Your dentist might have felt that your tooth was particularly more challenging. This could be due to a number of different reasons such as complex root canal anatomy, difficult access to the tooth in question, problems in numbing up the tooth and surrounding area, retreatment of previous root canal treatment. At the root canal specialist we also receive referrals for cases of difficult pain diagnosis and referred pain.
Specialist Endodontists are a selected group of about 250 UK, who have had extensive training (4 years) at Masters Degree postgraduate level in the field of Endodontics in programmes recognised by the General Dental Council and fulfilling strict criteria enabling them to be accepted on to the GDC Specialist Lists.
Root canal treatment is the specialised dental procedure by which the infected and necrotic remnants of the pulp tissue (nerves and blood vessels located in the root of the tooth), are carefully removed and thoroughly cleaned using small fine instruments (endodontic files) and disinfecting irrigating liquids. The clean root canal space is then filled with a biocompatible material which creates a tight seal in the root and prevents reinfection of the tooth.
In a small minority of cases the initial attempt of root canal treatment is not successful and bacteria manage to gain access to the root canal system which can perpetuate the infection. This can be detected on x-rays (radiographs) by the presence of small dark areas around the bottom of the root (periapical pathology), or the patient might experience gum swelling or an abscess, spontaneous pain of different degrees, pain on biting, a gum boil or pus discharge.
Root canal retreatment will ensure the removal of the previous root filling material and wash out all the irritating factors and create the space for a new root filling material to tightly seal the root canal space and address the infection present.
There is a range of symptoms you could experience.
You might experience sensitivity of different degrees to hot and your cold, Throbbing radiating pain to the opposing jaw or ear which can often disturb sleep.
Quite often the tooth will feel tender to touch and on chewing.
In some more severe cases the tooth might feel raised and the gums might be swollen (dental abscess) and there could be an associated sinus tract.
A great majority of teeth can be saved with root canal treatment providing that there is enough tooth structure remaining (above the gum level). The amount of tooth structure remaining will allow the tooth to be restored with a resilient cap/ crown following the root canal and prevent re-infection and leakage Into the root filling.
In cases where the tooth cannot be restored due to reduced tooth structure left, the patient can consider an implant, a bridge or denture. Nevertheless, overall cost-benefit a root canal carried out to the highest level of expertise as at the root canal specialist, will be better in the long run than a surgically placed implant.
Unfortunately once infection reaches the root canal system and spreads to the bottom of the root, the only way to kill the existing bugs in the tooth is by either extracting the tooth or carrying out the endodontic treatment. If this is not done the chances of recurrent gum swelling and abscesses , draining pus (gum boil/sinus tract) and continuous bone resorption (apical lesion) are quite high.
Most root canal treatment cases can be seen straight for treatment. Ideally the patient needs to send us a recent x-ray of their tooth and a description of the symptoms . Even if the treatment is started during the first visit a consultation will always be carried out before the treatment is started.
A consultation is an opportunity to assess the case, put the patient at ease, discuss any possible questions, associated risks and options.