Purpose of Treatment
The aim of root canal treatment (RCT) is to save a tooth that has been badly damaged due to decay, disease or injury. Most people prefer to save their tooth because it will generally function better than an artificial tooth. Problems with biting, chewing and oral health are associated with losing a tooth. Losing a tooth can also lead to problems with speaking and possibly a change in appearance. Root canal treatment can aid in complex treatment by allowing attachment of a crown to the tooth.
Root canal treatment may take between 1 and 4 visits to complete, depending on the difficulty of the tooth and how quickly infection is relieved. Success of RCT also relies upon a person’s immune system functioning well.
Endodontic surgery may also be required when conventional RCT will not or has not completely eliminated infection. This involves a small exposure of the tip of the root of the tooth and both removal of residual infection around the tip and the sealing off directly of the root tip.
Alternatives to RCT
No treatment may result in continued or worsening infection and/or pain which can lead to destruction of bone around the tooth or spreading of infection through the jawbone or the tissues of the head and neck. The only alternative to RCT which relieves pain and/or infection is removal of the entire tooth (extraction). Antibiotics only help the body to control the size of infection but will not cure an infected tooth.
Risks
As with all dental treatments, root canal treatment has some risks and possible complications. Such risks and complications include, but are not limited to:
Difficulty locating and working in all suspected canals due to curves or calcifications. Sometimes there are extra canals which may be undetected.
Incomplete filling of all canals.
Perforation or penetration of the surrounding bone or tissue with RCT instruments. This usually reduces the long-term prognosis of the tooth.
Separation of RCT instruments within the root canals during treatment may require referral to specialist (endodontist) for removal.
Bad response of the patient’s body to some materials used during cleaning, disinfection and filling of roots.
Reinfection of the canal system which will prolong treatment by requiring extra appointments.
Fracture of the remaining tooth may occur before a final restoration can be placed. If the fracture is at root level, the tooth may need to be extracted.
Whilst root canal treatment can save most teeth, the dentist cannot guarantee that it will be successful in every case. If any of the above occur, treatment may continue with the knowledge that a lesser prognosis is expected, or the tooth may be removed right away or you may require referral to an endodontic specialist. A return of problems in the future may require re-treatment or endodontic surgery.
Teeth that have received RCT are somewhat weakened because of the loss of tooth substance and therefore normally require more complex restoration afterwards, such as a crown; this needs to be factored into the overall treatment costs. Sometimes RCT is done so that a predictable and strong filling can be attached to a tooth to support a crown restoration with a good long-term lifespan.