Is needing a root canal treatment, really as bad as it sounds?

“You need a root canal treatment” is one phrase that patients read to hear from their dentist. All sorts of questions will go on through your mind and may be worth receiving advice and further scaremongering from work colleagues, family and other acquaintances.

You may even have had a bad experience with having a root canal treatment from a previous dentist, so, let’s separate the fact from the fiction.

There are other names for a root canal treatment. These come under:

• Taking out the root
• Taking out the nerve
• Endodontics
• Endo
• Treating / filling the roots

However the words “you need a root canal treatment” should really be a blessing in disguise because the alternative is an extraction where you lose the tooth and end up with a gap in your mouth. A root canal treatment should really be translated as the last attempt possible in order to keep a tooth going.

Before you have a root canal treatment carried out on your tooth, it is important to know what the treatment entails. Therefore, we will look at the following:

We will look at, when you may need a root canal treatment

A root canal treatment is needed when decay has gone so deep that the pulp or nerve inside the tooth has become infected which leads to an abscess forming. An abscess may already have formed but a root canal treatment can still be carried out. The earlier a tooth is diagnosed as requiring a root canal treatment, the better the chances of it having a successful outcome. Conversely, if infection is long-standing or very severe, then the chances of a successful treatment outcome is reduced accordingly.

Apart from Deep decay in a tooth, are there any other reasons why you may need a root canal treatment? The answer is yes, there are many other reasons as well.

One obvious reason may be that you have already had a root canal treatment in a tooth before and has not worked, there is always the option of having a root re-root canal treatment. 

Another fairly common reason comes under the heading of trauma. Quite often, if a front tooth receives a knock or a blow, the nerve or the pulp inside the infected tooth can die or become necrotic. In these instances, a root canal treatment will be necessary.

With around 20% of teeth which have had previous crowns or veneers carried out to them including large fillings, it is not uncommon to find that they need a root canal treatment.

Overall, root canal treatment does have a good success rate. 

We will look at any other alternatives that you could also consider

The most obvious alternative to having a root canal treatment carried out is obviously an extraction.

Sometimes if the decay in a tooth is deep however the dentist pay decide to carry out a procedure called a pulp cap. The reason why a pulp cap may work is because a part of the tooth does have an inherent ability to defend and repair itself against acid attack and bacteria. Having a pulp cap done is much quicker and easier than having a full root canal treatment. However, sometimes they work and sometimes they do not work because it depends on how far the decay has progressed.

Sometimes, even after a pulp cap has seemed to have worked, but the tooth can start giving problems months or years later down the line.

We need to look at how a root canal treatment is carried out

The words root canal treatment is associated with excruciating pain and lengthy appointments. It is true that in the past, root canal work was unpredictable, painful and many lengthy visits were required. Modern day root canal treatment is performed in one visit and is no worse than having a normal filling. The reasons for this difference is better equipment, techniques and a better understanding about how root canal treatment works and the causes of failure.

I was the first dentist in the whole country to start using Rotary Endodontic Files which was a major breakthrough in this kind of treatment. Rotary endodontic files started getting used in America but eventually they were introduced in the UK. Before the modern day rotary endodontic files came normal practice, I still used to use a piece of equipment called the gyromatic endodontic file. You could say this was in between using hand instrumentation and the full rotary instrumentation that we see now.

Even when I started using it, other dentists were sceptical and I got criticism for using an endodontic motor. The ironic fact is that these same dentists then started to ask me to teach them in this new technique. Using this technique I have saved thousands of teeth which otherwise would have been extracted.

The treatment allows the pulp to be removed and all of the infection followed by filling in the space with a paste like material which sets hard. This means no further infection can enter or spread and the tooth is saved. 

Once the root canal has been completed and x-rays taken to check its seal, the tooth is either built back up with a traditional filling or more commonly a crown to provide the best protection for the tooth.

Sometimes, a dentist may use a rubber Dam to isolate the tooth before carrying out a root canal treatment. This does prolong the procedure because a piece of rubber goes over the tooth in order to isolate the tooth from the other teeth. Up-to-date, there are no convincing scholarly papers to actually prove that using rubber Dam has a significantly higher success rate between those who do and those dentists who do not use rubber Dam.

The fact is that most dentists do not like to use rubber Dam and therefore don’t use it to carry out root canal treatment. The current guidelines state that you should use rubber Dam before carrying out a root canal treatment.

Treatment is carried out by numbing the tooth up in exactly the same way as you would do when having an ordinary filling placed in your tooth. In terms of how it feels, the procedure is exactly the same as having a normal filling done except that it takes longer. It takes longer to clean the tooth and also additional X-rays are taken during the procedure itself.

Although it is best to complete the procedure in one visit as it has been shown to have higher success rates, some dentists still will spend and more than one visit and even several visits on just one tooth alone. Also, if you need more than one root canal treatment, there is absolutely no reason and in fact it is a good idea to have all of them carried out in one visit.

In addition, will the treatment work or can problems arise afterwards

Like all dental treatment, there is never any 100-percent certainty or guarantee that the treatment will be successful. We have done hundreds of root treatments over many years and these treatments are still functioning after many years. These patients are also grateful that they did not have the teeth extracted and they still retain those teeth today.

Importantly, we will also look at the costs and fees involved

The main disadvantages of needing a root canal treatment are the costs as it will cost more than a normal filling due to the extra attention involved and the use of extra more expensive equipment and also the materials. However I believe that this cost still makes it much more sense because the alternative such as extractions, dentures, bridge work and implants are more lengthy, costly and uncomfortable.

Our practice will always give you a full treatment plan and this includes a description of the procedure and the full costs involved.