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Root Canal Treathment



   Root canal treatment (also known as endodontic therapy) aims to clean, shape and fill the entire root canal of a tooth. A root canal infection can be caused by several things, including decay, injury and possibly also gum disease. Root canal treatment can repair your damaged tooth without it having to be removed.


   The aim of root canal treatment is to get rid of the damaged pulp and the bacteria that are causing the infection. It involves removing inflamed or dead nerves and blood vessels from the centre of your tooth. This is done by drilling a hole through the top of your tooth to the root canal and removing the dead tissue. The empty root canal system is then cleaned, filled and a permanent seal put over the top of your tooth. The procedure may be carried out over one or two visits to your dentist.


   Why have root canal treatment?


   Your teeth have a core of blood vessels and nerves at their centre. This living tissue is called the pulp and is in a space called the root canal. The number of root canals varies depending on how far back the tooth is in your mouth. Front teeth often have just one root canal, while back teeth may have three or more.


   If your tooth is injured or has severe decay, the pulp can be damaged and the blood vessels may die. This results in a "dead" tooth which is likely to get infected because it's no longer protected by your immune system.


   There are a number of ways that a tooth's pulp can be damaged. These include:


             * decay

             * gum disease

             * injury

   All of these conditions can lead to bacteria getting trapped in your teeth. There is then the possibility that the tooth pulp will become infected, causing blood vessels and nerves to die.


   Without treatment, a collection of pus (abscess) can form at the root tip. This can lead to pain and swelling and may cause damage to the bone around your tooth. If you don't have treatment to remove the infected tissue, you may have to have the whole tooth taken out (extracted).


   What are the alternatives?


   Your dentist may not always be able to repair your tooth with root canal treatment. This may be the case if your tooth is very seriously damaged by decay or injury or if you have gum disease meaning that your tooth isn't well supported. Your dentist may recommend that you have the tooth taken out instead.


   What is involved?


   Your dentist will take an X-ray image of your tooth to check whether or not you definitely need root canal treatment. This can help to show how far any decay has spread, if there is an abscess and how many root canals your tooth has.


  If you have a dead tooth or one with severely damaged pulp, root canal treatment may be the only way to repair it. However, it's important to discuss with your dentist what is involved in this treatment before deciding to go ahead with it.


  If you do need to have root canal therapy, your dentist will give you a local anaesthetic. This completely blocks feeling from the area and you will stay awake during the procedure. It may not be necessary to have an anaesthetic if your tooth is dead but your dentist will discuss this with you.


   Your tooth will be separated from the rest of your mouth using a thin sheet of rubber called a dam. This keeps your tooth dry and protects your airway. It also allows effective cleaning of the root canal system and prevents it from becoming contaminated again, which can cause infection later.


   Your dentist will first make a hole in the top of your tooth through which the dead or diseased pulp is removed. The empty pulp cavity is then cleaned and your dentist may also put in some medication to help get rid of bacteria.


   It may be that this is all your dentist does at your first visit - if so, he or she will put a temporary filling on your tooth to keep it sealed until you go back for further treatment. However, your dentist may decide to fill the cavity immediately if the root canal infection hasn't caused you any serious problems.


   If you have had a temporary filling, when you go back to your dentist he or she will remove this and then fill the root canals with a suitable material. This is likely to be a putty-like substance called gutta percha. A permanent filling or crown is then placed over the top of the tooth to protect your filled root canal and the vulnerable tooth structure. You will often be recommended a crown made from gold or porcelain. If your dentist thinks it's necessary, he or she may also place a metal or plastic rod inside the canal to help support the crown.


   After the procedure


   You may find that you have some discolouring in the tooth that has been treated, although this is less common now as techniques have advanced. However, if your tooth does discolour, you may be able to have treatment to correct it.


    After treatment it's important that you take care of your repaired tooth as you would any other. Brush your teeth at least twice a day and visit your dentist regularly.


   What are the risks?


   It's unlikely that you will have any further problems following root canal treatment. However, if your tooth does become infected again, your dentist can repeat the procedure, although the rate of success is reduced with subsequent treatments.


   Very occasionally after root canal treatment, you will still have inflammation at the tip of your tooth. You may need to have a procedure called an apicectomy to remove the root tip.