Endontonic (Root Canal Treatment) services

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Most endodontic procedures can be carried out by a general dentist with normal skills and standard equipment. However, some procedures are more complex due to the anatomy of the tooth or previous treatment that has been provided. In these cases there can be advantages in having treatment completed by a dentist with advanced skills in this field. You may be offered a choice of referral privately to an external specialist or treatment by an accredited Dentist with Special Interests.

Q. What is a dentist with special interests (dwsi)?

A DwSI is a dentist who has demonstrated advanced skills in a particular dental field and has been contracted by the Primary Care Trust to treat complex cases on referral.

Q. Why is root canal treatment needed?

If the pulp becomes infected or inflamed, infection may spread through the root canal system of the tooth, eventually leading to an abscess. If RCT is not carried out, the infection may spread and the tooth may need to be taken out.

Q. What does rct involve?

The treatment may involve an initial consultation followed by two or more appointments. The tooth will be made numb using a local anaesthetic and the tooth will be kept clean and isolated during treatment using Rubber Dam. The infected tooth pulp, or previous root filling, will be removed and any infection drained. The root canals will be cleaned, disinfected and shaped ready for a new root filling. Medication may be sealed into the roots for a period with a temporary filling. When the dentist is confident the tooth is as clean as possible, the root filling can be placed into the root canals. The root filling is a rubber material that is compressed into the roots to seal them. A provisional filling is then placed on top of the root filling to seal the tooth. You will need to return to your own dentist for a permanent filling or crown on the tooth.

Q. Does it hurt?

A local anaesthetic is used and the whole procedure should feel little different to that of having a normal filling- although the appointments will be longer. There will often be some pain or discomfort for 3-4 days following the treatment, and occasionally some swelling. The tooth may feel slightly tender and "different" for a few weeks afterwards.

Q. What if the infection comes back?

Root canal treatment is not always successful, and the chance of a good outcome depends on the state of the tooth prior to treatment. You have been referred to a Dentist with Special Interests (DwSI) because your tooth has a complicating factor, your DwSI will be able to advise you of likely success rates in your particular case.

Q. How much does it cost?

Root canal treatment, when recommended, is available on the National Health Service. If your tooth has a complicating factor that makes it eligible for NHS referral, your referring dentist should have collected the relevant NHS fee from you and there should be no further charge when you see the DwSI. If you are a patient at Temple Street Dental Practice and have elected to have your root-treatment completed privately by Mike Cooper, a quote will be given. Private fees start at £350 per tooth.

Q. Are there any risks?

Root canal treatment is an intricate procedure that does not have a guaranteed outcome. There are various complications that can occur and the treatment may not be successful in up to 50% of the most difficult cases:

  • It is likely that you will experience some pain or discomfort, and possibly some swelling, immediately following treatment and for a few days afterwards. This is normally relieved by over-the-counter painkillers but can occasionally be more severe.
  • Sometimes there can be a spreading infection from the tooth in which case we may prescribe antibiotics.
  • The dentist may "perforate" the tooth (this is when a hole is made through the side of the root-canal when searching for a particularly small or difficult root canal)
  • Root-canal instruments are very fine and fragile- there is a possibility that one may break inside the tooth.
  • The root filling may sometimes extend beyond the tip of the root, or may not completely fill the root to the tip.
  • A root-filled tooth may become a little darker in colour than its neighbouring teeth.

Any of these complications may compromise the prognosis for the tooth, and delay or prevent healing. A serious complication may necessitate extraction of the tooth.

Q. What will happen to my tooth after treatment?

You will need to return to your own dentist to have a permanent filling placed over the root-canal treatment. Root filled teeth are weaker and more brittle than live teeth- it is often advisable to restore the root-filled tooth with a crown or onlay to reinforce the tooth.