Procedures


How we work

At your first visit a comprehensive examination will be conducted in relation to the tooth or teeth that you were referred for. You will be provided with a diagnosis and the available treatment options, and any questions you have will be answered. This process enables you to make an informed decision about the proposed treatment options for your tooth/teeth.  At the end of the discussion you will be given a pamphlet explaining the chosen treatment procedure.  You will also be asked to sign a consent letter and a written quote.

It is common to start the first stage of treatment after the consultation, especially for patients from out of town.  Root canal treatment is normally done over two visits but sometimes a single visit is sufficient. In complicated cases more than two visits may be necessary.  You will be advised on the number of appointments required to complete your treatment at the consultation appointment or during treatment.

On completion of your root canal treatment, a completion report, together with radiographs, will be sent to your dentist.

Conventional Root Canal Treatment

Root canal treatment is aimed at saving a tooth presenting with an inflamed or infected pulp and root canal system.  During root canal treatment, the inflamed pulp (nerve) or infection is removed to eliminate the source of the problem. A small hole is made on the top or back of your tooth into the pulp space and the root canals are identified, cleaned and shaped using small files and antibacterial irrigants. The root canals are usually medicated for 1-2 weeks and are then permanently sealed followed by the placement of a permanent restoration to protect the tooth.

Re-treatment

Occasionally a tooth that has undergone root canal treatment fails to heal or remains painful. Sometimes a new problem can emerge from a tooth that was successfully treated in the past. In these cases, retreatment of the root canals is necessary to save the tooth.

This procedure takes longer than the initial treatment, as it involves removal of the restoration and old filling materials, as well as looking for extra canals that may harbor inflamed or infected nerve tissue, decay around restorative margins or cracks that may be causing leakage.

Apicectomy (Periapical Surgery)

Apical surgery is normally done if previous root canal treatment has been completed to a high standard or if retreatment of the root canal is not possible due to a post or obstruction in the tooth.
Apicectomy is a minor surgical procedure performed under local anaesthetic. It allows access to the root end to remove a persistent inflammatory or infective lesion (abscess) around the end of the root. The procedure involves lifting back the gum to access the end of the root. The lesion, generally an abscess or a cyst, is removed and the root end is sealed with an extra filling.

Recall visits

You will be given a review appointment, 6 -12 months after completion of any of these treatments to confirm clinical and radiographic healing.

What to expect after root canal treatment

It is common to experience some discomfort following root canal treatment. It normally presents as tenderness when biting on the tooth. In some instances the treatment can result in an inflammatory flare-up associated with swelling and pain a few days after treatment. In these instances you need to phone the practice to discuss further management with us.

If your tooth has been symptomatic for a long time it may take a while for these symptoms to completely disappear. This can take weeks or even months.

Dental Trauma

Dental trauma can cause damage to the tooth crown, the tooth nerve, the root structure and the root's surrounding tissues. Treatment of traumatic dental injuries varies widely depending on the type and extent of the injury. The simplest form of injury is chipping of the tooth crown without exposing the pulp, while in other cases the dental pulp (nerve) gets damaged with the need for root canal treatment. More severe injuries include root fractures, displacement of the tooth or complete dislodgement of the tooth out of its socket.

Dental trauma needs to be dealt with quickly, and may require several visits and long-term monitoring.

Bleaching of Discoloured Teeth

Bleaching is carried out internally on a discoloured root-filled single tooth. This is not to be confused with external bleaching of multiple teeth commonly referred to as “teeth whitening”.

 

More information

Please call or email us if you need more information about endodontic procedures. Alternatively, you can also find clinical resources, guidelines and other treatment information at the American Association of Endodontics site www.aae.org