Dentistry

The Root Canal; A Mainstay In The Dental Clinic

You may have just found out that you need endodontic work (endo- beneath, dontic -tooth). The root canal is an old dental procedure but was rarely effective before the widespread adoption of antibiotics, and its effectiveness has improved with antiseptic washes.

The practice of performing a root treatment or canal filling was to save teeth that would otherwise have been extracted and to clean out an abscess beneath the tooth. The average treatment is carried out over two sessions due to the fiddly nature of the work and the care required. Not to mention, constantly focusing for 2 hours or more would not only be excruciating for a dentist but would increase the chances of errors from fatigue.

One of the drawbacks of early treatment was a high rate of reinfection or secondary infection as the debris and the contents of the abscess would be moved directly into the exposed surrounding tissue. A course of antibiotic treatment before the treatment is essential in an effective root canal, and the practising dentist will delay treatment if the abscess is active.

Preparation

The use of X-rays has also greatly improved the success rate, by allowing the dentist in St johns wood to prepare for the work rather than having to improvise during the cleaning or filling process. It also gives your dentist a more accurate look into how complex the case may be and refer the patient to a specialist if required.

After the application of a local anaesthetic, an oral dam is placed over the tooth that is to be treated for protection and to also prevent the gum from being damaged. It also prevents the patients from swallowing any of the fragments from the cleaning and filling of the root canal.

The procedure

The top of the tooth is opened with a dental drill, giving access to the pulp; the access point is usually less than 1 mm in diameter. Widening is performed by filing the inside of the canal; this has to be done cautiously and is a test of the dental clinician’s skill, using long files and a dental microscope.

This can take 1 hour per root; with front teeth usually having 1 root and molars having 2 but this is not always the case. Straight roots are far easier to treat and very convoluted or ‘knotted’ roots are considered too complex for most local dental clinics. Such presentations will often be referred to a specialist endodontist or the local hospital for treatment.

In order to continue the treatment, the partially cleaned and widened canal is cleaned with a sterilising solution which slowly seeps into the dentin of the tooth, and is capped with a temporary filling.

The Full Root Filling

When the widening of the canal is completed and the cleaning is finished, it is time to fit a filling. The filling starts beneath the tooth and fills the space left in the bone by the abscess and continues up the length of the root and tooth, stopping at the initial access hole.

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