For some people, when the dentist says “You need a root canal treatment”, this is met with dread and anxiety. There is often a strong association with root canal treatment and pain. However, root canal treatment is actually performed to relieve pain.
When is a root canal treatment necessary?
The core of every tooth contains the pulp which is made up of nerves and blood vessels. Dental disease such as decay, gum disease or even trauma (a knock to the teeth) can cause damage to the pulp which can lead it to become infected and lead to the death of the tooth pulp. As the pulp is dying, this can cause an excruciating toothache (although sometimes the nerve of the tooth can die silently without any pain at all). When the pulp is damaged beyond repair, performing a root canal treatment can eliminate the pain and clear infection. The root canal treatment saves the tooth as the alternative to having a root canal treatment is usually extracting the tooth.
Will it hurt during the root canal?
A root canal treatment is always done under local anaesthetic which numbs the tooth and surrounding tissues so the procedure is painless. It is common to experience discomfort for a few days afterwards as the tissues heal and the infection is cleared. This can usually be managed by over-the-counter pain killers such as ibuprofen or paracetamol.
If the tooth that requires root canal treatment is severely infected, sometimes the local anaesthetic will not work as effectively. If your dentist is unable achieve complete numbing, they will not continue with the procedure. They may ask you to come back after the infection has settled down. You may receive antibiotics to help manage the infection.
What does a root canal involve?
A root canal treatment usually takes a few dental visits to complete. We can divide them into 3 stages:
Stage 1. Open and drain
This is the first part of the root canal where a hole is drilled into the tooth and the infected nerve is removed. If you had a toothache beforehand, this part will relieve the toothache. You may still feel sensitive or tender in the first few days after this procedure is performed.
Stage 2. Cleaning and shaping
The next part of the root canal is to disinfect the root canal system using special files and disinfecting solution. It is important for the root canal system to be free from as much bacteria as possible to maximise the chance of success of the root canal treatment. The tooth is also shaped to receive the root canal filling.
Stage 3. Filling
A filling is placed where the pulp of the tooth used to be, sealing off the inside of the tooth to bacteria that is in the mouth.
Sometimes, one stage can take more than one visit or two stages can be combined into the same visit. This might mean that your root canal treatment is longer or shorter than average. Your dentist will discuss with you how long your root canal may be expected to take.
Do I need a crown after the root canal?
A tooth with a root canal treatment is more delicate than a healthy tooth. This is because root canal treated teeth usually had large cavities beforehand. You may also bite with more pressure on root canal treated teeth after the nerve has been removed. This makes the tooth more likely to break or crack in the future. Cracks can cause the root canal to fail and the infection to return. This sometimes means the tooth has to be extracted. A crown is made of a strong material that helps to hold the tooth together and reduce its chance of breaking in the future. Think of it like taking out an extra insurance policy on the tooth!
I don’t have any pain right now, do I still need a root canal?
A dentist might tell you that you need a root canal even though you have no pain. This is usually because the nerve of the tooth is dead and is no longer transmitting sensation signals to the brain. Signs that you may need a root canal include:
- A previous toothache
- Pain on biting on a tooth
- Discolouration or greying of a tooth
- A recurrent or persistent pimple in the gum
Sometimes there will be no symptoms at all. Leaving a tooth that needs a root canal can lead to a painful abscess. In some cases, a tooth infection can become life-threatening when it spread to parts of the jaw or brain, requiring urgent treatment.