What two words can a dentist say to make people cringe?


For some reason, when people hear the words ‘root canal,’ they suddenly think the worst.

At Dentists at Pymble, we have been trying to understand why root canals have such a bad rap.

Is it because it can be a longer procedure than others? Is it because people think it will be painful? Is it the cost? Or is it because people don’t understand what a root canal treatment is?

At Dentists at Pymble we are not sure…

That is why the Dentists at Pymble team decided to write this article. We want to give you all the information we can. Then hopefully, together we can try to remove the negative stigma commonly associated with root canal treatments.

Without root canal therapy, teeth which are
infected or heavily decayed would have to be extracted!


What is a root canal treatment?

Root canal therapy is a dental procedure designed to repair or save a tooth which has been damagedtraumatised, or infected.

It involves removing the nerve and nerve tissue of a tooth, then cleaning and sealing it with a special filling material.


What is the nerve and where is the canal?

The nerve is responsible for keeping your tooth alive. It provides sensory function to teeth.  For example, this is how your teeth can feel hot or cold sensations.

The nerve can be found in the middle of your tooth.

At Dentists at Pymble, we often say that teeth have three main layers. The outer layer which you can see is the enamel. The layer underneath the enamel is the dentine. Then finally, right in the middle of your tooth is the nerve (pulp).

But your teeth extend further than you can see in your mouth.

Every tooth is held in your mouth (or jawbone) because teeth have roots. The roots are like legs, helping hold the tooth in place and keep them stable – allowing us to eat, chew and talk.

However, the roots have fine canals that run through the middle of them, hence the name root canal.  These canals contain the same nerve tissue found in the nerve of the tooth, as they are connected.


Why does a tooth need to be root canal treated?

There are a few reasons why a tooth may need root canal treatment.

It can be because of:

  • Decay
  • Trauma (like a severe knock to the tooth)
  • Tooth wear
  • A crack or breakage
  • A history of extensive dental work.

These things can cause a tooth’s nerve to become inflamed, damaged, or diseased. And if nerve inflammation or infection is left untreated, it can cause a periapical abscess to form.

periapical abscess is a pus-filled sack of fluid found at the tip of a tooth’s root. These abscesses can cause damage to the bone surrounding the root and can be very painful as the fluid builds up. They can also cause a ‘pimple’ to form on your gum, as a means to release the fluid.

If the infection and abscess are left untreated, they can continue to grow and can make you feel very sick and unwell. But they can also cause a toothache!


How do you know if your tooth needs a root canal?

Your dentist is the best person to advise you if your tooth needs a root canal treatment.

First, your dentist will clinically check your tooth. They will do a few tests to see if the nerve is alive or not, and they will take x-rays (radiographs) to look for infection at the roots of the teeth.

You may also experience symptoms, such as:

  • A prolonged dull toothache
  • Sensitivity to hot and cold
  • Tooth discolouration or turning dark
  • Swelling or a pimple-like formation at the gum


What happens during a root canal procedure? 

Once we know that a tooth requires root canal therapy, a local anaesthetic is given to block pain or discomfort while we treat the tooth.

Often, at Dentists at Pymble, we then place a rubber dam over the tooth, which is like a rubber sheet. The rubber dam helps isolate the tooth, keeping it clean and dry. It also helps stop the tooth from being contaminated by saliva.

We then create an opening in the tooth, allowing us access to the nerve chamber.

Using special instruments and files, we gently remove the infected nerve tissue, extending down into the roots where the canals are. Each canal is cleaned, shaped, and treated with anti-inflammatory and antibacterial medicine.

Along the way, we like to take x-rays to ensure the tip of the root and all canals have been accessed.

If we are doing the root canal over a few visits or stages, then we will place a temporary filling to protect the tooth between visits.

Once we are happy and know that there is no more bacteria or nerve tissue left inside the tooth or roots, it is carefully filled and sealed. A final restoration is then placed to close over the opening we created to access the nerve at the beginning of the treatment.


How long does a root canal treatment take?

The time it takes to complete a root canal depends on how many canals there are and how the tooth itself is responding to treatment.

Sometimes it can be done in one visit. Other times, we may need to see you more than once.

Your dentist will let you know how long each visit will be, but generally, it takes at least one hour each time.

At Dentists at Pymble, we also like to see you a few months after your root canal treatment has been completed, or at least at your next check-up appointment. This allows us to review the tooth and ensure there is no residual or recurrent infection.


Can I go to work after a root canal treatment?

Yes. You may go back to work or school following root canal treatment.

You may be numb for a few hours, so it is important to be careful, especially when eating and speaking. Often at Dentists at Pymble, after any dental procedure involving numbing or local anaesthesia, we recommend that you avoid eating until it wears off. This helps avoid the risk of biting your cheek or causing damage while you can’t feel it.


Is root canal treatment painful?

This is somewhat a common misconception when it comes to root canal therapy.

Most of the time a root canal treatment is no more painful or uncomfortable than having a filling done. The procedure is done under local anaesthetic, so you won’t necessarily feel it.

However, because people often have pain or a toothache – which is why they need root canal therapy – they think the procedure itself is the painful part. In some cases, the nerve is already ‘dead’, so there is minimal to no pain at all.

At Dentists at Pymble, we generally like to warn patients that they may experience some discomfort after the procedure, just as the tooth settles or where the injection was given. But often it settles without complications or concerns.

However, if after a few days the tooth has not settled, it is important to have it checked again by your dentist.


Is root canal treatment expensive?

The price of root canal depends on how many canals the tooth has. Your front teeth generally have one canal. Meanwhile, your molars at the back may have three or four canals, sometimes more!

All the canals must be treated to give the tooth the greatest chance of success following treatment. This means that price can vary depending on the tooth being treated and the number of canals.

However, if you were to lose that tooth and consider replacing it with a crown and bridge or a dental implant, then soon the price of a root canal may be very similar and sometimes even cheaper. But also, an artificial or fake tooth is never as good as your natural tooth… that is why at Dentists at Pymble, we always try our best to save teeth!


What happens after a tooth has had a root canal?

After a tooth has undergone root canal treatment, the tooth may be more fragile and may be weaker than your other teeth.

This means if it is subjected to a lot of force, which happens when we eat or clench and grind our teeth, it can slowly cause fatigue to the tooth. This can make the tooth more likely to break. Therefore, after a tooth has had a root canal treatment, at Dentists at Pymble, we will commonly recommend you have a crown placed over the tooth.

Sometimes, following a root canal treatment, a tooth may start to discolour or turn dark. If this happens, your dentist may be able to internally bleach the tooth, or a crown will also help to cover and hide this discoloration.


Do all root canal treated teeth need crowns?

In an ideal world, yes! A crown helps to strengthen a tooth, and root canal treated teeth are weaker and more prone to breaking.

A crown acts like a helmet or cap which goes over the top of the tooth. It helps  evenly distribute force over the entire tooth and protect the tooth from breaking.

At Dentists at Pymble, we may not crown a tooth immediately after it has been undergone root canal treatment Sometimes we wait to ensure the infection and inflammation has completely resolved first.

So, your dentist will let you know when is the best time to consider a crown based on your tooth.


How do you look after a tooth following a root canal?

It is important to look after your root canal treated tooth as you would any of your other teeth.

Even if the nerve is no longer present, the tooth is still at risk of decay or other dental diseases. So make sure you keep up with your brushing and cleaning in between!

It is also important to be careful with these teeth, since root canal treated teeth are not as strong as your other teeth. Try not to place too much force or stress on them!

Remember to also see your dentist regularly, so they can take an x-ray to check that the infection has resolved and does not return. You will no longer have any sensory function in the tooth, so if the tooth does become decayed or reinfected you are unlikely to feel it.


Does a root canal last forever? 

Although a root canal is designed to save a tooth, it is not a guarantee. It is also not possible for us to predict how long they will last, either.

This is because every tooth responds differently to treatment and every mouth is different.  However, the success rates of root canals are quite high!


Who does root canal treatments?

At Dentists at Pymble, our dentists routinely do root canal treatments here in the practice!

However, sometimes the anatomy or history of a tooth makes it a more complicated procedure. In which case, we may prefer that you see an endodontist, who is a root canal specialist. You can also choose to see an endodontist right away if you would prefer.

Well… that wraps up our article on root canal treatments. 
Hopefully, it has helped you to understand more about them and how they work to help save teeth.

But if you have any questions or concerns, then please do not hesitate to contact the team at Dentists at Pymble at 02 9488 7555, or email us at info@dentistsatpymble.com.au to arrange an appointment with our friendly dentists.

From all of us here at Dentists at Pymble, thanks for reading!



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