Root canal treatment

What is root canal treatment?

If irreversible damage to the tooth pulp has occurred as a result of caries or trauma, the tooth requires root canal therapy.

During treatment, infected and inflamed pulp tissue is removed from inside the tooth, the tooth is cleaned, and the root canals are shaped.

The root canals are then closed with a hermetic root filling. After that, the tooth is restored with either a filling or a crown, and the tooth functions just like any other tooth.

Read more on the sheet about when root canal therapy is necessary, how the treatment is performed, and what the cost of root canal treatment is.

Would you like more information about root canal therapy or to make an appointment for the procedure?

Watch the video (in Estonian) to find out more about root canal treatment

Maxillas dr. Ilja Pestov explains, among other things:

• How do I know if root canal treatment is needed?

• What causes tooth root inflammation?
• How to prevent it?
• Is the root canal procedure painful?
• What should be monitored after a root canal procedure?
• How is root canal treatment performed and how long does it take?

And much more!

What is root inflammation and what does a “dead tooth” mean?

Due to deep decay or trauma, the nerves and blood vessels inside the tooth, or dental pulp, can become infected with bacteria. As a result, inflammation occurs inside the tooth and the tooth starts to hurt. It hurts to eat and the tooth reacts to temperature changes. After a while, the tooth nerve dies and no longer responds to stimuli; such a tooth is called “dead”. At first, root inflammation is called pulpitis. If left untreated, periodontitis develops – the inflammation spreads to the tissues surrounding the tooth.

Is root canal therapy painful?

The goal of root canal therapy is to relieve pain, and with modern anesthesia options, this procedure is completely painless. However, the tooth may be sensitive or painful for a few days after the procedure, and sometimes it is necessary to take over-the-counter painkillers during this time. The tooth may feel different compared to other teeth, however, this feeling usually passes. In case of very severe pain or swelling, you should return to your dentist.

How do I know if I need root canal therapy?

Teeth with infected pulp require root canal therapy. During diagnostics, the dentist will find teeth that need treatment. A tooth that needs root canal therapy may have the following signs:

• Severe pain when eating or biting
• Pus or swelling of the gums around the tooth
• Broken tooth or deeply fractured filling
• Severe pain after exposure to cold or heat that persists even after the stimulus is removed
• Deep tooth cavity or discolored tooth

If I have been diagnosed with pulpitis but the pain subsides over time – does this mean that the tooth does not need to be treated and has healed on its own?

In untreated teeth, acute inflammation can become chronic, in which case the tooth may not hurt. However, persistent inflammation causes destruction of both the tooth and the surrounding bone tissue. Later, more extensive inflammation can cause swelling, pus formation, and even more severe pain. The tooth does not heal on its own from irreversible pulpitis, as the tooth nerve dies as a result of irreversible pulpitis.

After mild irritation (for example, after replacing a filling), the tooth may become sensitive; such a condition is called reversible pulpitis. Sometimes this sensitivity surpasses, the tooth nerve survives, and the tooth does not require further treatment. Whether it is reversible or irreversible pulpitis will be determined by the dentist during the diagnostic process.

Does root canal therapy ensure tooth healing, or can root canal therapy also fail?

The success rate of root canal therapy is over 95%, however, it is not 100% successful. The procedure may fail due to several factors. Much depends on the anatomy of the root canals and how extensively the tooth has decayed. If the root canals are not cleaned or filled sufficiently during therapy, bacteria will remain inside the tooth and chronic inflammation will occur.

Therapy may not be successful if the root canals are very narrow or curved, and if the inflammation has already become too extensive. If the tooth has not been properly restored or a new cavity has emerged, bacteria can re-enter the tooth and cause new inflammation. Teeth with a cracked root are not amenable to therapy. Serious general health conditions can also hinder recovery.

What happens if root canal therapy fails?

If root canal therapy fails, repeated root canal therapy, or root canal restorative treatment, is performed. Sometimes surgical cleaning of the root apex is also performed. An alternative to restorative treatment is tooth extraction. Which solution is best depends on the specific situation.

No method of tooth replacement is better than a natural tooth, so modern dentistry tries to save as many of your teeth as possible. However, if your tooth needs to be removed due to root canal therapy failure, it can be replaced with an implant, for example.

What is the price of root canal therapy, is it expensive?

The price of root canal therapy depends on the complexity of the therapy (for example, whether it is primary or repeat root canal therapy) and the type of tooth (treatment of front teeth is usually cheaper than treatment of back teeth). The less decayed the tooth is, the cheaper it is to restore it. Root canal treatment under a microscope is more expensive than regular root canal therapy. Root canal therapy can be two to four times cheaper than its alternative, i.e. dental implant. Indicative prices for root canal therapy can be found in Maxilla price list. The specific cost of treatment will be determined during the treatment.

Very often, it makes much more sense to keep your tooth than to have it removed and replaced with an artificial alternative. Preventing the need for root canal therapy through proper oral hygiene and regular check-ups with a dentist is much cheaper than more complicated and time-consuming dental procedures.

What is a root canal therapy with a microscope and why is it better than a regular root canal therapy?

Root canal treatment under a microscope is the most modern way to perform root canal treatment. Thanks to its very good magnification, a microscope enables to treat teeth much more precisely than with the naked eye or magnifying glasses. Therefore, the probability of success of treatment performed under a microscope is higher. The use of a microscope is especially important for root canal therapy, as the root canals inside the tooth can be so fine that they cannot be seen without magnification.

How many times do I need to visit the dentist for root canal therapy?

Often, therapy can be completed in one appointment (with a dentist who specializes in root canal therapy), however, it also depends on the extent of the inflammation, the length of the appointment, and the dentist’s skills and experience. In most cases, two or three appointments are sufficient. This may include additional appointments required for tooth restoration (filling or crown).

Is there any way to treat root canal inflammation with home remedies?

Toothache can be relieved with home remedies: painkillers (such as a combination of Ibuprofen and Paracetamol) work best, and sometimes a cold compress or rinsing the mouth with salt water, or throat lozenges with an anesthetic effect provide relief.

However, these methods do not help with inflammation, as inflammation is caused by an infection within the tooth and can only be effectively treated by a dentist.