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Root canal Treatment

One of the most common origins of dental pain is from the dental pulp.  The pulp is the soft, sensitive centre of the tooth which includes the blood vessels and the nerve.  There was a time when the only way to deal with this was to extract the tooth, but now with root canal therapy, keeping the tooth and getting rid of the pain is often an excellent option.

Under normal circumstances, the tooth has a healthy pulp inside with blood vessels which carry a blood supply providing an immune system to the tooth. As teeth are slightly porous, when bacteria get through the tooth, white blood cells deal with the bacteria. However, if more bacteria get through than your immune system can handle then parts of the pulp die and with it the blood supply providing the immune system.  The bacteria get the upper hand and eventually the whole pulp inside the tooth dies.  The immediate effect of this is that the associated pain goes away, but not for long. The bacteria then start to spread from the tip of the tooth root into the bone.

Bone does not have a good immune system and is dependent on soft tissue to act as a barrier to bacteria.  Therefore the body tries to halt the advance of the bacteria by removing bone and replacing it with soft tissue.  This has many blood vessels which transport the white blood cells to the site where they are most needed; just where the bacteria are spreading out through the tip of the root of the dead tooth. The white blood cells engulf the bacteria and this is how pus forms. As the pressure from the pus builds up, an abscess forms and the pain returns.

The solution is to this, if you do not want the tooth extracted, is to block the passage of bacteria to the bone by cleaning out and sealing off the pulp chamber. This is quite a complex procedure as the canals where the pulp used to be are a hair’s breadth in places. We therefore use an operating microscope to find the canals and clean out the bacteria and dead pulp material both chemically and mechanically. The clean canals are then shaped and sealed with materials which keep the bacteria out.

This means that in most cases you can keep your tooth for many years.  The success rate of root canal therapy will depend on a number of factors including the use of meticulous, internationally recognised techniques and whether this is the first time a tooth has been root-filled.  Root canal therapy using these techniques, the first time round, gives the best results.  Where the tooth has been previously root-treated, the job of overcoming the infection becomes more difficult but not impossible.

After root treatment of a back tooth, it is usually necessary to place a crown or onlay on the tooth to strengthen it.

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