Treatment › what to expect?
Non-surgical endodontics
The rationale behind this procedure or RCT is cleaning, shaping and filling of the root canal(s). The process will be carried out under local anaesthesia and so there should be no discomfort. Sometimes the tooth may be difficult to anaesthetise and in these situations special anaesthetic techniques will be used to ensure that the procedure is carried out without any discomfort.
The first step involves isolation of the tooth using a rubber sheet called a rubber dam which will prevent any contamination of the root canal with oral contents and prevents any oral leakage of the chemicals used in the root canal cleaning process. After this a hole is made on the top of the tooth to gain access to the root canal(s). Once in the root canal, this will be cleaned and shaped using special instruments called files. Along with this, the root canal will also be cleaned using chemicals to reduce the bacterial numbers. On completion of this stage, depending on the clinical picture, the tooth will be dressed with a medicament and a temporary filling placed OR will have the final root filling done and a temporary filling placed. When the final root filling is placed, the permanent restoration/crown must be placed as soon as possible – you should contact your dentist for this to be carried out.
Root canal procedures are very complex and as such are time consuming. Each visit may take up to 2 hours and it may require up to 3 visits to complete the procedure. This will depend on the number of canals in the tooth and the complexity of the case.
You may have some discomfort post treatment and it may be necessary for you to have painkillers regularly for a few days. If there are any adverse events such as increase in pain or swelling, you will need to contact me in the first instance.
Surgical endodontics
This is surgery carried out to gain access to the root end and surrounding areas to remove infection and inflammation. In this procedure, an incision is made on the gum and a gum flap raised so that the root end and the surrounding areas can be visualised. The area is then cleaned and any infected or inflamed tissue removed. The end of the tooth is also removed and the root canal is sealed with a filling. The gum flap is put back and sutured. The stitches are dissolving in nature, but the stitches are usually removed in a week or two.
The surgical area will be uncomfortable and swollen for 2-3days after which it will start to get better. Regular analgesics and anti-inflammatory medication will be prescribed along with any antibiotics if required. Use of a cold pack on the cheek over the treated area is recommended to help reduce the swelling. Avoid any hot fluids, smoking, alcohol or any hard food for 24hrs. You will need to keep yourself hydrated and so take plenty of fluids. The area will need to be kept clean and the use of mouthwash will be recommended. Sometimes you might have bruising of that area which will resolve in time. If the symptoms increase in intensity, you will need to contact me in the first instance.