Root canal treatment (endodontic therapy) is a odontological method of treatment where inflamed or dead tissue in the root canal of the tooth is extracted and replaced. The goal of the treatment is to hinder the development of an infection spreading to the bone around the tooth.
Sometimes a cavity or damage to the tooth has penetrated all the way into the nerve ending and infected it. Another, less common cause, is that the dentist has drilled too deep by accident.
The nerve ending, connective tissue and the veins in the afflicted tooth will – if exposed for too long – die. The bacteria colonize the root canals and spreads into the bone surrounding the tooth. We cannot effectively fight the bacteria ourselves and the infection can become quite serious if left alone.
Puss will start emerging from the root canals, but there may no be any pain. Often the dentist will find teeth in need of root canal treatment before the patient notice any pain or discomfort. However, if left alone the infection will spread, causing pain all along the jaw bone and creating a tooth abscess.
The root canal treatment entails removal of the soft tissue inside the tooth, thorough cleaning and the inserting of a bactericidal substance. Lastly the canal is filled before restoration of the crown begins.
Cleaning of the root canals usually requires several visits. If the pain returns after treatment with the bactericidal substance, the filling is removed and the root canals are cleaned again.
During your first visit we ensure that the area around the tooth is anesthetized. If any of the nerve endings are still alive, we will also apply anaesthesia.
We use a dental dam to ensure a clean and safe working environment. The dental dam prevents bacteria from traveling from the oral cavity and to the tooth. It also prevents the patient from getting any chemicals or instruments down their throats.
We always use a microscope with powerful lights and magnification during root canal treatments. This is an essential tool for ensuring a proper treatment. The use of a microscope will reduce the risk of discolouration and unsuccesful root canal treatments.
We use an apex locator to determine the length of the root withing an accuracy of 0,5 mm.
We continue by cleaning the root canals mechanically (Bio-RaCe) and with chemical solvents (NaOCL, chlorhexidine and EDTA-c). The solvents are strong disinfectants and also serve to grease the mechanical files we use. X-rays are also used to ensure that the canals are cleaned properly.
Erbium YAG laser with PIPS system is used to aggitate the solvent. The root canals are then filled with a temporary inlay (CaOH2) which is very basic and have disinfecting and soft tissue dissolving properties inside the root canal, and healing properties outside.
A temporary white cement ensures that the tooth is sealed and after 1 week to 3 months the patient returns for further cleaning or filling of the root canals.
During the second visit the temporary filling is removed and exchanged for a permanent root filling – gutta-percha. Gutta-percha is based of natural rubber and seals the root canal and denying any bacteria access to the root canal, preventing further infections.
Normally there should not be a significant amount of pain after a successful root canal treatment. The treatment is however to be regarded as an amputation and it is not unusal to experience som sensitivity and tenderness after the treatment.
In rare cases the infection can return, and it is not fully understood why this happens to about 5 % of patients. If, after the treatment, you experience swelling and pain, we can provide painkilling medicines, penicillin or other antibiotics to combat the infection.
Phantom pains and additional canals
After the root canal treatment the soft tissue and nerve endings in the tooth is removed. The tooth therefore will not be able to experience any pains. There are, however, some cases where the tooth continues to hurt after the treatment. This could be caused by undiscovered canals in the tooth.
We use a microscope, halogen lights and powerful amplification during root canal treatments to prevent the risk of canals going undetected.
Even after a successful root canal treatment the nerve cell that was connected to the tooth is still there. Nerve cells are like starfish with many and long “arms”. The root canal is at the end of one such “arm”. In some cases pain can occur even if the nerve endings are removed from the tooth in question.
The cost of the treatment will vary on a case-by-case basis. We will provide you with an estimate based on a consultation and examination. If complications arise the cost may exceed the estimate, but most root canal treatments are successful and without any complications. If necessary, we can refer you to specialists for further treatment. See our price-list for further details.