Root Canal Treatment

Root Canal Treatment

Root Canal Treatment
Synonyms : Root Canal Therapy, Endodontic Treatment, Endodontic Therapy, RCT

FAQ about Root Canal Therapy

Question : Why Would a Tooth Needs Endodontic Treatment?
Answer : Endodontic treatment is necessary when the pulp is already on it irrerversible state, meaning even restoring the tooth with a composite the disease process in the pulp would continue and eventually the pulp will die and lead to an abscess formation.

Q : Signs & Symptoms Commonly Experienced by Patients Requiring Endodontic Needs.
A : The most common symptoms would start from sensitivity to cold that lingers then finally also sensitive to hot drinks or food. On chronic stage the patient would see a pimple-like structure on the gum area (sinus tract) of the affected tooth.

Q : Is a Root Canal Treatment a Painful Procedure?
A : Root canal treatment can be done without pain with proper use of anesthetics. However, occasionally there are some teeth considered as “HOT TOOTH” and anesthesia is difficult. In this case a devitalizer is placed on the cavity and the patient is asked to come back to continue the treatment.

Endodontically treated lower premolar restored with a lithium disilicate dental crown. Photo credit: Dr. Jesus Lecitona

Endodontically treated lower premolar restored with a lithium disilicate dental crown. Photo credit: Dr. Jesus Lecitona


Q : What is Expected Following Endodontic Treatment?
A : The tooth might be painful and sensitive especially to biting after the treatment especially if the tooth was pain or infection prior to treatment. The pain and tenderness in the area is normal few days after the treatment. The pain can be alleviated with the over the counter pain relievers. Just in case the pain is continuous and swelling is present, please inform your dentist.

Q : Taking Care of the Tooth after Endodontic Treatment
A : You are expected to have the final restoration done within a month after the completion of root canal treatment. Root canal treatment does not end at the filling of the canal but after the final restoration with either composite or crown.

Q : Can All Teeth be Treated Endodontically?
A : Almost all teeth can be treated endodontically as long as it is restorable, with good bone support and no vertical fracture. Complicated root anatomy would make the treatment difficult but can still be treated especially by the endodontic specialist.

Pressed glass ceramic dental crown for root canal treated lower premolar. Photo credit: Dr. Jesus Lecitona

Pressed glass ceramic dental crown for root canal treated lower premolar. Photo credit: Dr. Jesus Lecitona

Q : How Does Endodontic Treatment Save the Tooth?
A : The infected pulp is removed together with organic tissue and debris inside the pulp cavity. The canal is cleaned and enlarged and finally filled the canal to seal the entire pulp cavity. Final restoration is then done on the tooth.

Q : What are the Alternatives to Endodontic Treatment, Retreatment and/or Endodontic Surgery?
A : Extraction is the only treatment alternative. Extraction of the tooth would require a replacement in the form of implants, fixed bridge or removable partial denture and at the end would appear more expensive than doing root canal treatment. No matter how good the prosthesis is, nothing compares with the natural tooth.
Retreatment is a procedure done after the conventional root canal therapy failed. Symptoms are pain, formation of fistula for the chronic type and swelling for the acute type of infection. In case this symptoms occur, a second chance to save the tooth is done which is known as retreatment. The success rate of a retreatment case is lower.

Q : Who Performs Endodontic Retreatment?
A : All dentists had received basic root canal treatment training in school. However, retreatment requires more skill, knowledge and experience, most of the retreatment is best treated by an endodontic specialist. Endodontic specialists have more experience and advance training in root canal treatment. Since their clinical practice involves more endodontic cases, they are more skillfull in handling difficult and complicated cases. Most of them also equipped themselves with highest technology to perform special services.

Q : Why Another Endodontic Treatment is Needed?
A : In some instances root canal treatment fails because of different reasons:
1. Complicated canals, narrow, calcified, curve might not have been completely treated due to its condition.
2. Failure to locate and treat all existing canals.
3. Final restoration of the tooth was neglected.
4. Presence of leakage on the final restoration
5. Undetected vertical fracture
6. Failure of the body’s immune system to resolve the infection

Q : What Happens During Retreatment?
A : The tooth will be examined and treatment options will be discussed. Depending on the problem detected, treatment will be based on the problem. The tooth will then be subjected to root canal procedure and the additional treatment necessary like removal of ledge, separated instruments, perforation repair, location of undetected canals, increasing the working length and a lot more. Finally after the treatment, the patient is sent back to the referring dentist for final restoration. The patient is usually asked to come back for a follow up treatment.

Q : Is Retreatment the Best Choice?
A : Retreatment is a better option than extraction provided that the tooth is still restorable. Retreated tooth can still function for years and even for a lifetime.

Q : How Much will the Procedure Cost?
A : The cost will vary depending on the type and the complexities of the problem to be solved. Usually it is more expensive than the first treatment because it involves problem solving and requires expertise to solve the problem.

Reference
American Association of Endodontists. http://www.aae.org
American Dental Association. http://www.ada.org

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