Root Canal Treatment (RCT)

Endodontics is the dental term for root canal therapy.

This is the ONLY treatment that can save a tooth when the nerve is damaged.

Nerves get damaged by:

• Decay
• Grinding and clenching
• Huge old fillings that don’t protect a tooth properly can cause small cracks to appear.
• Any treatment that enters the dentine of the tooth, in other words any filling, porcelain or crown, can potentially damage the nerve. Fortunately this can more often than not, be pre-empted while treating the tooth and your dentist should advise you at this stage to rather get an RCT or take a chance.
• Out of the blue!

Diagnosis is OFTEN done by listening to the patient’s symptoms.

• If the tooth keeps you awake at night, IT HAS AN ABSCESS AND NEEDS A RCT.
• If the tooth is sensitive to heat, the nerve is probably damaged and the chance of full recovery is very slim. It will probably need a rct.
• If a tooth is VERY cold sensitive, the chances of recovery is better, provided the cause of the problem is treated.

When RCT is done, the tooth is ALWAYS weakened.

• In front teeth, we will recommend building a post and core which will help to strengthen the tooth. Sometimes, crowning of a front tooth won’t be necessary.
• In molars and premolar teeth, crowns of porcelain overlays are ALWAYS necessary. These teeth function to chew and because of the extreme forces, these teeth WILL BREAK if not protected.

What to expect from an Root Canal Procedure

Good news: This treatment is normally painless!

If the tooth has an abscess, we would often prescribe antibiotics for a day or two before root canal treatment (RCT) is commenced. This generally ensures that the local anesthetic is effective.

During the treatment:

• All the cells inside the canal/ canals will be removed. (Some molars can have up to 6 or 7 canals instead of the normal 3 or 4). We do this treatment with the aid of our Zeiss microscope to ensure we get them all.
• The canals are then shaped
• Irrigation with hypo chloride. Waterlase lasers effectively fight endodontic infection and can perform disinfection and cleaning, open dentinal tubules, decontamination prior to obturation, pulpotomy and pulp extirpation, and smear layer removal in the canal.
• Using patented radial firing tips to deliver laser energy in a 360-degree cone within the canal, Waterlase can have a dramatic, positive impact on clinical outcomes for endodontics.
• Irrigation is then done with Ozonated Water. This helps to dilute the strong chemicals used and helps to prevent pain after the treatment.
• We then dry the canals and blow some ozone gas into these canals to ensure optimal cleanliness.
• The canals are then sealed with a cement and gutta percha (a kind of biological acceptable plastic). This is melted into the canals to get an optimal seal. The cement we use promotes healing of the surrounding bone, so we try to extrude a little through the tip of the root.

WHAT TO EXPECT AFTER RCT.

• NO PAIN or
• A little pain.
• A lot of pain (in about 10% of cases)

Remember, we work with chemicals that often goes through the tip of the root (apex) and THAT causes inflammation. We treat this pain with anti-inflammatories (like Cataflam) and Panado.

If the medication is not taken as prescribed, IT WILL NOT WORK.

As a rule, we would prescribe Cataflam (1 tablet eight hourly) after treatment to PREVENT the inflammation.
As a rule, antibiotics would NOT be prescribed (only in case of HUGE abscesses).

Remember, when your tonsils of appendix is surgically removed, there is pain after the treatment.

This is the same for RCT.

Avoid chewing on that side for a week or two and DEFINITELY do not chew on it until the crown or inlay has been fitted.