Demystifying root canal treatment by Dr Anthony Druttman

Will a root-treated tooth feel different?

The treated tooth is referred to as being dead because it has lost its internal nerve and blood vessels. However there is still a nerve and blood supply to the outside surface of the tooth, so the successfully root-treated tooth should feel normal.

Is there an alternative to endodontic treatment?

If you choose not to have root treatment, your affected tooth will be extracted. Should you fill the space? That depends on functional and aesthetic grounds. People today are aware of their mouth and smile, so someone displaying unaesthetic black gaps between their teeth may feel self-conscious about speaking or smiling. Back teeth may not be immediately noticed in a smile, but they are very important in terms of chewing function. Every tooth stabilizes the teeth adjacent to it and those immediately above or below. If it is removed and not replaced, other teeth may well shift from their natural positions. This will stimulate problems with gum disease, food packing (leading to further decay) and bite problems.

If a tooth needs extracting, what next?

Teeth can be replaced with bridges, implants or removable dentures and the possibilities should be discussed with your own dentist. Implants have revolutionized restorative dentistry and can be an excellent substitute for the natural tooth. The dental root has often been described as nature’s implant, so wherever possible existing teeth should be kept in place. However there are situations when it is neither feasible nor cost-effective to keep the tooth. The options have to be considered carefully either by your general dental practitioner, or by an endodontics specialist.

How successful is endodontic treatment?

Nobody can guarantee success. However when the endodontic treatment and the restorative treatment that follows it are both carried out to a high standard, long-term success is very likely. Failure would be caused by the leakage of bacteria into the root canal system or by mechanical failure i.e. fracture of the remaining tooth.

Should endodontic treatment fail, it may be possible to re-treat the tooth. If further treatment is impossible, the tooth may require extraction. Endodontic re-treatment may be carried by your own dentist or by an endodontist, depending on the particular problems and reasons for the failure.

General dentist or root canal specialist?

General dentist are trained to carry out root canal treatment and many of them do this to a very high standard. Whether root canal treatment is carried out by your regular dentist or an endodontics specialist will depend on many factors. Is your dentist skilled, experienced and confident in performing these kinds of procedures? Is it a straightforward treatment or are there complications? The molar teeth have a more complicated root canal system than the front teeth (incisors and canines), are harder to access and may require more specialized equipment.

While endodontics specialists are usually more expensive, their training and experience enable them to deal more easily with complications. In many cases, this involves re-treating teeth where the original root treatment has failed.

Dr Anthony Druttman, Endodontics Specialist, www.londonendo.co.uk

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BIO:

Dr Anthony Druttman is a specialist in Root Canal Treatment, operating from two practices in Central London UK. He offers Endodontics services to other dentists as well as directly to patients.

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