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  • TinWai Ip

Root Canal Treatment: The Scary Truth

Updated: Aug 22, 2023

Root canal treatment.

My condolences. If you’re here then you probably are considering a root canal treatment because of a poorly tooth. I’m sure it’s been a hard decision, and you’ve been obsessing about the causes that brought your tooth to this point, weighing the different options, fearing the actual treatment, and anxious about the change to your lifestyle afterwards. Know your options and figure out what is the best treatment for you. (Please consult your dental professional for full options and your personal risk assessment)

The aim of root canal treatment (RCT) is to treat infection that affects the nerves and blood supply of the tooth.

Why has it come to this?

Bacteria feed on your diet and causes dental decay (caries) in teeth. The dental decay weakens the structure of your teeth and causes holes in the teeth. When dental decay is not treated early, it can ‘eat’ through the layers of your tooth until it reaches the pulp (or core of the tooth). This creates a direct passageway for bacteria to infect the pulp, which contains the nerves and blood supply of the tooth. Infection of the pulp (i.e. pulpitis) leads to death of the tooth.

What are the signs and symptoms of symptomatic irreversible pulpitis?

- Permanent pulpal inflammation

- History of facial swelling/ dental infection

- Pain with pressure

- Discomfort last > 30s after removal of stimulus

- Pulp incapable of healing

- Postural changes can accentuate pain (e.g. sitting up or lying down)

- Ibuprophen may not be as effective a pain relief

What are the signs and symptoms of a dead tooth?

- Death of dental pulp

- History of facial swelling/ dental infection

- Not responsive to pulp vitality testing (available at your dentist’s)

- No pain

- Infection seen on x-rays

What to expect from your treatment:

1) Rubber Dam and LA

Once the tooth is fully numbed with local anaesthetic, a rubber dam is placed around the tooth (like a bib). This prevents our water from collecting at the back of your throat and keeps the tooth sterile, away from your saliva.

2) Into the tooth

The tooth is accessed through the crown and the root canals are located

3) Shaping and disinfecting canals

The canals are shaped and smoothed with files. The infection is clean chemically and

mechanically with disinfectant and filing. This may take a few appointments depending on

the infection and tooth structure.

4) Temporary dressing

Between appointments an antiseptic (medicated) paste is placed into the root canals, which

helps with the persisting pain. The top of the tooth is sealed with a temporary filling until our

next appointment.

5) Root filling

Once infection resolved, filling material fills and seals the root canals.

6) Tooth filling

The final filling material is placed into the tooth. Generally, a crown (made by a lab) is

recommended on a tooth after RCT to prevent fracture.


Pain (pre/during/post-treatment); failure of RCT; separation of files; perforation of tooth; discolouration; weakened tooth structure; fracture of tooth or crown

After treatment:

Expect some discomfort after treatment, over the counter painkillers may be taken 2 hours after treatment to relieve pain. Because of the change in tooth structure, a crown is recommended after successful root canal treatment to prevent fracture.

Good oral hygiene habits are always encouraged to maintain a healthy mouth.

Message or call to book an appointment if you have further questions or you would like to know more about your different options.

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