Endodontics (Root Canal Treatment)

​Teeth are vital structures supplied by nerves and blood vessels located within the pulp chambers. Tooth decay that progresses close to or penetrates the pulp chamber will lead to a bacterial infection of the chamber. Mild toothache may develop into severe toothache when the pulp inflammation becomes irreversible. If left untreated, loss of vitality occurs, and bacteria may gradually spread into the surrounding bone through the root tip. Severe swelling, pus accumulation, fever and pain may develop.

Root canal treatment is a procedure to remove infection from the pulp chamber and root canal system of the affected tooth. Infected and non-vital tissue will be removed from the root canal system with endodontic instruments and disinfected with chemical irrigation. The clean root canal system is then filled with an inert material and the tooth subsequently restored.

This treatment can be completed in one or two visits, depending on the pre-existing state of infection. Our dentist will conduct an examination to assess the extent of tooth decay or infection and take dental periapical radiographs to assess the remaining tooth structure and condition of surrounding bone. Thereafter, our dentist can determine if root canal treatment is suitable for the affected tooth. Most teeth can undergo root canal treatment. However, if there is insufficient remaining tooth structure, lack of bone support or if the tooth is severely fractured, the prognosis of treatment will be poor. The dentist will then advise for an extraction to be performed. If treatment prognosis is good, root canal treatment can be done.

Local anaesthetic will be administered at the site of treatment. A rubber dam will be draped over the tooth to be treated to prevent contamination from surrounding saliva in the oral cavity. After that, an access cavity will be prepared, and the infected pulp tissue removed. After cleaning and shaping of the root canal system, the resultant space will be filled with a rubber-based material called gutta percha. This aims to seal the root canal space. A definitive filling or crown will need to be placed to complete the management of a root canal treated tooth.

Discomfort, in the form of tooth tenderness when eating, may occur in the interim and after the procedure. This is more common if there was pain or severe infection before treatment was instituted. This discomfort can be relieved with mild painkillers. You are advised to go on a softer diet until the final restoration has been completed. Hard food should be avoided in the long term to prevent post-treatment fractures.

Root canal treated teeth require regular home care such as twice daily toothbrushing with regular flossing. Post-treatment reviews, after 3 months and after one year, are usually scheduled to assess healing status.