What is root canal treatment?

A root canal treatment is a significant procedure in Melbourne, but one that dentists handle every day. Before engaging in any type of dental work, it’s important to know the facts about root canals and their treatment.

Root canal treatment (also known as endodontic treatment) is a well established and researched treatment designed to eliminate bacteria from the infected root canal, prevent reinfection of the tooth and save the natural tooth. The treatment basically involves the removal of inflamed or infected pulp and the inside of the tooth is carefully cleaned and disinfected, then filled and sealed.

Root canal treatment in Melbourne is a common, mainstream treatment which had a bad reputation in its early days but the techniques have changed dramatically in the last 10-15 years and it is now a predictable, and universal treatment performed by both general dentists and specialist endodontists. Millions of teeth have been treated this way all over the world since the 1960’s. Our Coburg dentists located in the north of Melbourne and just a short distance from Essendon, Pascoe Vale, Brunswick, Northcote and Thornbury, have been performing root canal treatment virtually every day.

Inside your tooth, beneath the white outer layer called the enamel and a hard inner layer called dentin, is a soft tissue called the pulp.

The top part is called the pulp chamber and this leads on to the canals.  There can be on or two canals for front teeth and 2 to 4 canals for back teeth. There can be variations of this also.

Some people refer to the pulp as the nerve of the tooth but it’s actually a lot more than just a nerve. This tissue contains blood vessels, minor nerves and some connective tissue, which help grow the root of your tooth during its development. Once a tooth is fully developed it can maintain its health without the pulp because the tooth continues to be nourished by the tissues including the gum surrounding it.

A root canal filling which is placed after the pulp canal has been cleaned is very similar to a routine filling and can usually be completed in one or two appointments. A number of factors will influence the number of visits including the amount of infection, the condition of your tooth and your personal circumstances. Getting a root canal in Melbourne is relatively pain free and usually painless because we use local anaesthetic which is extremely effective. You’ll be back to smiling, biting and chewing with ease in no time.

What are the advantages of saving the natural tooth with root canal treatment?

There are several advantages of root canal treatment over the alternative treatments including

  • Efficient chewing and biting with the same sensation
  • Normal biting force
  • Natural appearance
  • Protects other teeth from excessive wear or strain
  • Maintains the jaw bone quantity and quality
  • Maintains the gum shape

After endodontic treatment the tooth is pulpless, but it is not a dead tooth.

How does the pulp become diseased?

The most common cause of pulp damage is deep tooth decay which extends beyond the enamel and the dentine and then allows bacteria from your mouth to reach the pulp. Because these bacteria are not normally found in the pulp, they multiply and spread and the pulp may then become inflamed or infected. Products of infection may then spread through the opening at the tip of the root, called the apex, into the surrounding bone. If allowed to continue, the infection will form into an abscess and this may cause pain to hot and/or cold and chewing or biting and a swelling which can become quite large. Other causes of pulp damage include: trauma to a tooth, leakage around old, loose or defective fillings, excessive wear of teeth caused by grinding (bruxism), and cracked teeth. These processes can then lead to the infection of the pulp.

What are the signs and symptoms that a tooth may need root canal treatment?

Some signs to indicate you may need endodontic treatment include:

  • Continuous pain
  • Extreme or prolonged sensitivity to hot or cold especially if not relieved with toothpastes for sensitive teeth
  • Discomfort when chewing or biting
  • Discoloration of a tooth. This may be grey or a darker yellow when compared to other teeth
  • Facial swelling or swelling of the gum

Sometimes you may have no symptoms at all, which is why regular check-up appointments with your dentist in Melbourne are so important.

How is a diagnosis made by the dentist in Melbourne?

Following the initial discussion and questioning about the symptoms which the patient is experiencing, an examination with a mirror and probe is undertaken. Following this, the dentist will take an x-ray to assess if there is tooth decay, a crack or an abscess and will then assess if the tooth is restorable.

Additional tests such as a pulp sensibility test where ice or cold cotton bud is placed on the tooth will also give the dentist information about the status of the pulp. There is also an electric version of this test.  The dentist may also tap the tooth with the handle of the mirror to confirm the diagnosis.

In some less common circumstances the dentist may order a special type of x-ray called an OPG or a cone beam CT to give additional information.

How does endodontic treatment in Melbourne save the tooth?

By removing the infected pulp, cleaning and shaping the root canals, the inflammation and pain is resolved. The root canals can then be filled and sealed to help prevent reinfection. Afterwards, the dentist places a crown or other restoration over the remaining tooth to protect it, prevent the tooth cracking or slitting and stop reinfection. Once restored, the tooth continues to function like any other tooth.

Should I have the tooth extracted and have an implant placed instead of a root canal treatment?

In recent years, a misconception has developed amongst some dentists that implants have a ‘more predictable’ long-term outcome than root-filled teeth. This has not been supported by research. In reality, when carried out to a high technical standard, root canal treatment is very successful. This actually holds true for all treatments! Research has shown that statistically over 90% of root treated teeth will be present in ten years, which is comparable or better than most alternatives. We have found this in our clinic in Melbourne also.

There are important factors to consider when deciding between root canal treatment and implants, and this decision should be made with the benefit of professional advice.

As we age, our general medical health can often deteriorate and many conditions such as osteoporosis and diabetes will have an adverse impact on the long-term success of an implant. Similarly if you have periodontal disease (gum inflammation) or are a smoker, implants are generally more at risk of failing than a root filled tooth.

This is because diabetes, smoking and other conditions adversely affect the body’s ability to heal well.

Implants are also more likely to be linked to problems with gingival aesthetics (the appearance of the gums). Implants do not retain the jaw bone as well as a root-filled tooth and in the front of the mouth that can cause cosmetic problems over time.

From a financial and practical point of view, root canal treatment in Melbourne and subsequent restoration of a tooth, is in most cases, cheaper and can be completed over a much shorter period of time.

Root canal treatment also avoids the need for patients to go without a tooth while an extraction site is healing or needing to wear a temporary denture for any period of time during the implant healing phase.

The evidence is clear that good quality root canal treatment in Melbourne, combined with a good quality restoration such as a crown, leads to an excellent long-term outcome. For that reason, root canal treatment should always remain the first treatment choice for patients with a restorable tooth experiencing pulpal disease.

Our dentists in Melbourne will explain your situation in detail during your initial consultation and offer you all the alternative treatment modalities that are suited to your circumstances.  The ultimate decision to treat is based on the findings of the examination and the discussion with you.

Is there any pain during or after treatment?

Endodontic treatment is a comfortable procedure and it involves little or no pain, as the tooth will be anaesthetised with local anaesthetic during treatment. However, sometimes you may experience discomfort after an appointment. This may be due to inflammation in the tissues surrounding the tooth. The inflammation may take a few days to settle down and mild analgesics such as paracetamol or ibuprofen may be required.

Sometimes the jaw joints can be tender because you need to keep your mouth open for a long period of time during the treatment.

If you do experience severe pain, or if your discomfort lasts for more than several days, you should contact your dentist for advice.

Can this treatment be done under sedation?

We offer general anaesthetic and intravenous sedation (sleep dentistry) options for treatment, if required. The general anaesthetic or sedation is offered on certain days when we book a medically qualified specialist anaesthetist to visit our rooms to administer the anaesthetic drugs to our patients.

We can also administer a light sedation (conscious sedation) which does not require the services of an anaesthetist.

Please contact us to discuss what’s best for you, or you can speak with your dentist directly about your options during your initial consultation.

Is every treatment successful?

Your tooth will only be treated if there is a good chance it will last a long time. However, people have varied healing responses and some infections may respond differently, so no guarantees can be given.

Studies have shown the majority of endodontic treatments are successful and uneventful. And we will inform you if your case is considered less favourable.

Healing of the jawbone around the tooth can be slow and it is important to have your tooth reviewed regularly to assess success. This can be done during your regular hygienist visit and check-up appointment.

In rare cases, additional endodontic procedures may be required to aid the healing of the tissues around the tooth. In some circumstances a referral to a specialist endodontist in Melbourne will be advisable. Our dentist will discuss this with you if it becomes necessary.

Is it common to require retreatment?

Whilst root canal treatment has a very high success rate, not all treatments are successful initially and some teeth can become reinfected at a later date. There is a common misconception that teeth with ‘failed’ root canal treatment have a high risk of repeated failure and so they are often extracted instead of being retreated.

The most common reason for unsuccessful initial treatment is generally persistent bacteria in the tooth. This usually occurs because of inadequate cleaning of the root canals, a poor restoration on top of the root canal treatment, a split in the tooth or a complex tooth anatomy such as an extra canal. If a retreatment is required, we usually refer the patient to a specialist endodontist.

During retreatments, an endodontist may locate and clean extra canals and access complicated parts of the inside of the root such as fins, isthmuses and lateral canals. These extra canals and complex hidden anatomical features are generally only visible with a microscope and able to be accessed with specialised tools and techniques.

Reinfection that occurs years after the initial treatment generally occurs because of more bacteria entering the tooth. This is may be due to leaking fillings, decay or cracks that have developed in the tooth. Using magnification or a microscope, dentists and endodontists are able to diagnose these problems quickly to ensure the infection is removed so the problem does not reoccur after retreatment.

With modern techniques in Melbourne, the prognosis of a retreated root canal tooth is virtually the same as a first-time treated tooth.

Is it safe to have root canal treatment during pregnancy?

Preventative dental check ups and cleans are usually recommended and the norm prior to and during pregnancy to avoid more significant problems arising. If issues do occur, it is still safe to have dental treatment including root canal treatment carried out during pregnancy. In fact, it can be more risky to leave infection in teeth untreated as complications like an infection spreading, facial swellings and fevers with general malaise may develop. Generally treatment in the second trimester is preferred, as by this stage your child’s organ development is essentially complete, and by the third trimester lying on your back for a prolonged period of time can be uncomfortable.

We use anaesthetic that is safe throughout pregnancy and with low dose digital radiographs and lead aprons, there is minimal exposure (if any) of the baby to any x-ray radiation. All the root canal work is carried out efficiently to quickly relieve your dental pain and allow you to get back to concentrating on and hopefully enjoying the pregnancy.

If you have any doubt, please consult your doctor, obstetrician or mid-wife. We will happily consult with them to ensure your treatment is conducted in a safe manner with their recommendations.

However, emergency treatment in Melbourne can be carried out at any stage to relieve your pain and to reduce the stress on yourself and the baby. At Coburg Dental Group we are always available to manage emergencies in a timely manner.

Is there an alternative treatment to root canal treatment?

Endodontic treatment is a very safe procedure and it’s undertaken to save your tooth. There is no real substitute for your own tooth which is better than the original tooth– it’s far more efficient in chewing and biting than any type of artificial tooth.

The only alternative method of removing the infection is to extract your tooth.

If you do not have the tooth replaced with an artificial one, the adjoining or opposing teeth may move towards the space causing interferences and other issues with biting and chewing. Loss of a tooth may also lead to other complex problems including decay of other teeth, uneven wear of the teeth, jaw joint and jaw muscle problems, and gum disease. Replacing your tooth with an artificial tooth often involves more complex treatment such as dentures, bridgework or implants, which is often more costly, time consuming and requires more maintenance in the long term.

How much does root canal treatment cost in Melbourne?

At Coburg Dental Group, we’re committed to providing patients with an accurate estimate of all treatment costs at your initial consultation. The initial consultation fee is approximately $175 which includes an initial x-ray and all the initial tests.

The fees can vary depending on the number of visits required and the complexity of the case. Each case will be assessed at the time of your consultation and the dentist will discuss with you in detail the fees and number of visits required for your treatment, enabling you to make an informed decision on what’s best for you moving forward.

If you have private health insurance extras cover, your health fund may provide a rebate for endodontic treatment and the final restoration of the tooth. Our reception team can help you with the relevant item numbers so you can check the rebate with your health fund. Unfortunately due to privacy legislation we cannot do this for you.

We also have interest free payment terms and AfterpayÒ.  Our receptionists can help you with your application.

Any surgical or invasive procedure carries risks. Before proceeding, you should seek a second opinion from an appropriately qualified health practitioner.

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