What is Root Canal Therapy?

At a glance:

  • A tooth has hard dentine and enamel on the outside and soft pulp on the inside.
  • Dental pulp is a spongy tissue filled with nerves and blood vessels and helps supply nutrients to growing teeth.
  • If the dentine is damaged in some way, such as through decay or trauma, the pulp may become infected.
  • Root canal therapy is a procedure in which the infected or damage pulp is removed so the tooth can be saved.
  • A tooth can survive and function without pulp, and a natural tooth often functions better than an artificial replacement.
  • Root canal therapy may be performed by a general dentist or an endodontist - a dentist with a specialty in conditions of the pulp.

What is a Root Canal?

Inside each tooth is a mass of soft, spongy tissue known as dental pulp. The pulp is a vital part of the tooth as it is responsible for providing the tooth with both nutrients, blood and nerves. If the tooth becomes damaged in some way, whether it is through decay, disease or trauma, the pulp may become infected.

If infected pulp is not treated the infection may spread to surrounding tissues, leading to complications such as an endodontic abscess, jaw bone loss and/or losing the infected tooth. An endodontic abscess is a pocket of pus that develops when infection spreads from the tooth into the surrounding bone of the jaw. This infection may also lead to the degradation and loss of bone in that area.

Luckily pulp is primarily responsible for delivering nutrients to a tooth while it is growing. Once a tooth has fully grown and hardened, nutrition for the tooth is delivered by the tissues surrounding the root, so the pulp can be removed from the tooth to save from further infection or damage. An adult tooth can function perfectly well without pulp so long as it is taken care of.

A root canal is the removal of the dental pulp and filling the empty pulp chambers with a permanent barrier material. The procedure may be performed by a dentist or a specialist endodontist, a dental practitioner specialising in treatment of issues of the tooth pulp.

When is a Root Canal Required?

A root canal treatment may be required when the pulp of a tooth is damaged or infected. An appointment with a dentist is required for diagnosis, as a number of tests, including manual inspection and x-ray, need to be conducted to see if the tooth requires root canal therapy or may be treatable in some other fashion.

The pulp may become infected or damaged via a number of means, including decay, injury, repeated dental work on the same tooth, cracked or lost fillings, gum disease, habitual tooth grinding or trauma to the tooth caused by other means. 

Although having a tooth removed may, in some cases be a more immediate and cheap fix for the problem, saving a tooth is usually a much better option in the long run. Natural teeth often function better than replacements or dentures when it comes to biting or chewing. Replacing teeth may also require more extensive and invasive treatments in the future, such as implanting a titanium post into the jaw so a replacement tooth may be mounted on it.

Symptoms Indicating You May Need a Root Canal Treatment

Damage or infection to the pulp of the tooth may cause a number of symptoms, including:

  • Pain in the tooth - the pain may be unprovoked and sudden, continuous or flare when chewing or biting
  • Overt sensitivity in the tooth - may be especially apparent when eating or drinking hot or cold food or drink
  • Gum issues near the tooth - the gum may become inflamed around a damaged or infected tooth or pockets of pus may form in the gum around the root of the affected tooth
  • Loose tooth - an infected tooth may become loose
  • Inflammation - the gums or face may become inflamed in reaction to infection

If you exhibit any of the above symptoms, scheduling an appointment to see a dentist is a must.

A root canal may not be required to treat the problem, but the more you put off dental treatment the more likely expensive procedures are going to be needed to treat any oral health issues you may have.

What Happens During a Root Canal Procedure?

A root canal procedure may require a number of appointments to complete depending on the complexity of the tooth and extent of the damage. No matter how many appointments are required, a root canal treatment is typically broken into a handful of steps:

  1. X-ray - the tooth is x-rayed to see the extent of the damage and infection, the shape of the pulp chambers, and if there is any damage or infection to surrounding tissue or bone.
  2. Removal of infection/pulp - the area is anaesthetised and an opening is made in the tooth so the infected pulp and any other infected material, such as pus, may be removed.
  3. Shaping the pulp chambers - once all the infected material has been removed, the pulp chambers need to be shaped into smooth channels so that the filling can be effective and there are no hidden rough patches for any residual bacteria to hide and propagate. The shaping is accomplished with mechanical tools as well as specialty disinfectants and may require multiple treatments to remove stubborn bacteria.
  4. Filling the tooth - once the pulp chambers have been shaped and all traces of bacteria have been removed, the tooth is then filled with a long lasting material that acts as a barrier against future infection. During this part of the procedure supports may be placed in the root to give the tooth extra strength and stability.
  5. Restoring function to the tooth - once the pulp chamber has been filled and sealed, the final step is to make the tooth fully functional again. This is accomplished by repairing any cracks or damage in the tooth and capping it with a filling or crown. The exact measures that are needed to restore functionality depend on the condition of the tooth prior to the root canal.

Once all these steps have been taken the tooth should be fully functional and should not require further treatment so long as standard dental hygiene rules are followed - brushing twice a day and flossing.

The only potential side effect of having a root canal is discolouration of the tooth. A healthy tooth with pulp is typically a yellowish off-white. A tooth that has undergone root canal may turn greyish over time. If this is an issue there are a number of ways you can safely whiten your teeth .

How Much Does Root Canal Therapy Cost?

Having a root canal is not cheap, with prices in Australia averaging around $450 for a single canal treatment. On top of the treatment fee there are also additional costs for assessment, anaesthetic, caps or crowns and the like, so a root canal for a single tooth may cost $1000 or more to fix. As with all dental treatments, root canal therapy isn’t covered by Medicare, though some private health cover may apply depending on the policy.

Despite the price, saving a tooth is far more cost effective in the long term than having teeth replaced, or even doing without. A single tooth replacement dental implant can cost between around $3000 and $6000 in Australia, and more complex replacements (such as a dental bridge) can cost a great deal more. The cost of dental implants can run into the tens of thousands. Having teeth pulled can lead to problems chewing or points of possible infection in the gums.

Of course, the most cost effective thing you can do for your teeth is take care of them and schedule regular checkups with a dentist so you can take care of any problem before they become dire. 

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