A Root canal Treatment (RCT), also referred to as endodontic treatment, is a procedure to remove the infected pulp (nerves, blood vessels, and connective tissues) from inside a tooth. An opening is made on the surface of the tooth to remove the diseased and dead pulp tissues from inside the tooth. The root canal is cleaned, shaped and decontaminated using instruments and disinfecting solutions.
After the initial cleaning, if the dentist feels that bacteria still persist inside the tooth, a medicament is placed in the area to eliminate them completely. Antibiotics may also be given to treat and prevent infections.
The root canal is then filled with rubber-like material using an adhesive cement to seal the canal completely. It is mandatory to place a dental crown on the tooth after Root Canal Treatment.
When is this procedure recommended?
A Root Canal Treatment is recommended to repair and save a tooth that has been badly damaged, due to tooth Decay, trauma, a fractured restoration, Periodontitis extending into the tooth pulp, or a worn down tooth exposing the pulp.
What is the Advantage?
A properly executed Root Canal Procedure helps prolong the life of a dead/infected tooth against an alternative to extracting and replacing it with a denture or dental bridge/implant. The long-term success rate of a root canal treated tooth is 85 – 93% whereas that of a re-root canal treated one is 50-75% at best.
Reason for the Failure of Root Canal Treatment
- An extra canal in the tooth beyond what would normally be expected
- When the root canal is under filled or when root canal filling materials inadvertently extrude beyond (overfilled) the apex the root of a tooth
- Iatrogenic errors, such as poor access cavity design/preparation
- A breakdown or leakage of a restoration
- Unusual anatomy of a tooth
- Accidental instrument breakage inside a tooth
- An anaerobic infection that does not easily resolve
- What to do when a Root Canal Fails?
When a Root Canal Treatment fails, a Root Canal Re-treatment can be performed. A specialist in Root Canal Treatment or an Endodontist is the best person to treat such cases. Sometimes a surgical intervention like apicoectomy (root resection) may become necessary.
The success of Endodontic Therapy
The success of Endodontic therapy depends on many factors, including patient compliance and the condition of the tooth prior to treatment. Case selection should be done carefully based on the clinical scenario, x-rays and history of the patient. Instead of extracting and replacing a damaged tooth with a denture or dental bridge/implant, priority should be given to save the natural teeth.
How to avoid Failure?
- Avoid the use of a root canal treated tooth for chewing hard food
- Ensure regular follow-up visits
- Place a dental crown immediately after Root Canal Procedure to avoid tooth fracture and reinfection.
Compliance of all the instructions given by your dentist, including taking the medications exactly as prescribed and reporting to your dentist when any discomfort arises will help avoid complications after a Root Canal Treatment