontic Specialist.
Sometimes, root canal treatment needs to be repeated if infection builds up again. During a re-treatment, the dentist removes the original filling material, cleans and disinfects the root and then applies replacement root filling.
In more severe cases where the root tip and bone is affected, a surgical procedure called an “apicectomy” is performed where the infected root tip is removed and any cyst or infection in the bone is removed.
Finally, if endodontic treatment cannot successfully restore a tooth as it is too structurally compromised, it may be better to remove the tooth all together and replace it with a dental implant and crown.
Treatment can normally be carried out in one visit to the dentist, unless the case is more complicated and involving a severe infection, in which case more than one visit may be required.
Root canal work has a bad reputation, but with the right anaesthesia, it is normally painless. Our patients who have had root canal treatment often tell us that it was much better than they feared and the resulting pain-free gums, and the ability to eat and talk without discomfort again, made it all more than worthwhile.