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How are root canals performed? A guide to endodontics

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Whether you’re just curious or you have an upcoming appointment, it is time to learn about endodontics or ‘under the tooth’ procedures. First, there is a fair bit of variety in how each canal filling is carried out, based on the severity and different tooth structure of each patient. This article is going to talk about the typical (or uncomplicated) root canal Dentist Harley Street.

A full canal filling is very unlikely to be carried out in 1 appointment, usually 2 or rarely 3 based on the wishes of the patient. It cannot be performed if there is a progressive infection. As an abscess is usually the reason for endodontics, a course of antibiotics will be prescribed for a week before the tooth can be operated on.

Laying the groundwork

Step 1 is a set of x-rays; it is difficult to see the full extent of the infected root as it is below the gum line. The x-ray will give our dentist the information they need to proceed.

If the x-ray displays a case too complex for a regular clinic, the patient would be referred on to a specialist endodontist like us. Usually, a local anaesthetic is used but if the infection has killed the nerve, there would be no discomfort and such agents are unnecessary. With nervous patients, full sedation can be used.

The fitting of an oral dam is performed to protect the rest of the teeth and mouth, as well as stopping the patient from swallowing any of the tooth fragments.

man with swollen cheeks

Getting to the root of the problem

The upper surface of the tooth is removed, revealing the pulp and nerves; the pulp is scraped out and if there is any pus remaining it will be drained. Once the tooth is clear of infected debris the canal will be visible. Though it is far too narrow to clean or apply a filler, our dentist will enlarge it with a set of very fine files right down to the root tip. This has to be done cautiously and can easily take more than two hours per root.

There is a variation in the number of roots a tooth has, with front teeth usually having 1 and molars having 2 or 3 with wisdom teeth having up to 5! There are even root variations based on ethnicity. The work becomes much more complex with multiple roots, some of which may not be straight.

With so much time in the chair, breaks are needed. So, the partially widened tooth will be filled with a sterilising solution and capped with a temporary filling.

Root filling

With the canal widened and completely cleaned, a deep root filling can be used starting from the bottom of the root and extending up to the top of the tooth. Filled teeth tend to crack depending on how damaged the tooth is, so a crown may be needed.

A root canal saves teeth that would otherwise have to be extracted. Which, frankly, can be significant if it is a front tooth that is affected.

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