Teeth are held in the jaw by their roots. Front teeth normally have one root but teeth further back will have two, three or four. Inside, there are nerves and a blood supply in the ‘root canal’. When the tooth is healthy, the nerves are alive but decay or injury can cause the nerves to die. A dead nerve inside a tooth can cause an abscess at the end of a root. The objective of a root filling is to remove dead or damaged nerves along with any bacteria within the canals. The space that is left can then be filled and the tooth repaired. – It should be noted that a tooth that has reached this stage is not a whole, complete or healthy tooth.
What will NHS Dentist do?
- An x-ray will show the shape of the root canals and whether there are any signs of infection in the surrounding bone. Some tooth roots are easier to fill than others because of their shape Sometimes the x-ray will show that a root filling will not be successful. Your dentist will discuss this with you
- You will receive an injection to numb the area. As a general rule you should not eat or drink hot drinks until the injection has worn off
- A hole will be made in the tooth and enlarged until the opening to the root canal can be seen
- Narrow files will be used to find all the root canals and remove the dead or dying nerves
- Further x-rays will be taken to measure the length of the root canals
- You may have to come back for a second appointment, in that case the roots will be filled temporarily. Generally the roots will be filled with gutta percha permanently on the first appointment
The tooth may well be tender for up to 48 hours and you might need to take painkillers. It is advisable to leave yourself free for the rest of the day and evening as some people feel under the weather after a root canal treatment.
What are the benefits?
- Nerve damage can cause severe toothache but the pain will end quickly when the root canal is cleaned out
- Without a root filling, a tooth with a dead nerve would probably have to be extracted
- In approximately 80-90% of cases root fillings are successful and will extend the life of a damaged tooth
What are the disadvantages?
- During the course of treatment and between visits, the tooth being root treated may break or fracture due to its weakness. Most fractures are repairable. However if the breakage is severe, the tooth may need to be extracted
- Pain after the procedure
- Sometimes there can be a recurrence of an infection (the tooth will ache and become painful to bite on). Difficulties can prevent some teeth from responding to the treatment. The dentist can advise on the likely success of the procedure and difficulties prior to the procedure
- It should be noted that if a root treatment fails then ultimately the tooth may need to be extracted
- The metal files used to take out the nerves can fracture in the canal. If this happens, it is normal procedure to inform the patient, make a note on the file to watch this tooth for any signs of pain or infection and then fill the remaining part of the canal. Should the tooth display negative signs at any time in the future, a re-root treatment will be needed. This may be done by the dentist or you may be referred to a specialist
- It is also possible for the gutta percha point to go through the end of the root. Should this happen, you would be notified, a note will be made on your file and no further action would be taken. Studies show that this does not affect the general outcome of the treatment