Save Your Natural Tooth

Root canal treatment—also called endodontic treatment—is used when the pulp inside a tooth becomes severely inflamed, damaged or infected.

The affected tissue is removed before the inside of the tooth is cleaned, shaped and filled. The tooth is then sealed and restored to help prevent bacteria from re-entering.

Possible signs include:

• Persistent toothache.
• Pain when biting or chewing.
• Prolonged sensitivity to hot or cold.
• Swelling or tenderness around a tooth.
• A spot or swelling on the gum.
• Darkening or discolouration of a tooth.
• A broken tooth or a deep filling.
• Facial swelling associated with dental infection.

However, some infected teeth cause few or no noticeable symptoms. A dental examination and appropriate X-rays are required to determine whether root canal treatment is necessary.

The tooth is normally numbed with local anaesthetic, so you should remain comfortable during treatment. Modern root canal treatment is intended to relieve the pain caused by inflammation or infection rather than create it.

The tooth may feel tender for a few days afterwards, particularly when biting. This should gradually improve, but you should contact the practice if pain or swelling becomes severe or continues to worsen.

Your dentist will numb the tooth and usually place a rubber dam around it. This thin protective sheet isolates the tooth, keeps it clean and prevents treatment materials from entering your mouth.

A small opening is made in the tooth so that the infected or inflamed pulp can be removed. The root canals are measured, cleaned, disinfected and shaped before being filled and sealed.

X-rays may be taken before, during and after treatment to assess the roots and guide the procedure.

A rubber dam helps isolate the tooth from saliva and bacteria. It also protects your mouth and airway from the small instruments and cleaning solutions used during treatment.

Its use supports safe and effective root canal treatment.

Some root canal treatments can be completed in one appointment, while others require two or more visits. The number and length of appointments depend on the tooth, the complexity of its roots and the extent of any infection.

If treatment is completed over several visits, a temporary filling may be placed between appointments.

A root-filled tooth can be more vulnerable to fracture, particularly if it is a back tooth or has already lost a significant amount of structure.

Your dentist may recommend a crown, onlay or another protective restoration after assessing the remaining tooth. This helps protect the tooth and restore its function. Not every root-filled tooth requires the same type of restoration.

Root canal treatment is an established procedure that can allow many teeth to remain functional for years. However, no dental treatment can be guaranteed.

The outcome depends on factors including the tooth’s anatomy, the extent of infection, the amount of healthy tooth remaining and how well the tooth is restored and maintained.

In some cases, symptoms or infection can return. Further treatment, specialist referral, root-end surgery or extraction may then need to be considered.

Until the tooth has received its final restoration, avoid biting very hard foods on it. If a temporary filling becomes loose or falls out, contact the practice promptly.

Once restored, care for the tooth by:

• Brushing twice daily with fluoride toothpaste.
• Cleaning between your teeth every day.
• Attending regular dental examinations.
• Visiting the dental hygienist when advised.
• Avoiding using your teeth to bite hard objects.

Good oral hygiene and an appropriate final restoration are important for the tooth’s long-term survival.

Antibiotics do not remove infection from inside the root canal and are not routinely required for root canal treatment. They may sometimes be prescribed when there are signs that an infection has spread, such as facial swelling or systemic illness.

Your dentist will assess whether antibiotics are clinically necessary.

If a tooth cannot be restored or you decide against root canal treatment, extraction may be the main alternative.

The resulting gap may then be left, or replaced using a dental implant, bridge or denture where appropriate. Your dentist will explain the advantages, limitations and likely costs of each option.

An infected tooth will not normally heal by itself. Symptoms may become more severe, and infection can lead to an abscess, gum or facial swelling and loss of the tooth.

Seeking dental care promptly may improve the possibility of saving the tooth.