When a tooth is badly diseased, infected or decayed, it may need a root canal treatment. The root canal filling enables the patient to keep a damaged tooth by removing the pulp (the live part of the tooth), cleaning and shaping the canals, then filling them with a special filling material. Teeth that have been treated in this way should behave and feel just like regular teeth, although they may not be quite a strong as they were originally.

The treatment is usually performed over two dental visits, and under local anesthetic. It’s a more complicated procedure than a normal filling, since the dentist goes much deeper into the tooth to remove damaged pulp and bacteria. The process takes longer and involves specialist equipment and training.

It’s normally a highly successful procedure, with over 90% of patients having no further trouble. Occasionally, however, things can go wrong for various reasons and the treatment can fail. This can often develop into a root canal infection.

Feeling Pain

People like to tell scary stories about root canal fillings, but they’re no more painful to undergo than a regular filling. The dentist thoroughly numbs the area so, while it may take longer to complete, it shouldn’t cause undue discomfort.

Afterwards, because the dentist drilled deeper into the tooth to clean and repair the damage, you may feel some pain for a few days afterwards. This is a normal physical reaction to any procedure as the body begins to heal itself. The discomfort can range from a dull, aching feeling to a sharper pain although it’s not usually severe enough to prevent you going about your daily business.

Just occasionally, some bacteria may have been left behind during the cleaning process and, if this happens, it can reproduce and cause problems. Warning signs to look out for include if the tooth feels fine, then starts to hurt again. Don’t wait to see what happens, but contact the dentist for a follow up appointment so he or she can investigate. Further treatment may be necessary.

Undetected Cracks

Tiny cracks in the root of the tooth are often undetectable, and dentists can be unaware that they’re there until they cause trouble. When there are cracks present in the tooth or the tooth’s root, bacteria can enter and cause swelling and discomfort.

Branched and Overlooked Canals

Some teeth have complicated canal systems, which make it harder for the dentist to treat all of them effectively. Some forks or branches in the canal system can be minute, and are easily overlooked. It’s possible the dentist is unaware that they’re even there. Unfortunately, even microscopic canals are susceptible to infection and if they’re not cleaned and filled, they can cause problems in future by becoming infected.

Deterioration and Defective Materials

The root canal treatment creates a seal in the root that prevents bacteria reentering and creating more infection and irritating the tissues around the tooth’s root. Over time, the materials used in filling the root can deteriorate or break down, which leaves the area susceptible to infection once more. It’s important that the second, permanent filling is completed as soon as possible after the first, temporary filling was completed.

Once the root canal treatment is finished, the tooth is restored with a crown or, in cases where much of the original tooth remains, a permanent filling. Crowns are thought to be the most effective at preventing reinfection due to coronal leakage. When this happens, debris or bacteria inside the mouth can seep beneath the filling or crown that was supposed to protect and seal the root filling. This can result in the tooth reverting to the condition it was in before the root canal filling was done. Reinfection can occur very quickly, sometimes in a matter of days.

This is why it’s so important that temporary fillings and seals are replaced with permanent ones as quickly as possible, certainly within three weeks of the first step in this two-part dental process. Make sure you schedule your return visit as soon as possible

After Care of Root Canal Fillings

• Keep your teeth as clean as possible through thorough brushing. Make sure you floss at least every day. Twice a day isn’t too much to remove food debris from between teeth.
• Avoid chewing on hard, crunchy foods. They can cause teeth to break or crack, doing damage to root canal fillings.

Your own dentist is, of course, the best person to evaluate any problems you may have, as he or she knows your full dental history and the treatment you received.

However, problems can and do occur out of hours. We are able to investigate complications arising from root canal fillings, and can give pain relief and advice or treatment. If you’re having trouble or pain and your own dentist is closed, we are here to help with your root canal infections.