Root canal treatment

Root Canal Treatment: Pros and Cons

A root canal treatment is a dental procedure that can be done to treat a tooth with an infected or damaged nerve. The main advantage of a root canal treatment is that it can prevent the extraction of a tooth or molar. A root canal treatment also has a low risk of complications, making it an attractive option for many people. However, it's important to note that the success rate for root canal treatments varies by individual and by the stage of the inflammation. The procedure itself is not painful, but pain after a root canal treatment can occur once the anesthesia has worn off. 

What causes tooth or molar pain?

Toothache is a condition that causes pain in the mouth. The pain can be caused by many different factors, such as tooth decay/infection. There are many symptoms of toothache, such as:

• Tooth sensitivity when chewing
• Tooth sensitivity to hot and cold food
• Tooth sensitivity to sweets
• Redness or swelling around the jawbone area.

What is a root canal treatment and how does it work?

A root canal treatment is a dental procedure in which the diseased pulp tissue and nerve from the tooth are removed. Root canal treatments are used to save teeth and/or molars with irreversible tooth decay or damage. The procedure for root canal treatment begins with a dental examination to determine which tooth needs to be treated and to establish the extent of the disease in the tooth pulp. Root canal treatments can be performed on any tooth/molar in the mouth.

Within the roots of your teeth and molars runs the root canal. This contains nerve fibers and small blood vessels. This is called the pulp and it can become inflamed. If this infection persists for a long time, the jawbone around the teeth and molars can become inflamed and even be partially lost. When this happens, teeth and molars can become loose and eventually fall out. To prevent the tooth or molar from having to be extracted, it is important that the root is cleaned from the inside. The root canal treatment can be carried out by our dentists and in some unique cases can be outsourced to a specialist. For a root canal treatment, our dentists go through the following steps:

• First, the tooth or molar in question is carefully anesthetized;
• Next, an opening is drilled to the root canal. Existing fillings and crowns must be removed during this process; 
• As much infected tissue as possible is removed by rinsing with a chlorine solution to thoroughly clean the root canals and kill bacteria;
• The canals are filed to the correct length with electronic files and then filled with rubber pins;
• Ultimately, the treated tooth or molar is restored, either with a filling or a crown (sometimes the old crown can be reused) and possibly a post build-up. If initially a filling is chosen, it may be possible that a crown will be applied in the future due to the risk of a fracture in the vulnerable tooth or molar; 
• X-rays are important for monitoring to see if the treatment has been successful. 

Pain after root canal treatment and other complications and risks 

Root canal treatment is generally performed successfully and without issues, but sometimes complications arise. It may happen that the inflammation does not disappear and comes back. The dentist will then check if the root canal treatment needs to be redone, or if surgical intervention is required, or if the tooth or molar has to be extracted. When, prior to the treatment, the crown or post has to be removed, it can get irreparably damaged, meaning it needs to be replaced in the future. It can also occur that a tooth or molar gets damaged during the procedure or weakens and breaks after the treatment. The tooth or molar then needs to be restored. In rare cases, perforations can occur creating unintended openings to the gums or jawbone, or rinsing fluid might be pressed through causing pain or swelling.

Root canal treatment or extraction? What are the alternatives?

A root canal treatment is done to preserve a tooth or molar that might otherwise need to be extracted. If you don't want a root canal treatment (yet), the following alternative treatment options are available:

• Wait for clearer symptoms. However, this runs the risk of the infection spreading, further weakening the tooth or molar, which can lead to the damage of other teeth, molars, or the jawbone.
• In some cases, an apex resection might be a solution. This involves removing the tip of the root and a bit of the surrounding tissue.
• Extraction of the tooth or molar.

If treatment is not pursued and the infection persists, the jawbone around the teeth and molars can become inflamed and partly deteriorate. If that happens, teeth and molars can become loose and eventually fall out. Consult with our dentists to determine the treatment that fits your situation.