Endodontics (root canal treatment)

Endodontics, better known as root canal treatment, is the procedure used to remove the nerve and the infected tissue from inside a tooth. Every tooth has an inner space containing nerves and blood vessels, called the pulp. When that pulp becomes inflamed or infected, the tooth hurts and the infection can spread towards the bone.

The purpose of the treatment is to keep the natural tooth. Instead of taking it out, it is cleaned from the inside, disinfected and sealed, so that you can carry on chewing with your own tooth.

It is indicated when there is deep decay, a hard knock to the tooth, a very large filling that has reached the nerve, or an abscess. At Higienista Oral the first step is always an assessment with an X-ray, because not every toothache needs a root canal.

Signs that the nerve is affected

Nerve infection rarely appears overnight. These are the signs patients report most often:

• Spontaneous pain that comes on for no clear reason and is often worse at night.
• Sensitivity to cold or heat that does not settle when the stimulus is removed, but lingers for several minutes.
• Pain on biting or when clenching the teeth.
• Swollen gum near the root, or a small bump draining pus.
• The tooth darkens and looks different from the ones next to it.

There are also cases with no pain at all: the nerve has already died and the infection advances silently, only showing up on a routine X-ray. That is one reason not to skip check-up appointments.

How the treatment runs, visit by visit

The procedure is carried out under local anaesthetic and with rubber dam isolation, so that neither saliva nor bacteria reach the tooth while it is being worked on.

• Diagnosis. X-ray and testing to establish the condition of the nerve.
• Access and cleaning. The canals are reached, the infected tissue is removed and the canals are shaped with very fine instruments while being irrigated with disinfectant solutions.
• Medication, if needed. Where infection is active, a medicament is left inside the tooth and a further visit is arranged.
• Sealing. The canals are filled and sealed so bacteria cannot recolonise them.
• Build-up. The lost tooth structure is replaced and the definitive restoration is planned.

Some cases are completed in a single session; others need two or three, particularly molars, which have several canals, or teeth with an abscess. Your dentist will explain what to expect in your case once the X-ray has been reviewed.

Why a crown is usually needed afterwards

A root-treated tooth no longer has an internal blood supply and has also lost structure, both to the decay and to the opening made to clean it. It is left more brittle and at greater risk of fracturing when you chew.

That is why a crown is recommended for almost all molars and premolars: it covers the tooth, spreads the force of the bite and protects the work done inside. On front teeth, depending on how much structure is left, a composite restoration is sometimes enough.

Leaving a root-treated tooth on its temporary restoration for months is one of the most common reasons such a tooth is eventually lost.

Care after the procedure

• Some discomfort or tenderness when biting for a few days is normal and usually settles.
• Take medication only as it was prescribed to you.
• While the temporary restoration is in place, chew on the other side and avoid hard or sticky foods.
• Keep brushing and using dental floss as normal in that area.
• Contact us if the pain increases, if your face swells, or if the temporary restoration comes out.

If you have pain, sensitivity that will not settle or a darkened tooth, the next step is an assessment: we examine the tooth, take an X-ray and explain the options before any treatment begins. Book at Higienista Oral on 0312 4869987, by WhatsApp on 0312 4869987, or write to us at penaerika4872@gmail.com.