Root canal or endodontic treatment is necessary when the pulp (the soft tissue inside the root canal), becomes inflamed or infected. The inflammation or infection can have a variety of causes: deep decay, repeated dental procedures on the tooth or a crack or chip in the tooth. In addition, an injury to a tooth may cause pulp damage even if the tooth has no visible chips or cracks. If pulp inflammation or infection is left untreated, it can cause pain and/or lead to an abscess.
Signs to look out for include pain, prolonged sensitivity to heat or cold, tenderness to touch and chewing, discoloration of the tooth, swelling, drainage and tenderness in the lymph nodes as well as nearby bone and gingival tissues. Sometimes, however, there are no symptoms.
During treatment, the dentist or specialist endodontist removes the inflamed or infected pulp, carefully cleans and shapes the inside of the canal (a channel inside the root), then fills and seals the space. Afterwards your dentist will place a filling or other restoration on the tooth to protect and restore it to full function. After restoration the tooth continues to function like any other tooth.
Successful completion of the root canal procedure does not prevent future decay or fracture of the tooth. Teeth which have had RCT will require a permanent restoration. This may involve a filling or more extensive restorative work (pins, post, crown etc) depending on the clinical status of the tooth.
Unfortunately a small number of teeth may not respond favourably to the treatment and may require additional treatment in the future such as another endodontic treatment, dental surgery or extraction.
Although rare, there are associated risks and complications of root canal treatment. These include, but are not limited to:
During access to the tooth:
Extensive caries (decay) that may render the tooth unrestorable
Damage of existing prosthetic restorations (bridges, crowns, veneers etc)
Identification of a crown or root fracture which may mean the tooth is unrestorable
Possibility of a fractured instrument
Perforation (accidental openings) of the crown or root of the tooth
During the root canal treatment:
Blocked root canal that may not be fully negotiable
Loss of tooth structure that may weaken the tooth
Root canal filling material that may extend beyond the end (root) of the tooth
After the completion of the root canal treatment:
Post-operative pain, swelling or infection
Difficulty of closing or opening the jaw
Temporary or permanent loss of sensation (numbness)
Chance of failure