Endodontics

Endodontics is the branch of dentistry that includes root fillings (or root canal therapy).

Once the nerve in a tooth starts to die, the tooth may become painful with sensitivity to hot and cold and pain on biting. If the nerve has died, then pain may be accompanied by swelling.
This may be as a result of extensive damage to the tooth from decay, trauma or teeth that have required substantial fillings.
Either way, to save such teeth, will firstly require a successful root filling. Alternatively, the tooth would require extraction.

The process relies on good anaesthetic being in place. A hole is the made in the tooth, often through a filling, or even a crown if necessary. The nerve canals are then located, usually one in a front tooth and up to 4 in back teeth. This is why back teeth may take more time to treat. The canals are then measured electronically, to see how long they are. With a succession of files and flushing out with a disinfectant, the canals are thoroughly cleaned. Finally the canals are sealed with gutta percha (a rubber) and an adhesive, to ensure all the gaps are filled and made impervious to bacteria.

The tooth will then need to be rebuilt. For back teeth, this will usually involve placement of a crown, which will protect the tooth from cracking and most effectively seals the tooth from bacteria.

The complete process may take more than one visit, especially if a patient presents with pain. As it is a technically demanding procedure, it can also be time consuming, with treatment lengths lasting typically between 45 and 90 minutes.

Modern techniques involve the use of rotary nickel titanium files and electronic measuring devices, which has improved predictability and success. After pain and discomfort only occur occasionally and are usually mild, with success rates at over 90%.

Root fillings traditionally have a bad reputation that is no longer deserved, so you can choose this treatment option with confidence.

X-ray images showing a tooth before and after a root filling.

Root canal filling - Before

Root canal filling - After