Your teeth are calcified objects with a hollow space within. The hollow space is known as the pulp chamber, which comprises of the nerves, arteries, veins, lymph vessels and connective tissue that nourish the tooth.

The nerve of each tooth enters at the tip of its root and runs through the centre of the root in small root canals that merge ultimately with the pulp chamber. The number of canals varies according to the teeth. Generally, the front teeth have a single root canal while molars often have three or more canals.

A root canal treatment is performed when the pulp tissue of the tooth has become infected, this is done to prevent the formation of an abscess and the eventual spreading of the infection to the surrounding tissues.

If the tooth is left untreated it leads to the formation of an abscess, which is the collection of pus as a result of the multiplying bacteria, and it pushes beyond the root tips. As the abscess expands within the bone, the tooth rises slightly out of its socket making it feel tender when you bite down. Without treatment, this infection can further spread to the surrounding tissues and nerves resulting in symptoms of:

• Nausea
• Fever
• Difficulty in swallowing

Root canal treatment removes the infected pulp and disinfects the pulp chamber thereby stopping the spread and formation of further infection.

Root canal treatment can be needed on a tooth is needed for a variety of reasons, such as:

• untreated tooth decay - causing bacteria to spread into your tooth and infect the pulp
• Injury – a knock or blow to the tooth, which in turn affects and infects the pulp
• tooth breaks or fractures off at/near gum level. In order to build up with a retentive restoration (a post and crown), the tooth would first need to be root filled
• exposure of the nerve during routine dental treatment, if a cavity is quite deep, sometimes the nerve can become exposed when removing the decay

What are the indications for a root canal treatment?

By Symptoms

• Persistent toothache
• Presence of tenderness in your gums near a tooth
• Presence of swelling in your gums near a tooth
• A tooth that is partially or completely darkened following a trauma

• X-rays - show a dark spot at the tip of the tooth's root, indicating a reduction in the density of the bone surrounding the root's tip as a result of the infection inside the tooth.
• Routine evaluation - A persistent or recurring pimple on your gums detected by the dentist.
• Due to Exposure of a tooth's nerve during dental work – may occur when the dentist is carrying out other dental work, in which case a root canal treatment may be necessary to prevent the degeneration of the tooth’s nerve tissue.

• Front teeth have fewer canals than the back teeth and hence the treatment for the former tends to be more successful.
• Though re-treatment is possible for the same teeth, the margin of success reduces each time. We usually advise that this re-treatment be carried out by a specialist endodontist which we can refer you to.
• Complications although rare can occur in some cases.

Frequently Asked Questions

My tooth had a root canal, why does it still hurt?
The degree and type of pain you experience after root canal treatment depends upon a number of factors. These include the original cause of pulp damage, the amount of pain you had prior to treatment, the amount of manipulation necessary to work on the tooth and your unique reaction to dental trauma and treatment. Anti-inflammatory painkillers, such as Ibuprofen or.phpirin, may be required after treatment and should be taken as directed. The tooth can be expected to be sore for from a couple of days up to a few weeks. To help diminish this discomfort, the height of the tooth is often trimmed to reduce the force you can place on the tooth when chewing. You will be asked to avoid chewing on that side of your mouth until it is comfortable again.

How long can I delay having a root canal completed?
Ones a tooth is "opened" and the nerves are exposed, the is no turning back (except to have the tooth out). It depends on the severity of the problem or infection to how long one should leave between visits. It is reasonably safe to move on to the next step once the pain has disappeared. Between visits the tooth will be dressed with a temporary filling. There is a chance of re-infection due to possible leakage of the temporary filling, therefore one should not leave a root canal uncompleted for too long.

Will antibiotics cure a root canal infection?
Absolutely not! Antibiotics are useful in treating root canal infections to help relieve the symptoms in the short term, and is indicated where there is swelling, a temperature, or other systemic signs of infection. In a dead tooth there is no blood supply to carry the antibiotics to the source of the infection inside the tooth. Antibiotics only treat the infection in the surrounding bone. Although the pain might go after a course of antibiotics, the infection will reoccur later because bacteria are still present within the untreated dead tooth.

Do root canals hurt?
In reality the process of doing a root canal should not hurt. You should be numb and the tooth should have no feeling. For some teeth, profound local anaesthesia may be difficult to achieve due to the infection. What really hurts is the reason a root filling is needed in the first place; the patient is already in pain before the root canal is started. In some cases where the tooth has died of already, a patient may not experience any pain or discomfort. He/she may not even be aware of the problem.

Finally
There is nothing routine about doing a root canal. Every tooth is unique just as every person is unique. The value of root canal therapy is not what it costs, but the value of knowing you have done everything possible to save your natural teeth, a non-replaceable commodity.No one expects to get the performance and quality of a luxury car for the price of a bicycle. In life you generally get what you pay for, advanced dental treatment such as root canal treatment, is no different.