Endodontics is the field of dentistry that focuses on treating the ‘inside’ or ‘nerve or pulp tissue’ of a tooth. Healthy teeth have nerves, blood vessels and other cells contained within the root canal system inside the roots of the tooth. These give us, for example, the cold sensation when we eat an ice-cream or drink cold water. Various things can cause damage to this system including deep decay, a large filling, trauma, cracks, gum disease or due to malformed teeth. This may result in an inflammation or infection where the contents of the root canal system can be destroyed. The aim of Endodontic treatment is to save teeth and remove pain by treating existing infections and prevent recurring infections. The most common endodontic treatment is ‘Root Canal treatment’.
When is Root Canal treatment necessary:
Root canal treatment is done to save teeth. The alternative is normally extraction, with or without replacement, usually with Dental Implants. In most cases, Root Canal treatment is the more conservative and cost effective option.
Teeth that need Root Canal treatment often, but not always, have symptoms. This can be any of the following: Constant throbbing or sharp pain, lingering sensitivity to hot or cold, discoloration of the tooth, swelling of the adjacent gums or tenderness of the tooth, pain on biting or chewing and a history of trauma. Sometimes there are no signs or symptoms and a diagnosis of infection is made by chance when taking routine x-rays.
What happens during my consultation?
During your initial consultation we will discuss with you the concerns that you and your referring dentist have about your tooth or teeth. We will also consider your general and dental health followed by a thorough examination and tests of the offending tooth or teeth. We will require radiographs (X-rays) and sometimes a 3D scan to help us reach a correct diagnosis. We will discuss the options, treatment plan, costs, risks and benefits of the treatment. We will make sure that you understand the need for the treatment, what treatment involves and the possible outcome. The complete root canal treatment, including the consultation, can take 1-4 visits depending on the complexity of the tooth. If your tooth is hurting, we may start treatment immediately to relieve pain.
How is the treatment done?
Before starting any treatment, topical anaesthetic followed by local anaesthetic is used to numb the tooth. We use various specialised numbing techniques to make sure your treatment will be pain free. A plastic sheath called rubber dam is used to isolate the tooth requiring treatment. A small opening of the top part of the tooth is made to gain access to the root canal system. This complex 3-dimensional system of minute interconnecting canals is then cleaned and shaped with special instruments and disinfectants. The root canal space is then filled with an antibacterial paste and covered with a temporary filling. The rubber dam is then removed and another appointment scheduled to complete the root canal treatment.
During the next appointment, the temporary filling is removed and the canals are again irrigated with disinfectants under local anaesthesia and rubber dam. Following this, the root canal system is 3-dimensionally filled and sealed with a rubber based material called Gutta Percha. Once the canals are filled, you may be instructed to return to your dentist for a permanent restoration such as a crown. This is an integral part of the whole treatment as it prevents further entry of bacteria, protects the tooth, and restores the function and aesthetics of the tooth.
Why Choose an Endodontist?
Endodontists are specialists in saving teeth, committed to helping you maintain your natural smile for a lifetime. They have additional training and education to become experts in performing root canal treatment and diagnosing and treating tooth pain. In South Africa, unlike in most other developed countries, Endodontics is not a registerable speciality. However, some dentists, having undergone additional training, limit their practices to Endodontics and, as such, fulfil this role. The average endodontist completes 25 root canal treatments a week, while general dentists do about two root canals a week. Because they limit their practice solely to endodontic treatment, endodontists are efficient and precise. This equates to positive experiences and faster healing. We also go out of our way to accommodate patients with emergencies to relieve pain quickly and efficiently and we use state-of-the-art technology such as operating microscopes, digital imaging, ultrasonic instrumentation, laser disinfection and fibre optics, to treat patients effectively and comfortably.