Inside the tooth there is a small cavity where the tooth’s nerve and blood supply are located. If the tooth is subject to a major attack of caries (a hole in the tooth) or a trauma (a blow, for instance), the nerve can get damaged. In the vast majority of cases, when the tooth’s nerve is dying, toothache occurs. In dental terms, this process is known as pulpitis - an acute state of infection. In other cases, the dentist discovers that the tooth’s nerve is dead. This is revealed by an X-ray of the tooth or occasionally as a small spot in the mucous membrane next to the tooth’s root. A tooth with a nerve that has suffered permanent damage requires root canal treatment.
This involves the dentist flushing the inner tooth with a disinfectant fluid and cleaning inside the tooth with some small files designed to remove the tooth’s nerve. Once the inside of the tooth has been cleaned and disinfected, we make the root filling, which consists of a rubber material called ‘gutta percha’. This material fills the cavity in the tooth where the nerve was previously located.
Often, the root-treated tooth is first fitted with a plastic filling. But, in the vast majority of cases, at a late stage it will need a crown to protect the tooth to prevent it from breaking.
A root canal treatment often requires several visits to the dentist.
Occasionally it is impossible for the dentist to clean and disinfect the inside of the tooth sufficiently for all the infection to disappear. This is because some teeth have very narrow channels with small side branches that make cleaning impossible. In this case, the tooth will be subject to recurring or continuing symptoms in the form of a throbbing. This will appear in X-rays as a ‘dark glow’ around the root of the tooth. In such cases, retrograde root canal treatment - also referred to as root tip amputation - may be necessary This is a procedure, in which the dentist flaps the gums aside, next to the tooth in question, and removes the inflammation around the root tip as well as a small part of the root. A small filling is then placed in the root. The gums are put back in place and given some little stitches, which the dentist removes after a week.