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NHS Dental Care

Endodontics

Root canal treatment involves removing infected tissue from your tooth, cleaning it and then filling it to prevent further damage or infection. Root canal treatment can save a tooth that would otherwise have to be taken out.

If the nerve (part of the pulp) inside your tooth becomes infected this can spread to the root canal and your tooth may become extremely painful. The infection can spread further to cause a tooth abscess, which is a collection of pus. This can be painful and tender when you bite down on your tooth and can cause swelling around your tooth and jaw. Sometimes your tooth may look darker in colour than your other teeth, which means that the nerve inside your tooth is dead or dying. Without treatment the infection may spread further into your jawbone and you may need to have the tooth taken out.

The aim of endodontic treatment is to remove the bacteria and damaged pulp  that are causing the infection. Your dentist will drill a hole into the tooth and then access the root canal area below to removed the infected tissue. The canal is cleaned and  disinfected. The canal is then filled with a sealer and a filling is placed on the top of your tooth. Several radiographs are needed to check the shape and length of the root canals during and after the treatment. 

Endodontic treatment can save a tooth which would otherwise need to be taken out. When a tooth is removed it can affect how you look and also how well you chew.

root canal

Possible side effects of root canal treatment

As with all dental and medical treatments, root canal treatment has risks. The following list of possible side effects is intended to inform you about some of the potential problems. As other uncommon complications may occur, the list is not complete. If you have any concerns about possible risks or complications, please do not hesitate to ask for more information.

  • Loss of tooth: While root canal treatment can save most teeth, it is not possible to guarantee that it will be successful in every case.
  • Infection: Infection is likely to resolve completely but re-infection is possible, but low. If the tooth is re-infected, it can be treated again or removed.
  • Discolouration: In some cases the tooth can become darker, which can be treated by bleaching, or an artificial crown or veneer.
  • Pain or discomfort: Some people may continue to have pain or discomfort around the tooth during and following treatment. If pain is severe or lasts more than a few days, additional treatment may be needed.
  • Weakness: An endodontically treated tooth may be not as strong and durable as a normal tooth. This especially true for the back teeth (molars) and this is why a crown is recommended.
  • Altered feeling: During and after treatment, the tooth may feel slightly different from the other teeth. This should disappear gradually. If feeling persists, further treatment may be needed.
  • File fracture: Special metal files are used to clean the inside of the root canals. These instruments are very fine and occasionally may break during use. Special procedures may be needed to remove the broken portion of the file, or you may be referred to a Specialist. In some cases, it may not be possible to remove the fragment. 

Most people prefer to save their tooth because it generally will function better than an artificial tooth. Your own tooth is usually stronger and more efficient for biting and chewing. Cleaning and maintenance of a natural tooth are much easier. However a good dental implant, bridge, denture or gap can be an alternative treatment option to root canal treatment.

Why does my dentist want to refer me to a Specialist or Dentist with Special Interest in Endondontics?

Root canal treatments range from simple to complex with individual cases requiring more advanced care than your general dentist is able to perform successfully. In such cases your dentist has a duty of care to refer you to ensure the best standard of care.

Will this be more successful for me? Generally, yes. The chances of success are very high under the best circumstances, over 95%, but there are no guarantees. Each case must be judged on its own merits. Evidence-based studies suggest that endodontists achieve greater successes due to their experience, expertise and equipment.