After Treatment
What are the after care guidelines to follow following root canal treatment?
Cleaning
•Clean your teeth at least once a day with a fluoride toothpaste
•Floss or use interdental brushes to clean in between the teeth daily
Eating habits
•Avoid chewing or biting down until the treatment has been completed
•Reduce the intake of sugary snacks and drinks as it limits the exposure of your teeth to acid, and hence the risk of decay.
•Minimize chewing on the tooth that has undergone or is undergoing root canal treatment until advised otherwise by the dentist to:
◦Prevent the temporary filling from coming out and contaminating the interior of the tooth again
◦Prevent tooth form breaking or cracking before it has been fully restored
Further dental work for restoring the functionality of the tooth
Often the tooth that has undergone root canal treatment may require restorative dental work to make them sturdier. Also, restoration work also helps to seal the teeth protecting its interior cavity from contamination by bacteria or other debris. The common restorations recommended by your dentist will vary according to your dental condition, and may comprise of any of the following:
1. A dental post – Posts are placed in teeth that have large portions of their tooth structure missing. To increase the stability of the tooth, dentists will have to increase the amount of tooth that extends up to the centre of the dental crown. This can be accomplished by using a dental post which will serve as the anchor for the filling material used to increase the height of the internal core of the tooth.
Method
A dental post is a rod made out of metal placed in the canal space by drilling and removing some of the gutta percha filling. The post is then cemented and a core of filling material is used to fill around the upper portion of the post.
2. A dental crown – Used to restore or repair a broken tooth and improve its appearance. Crowns are made of porcelain or metal and serve as excellent seals for tooth by preventing the contamination by bacteria or other debris in the mouth.
Method
•The treated tooth is prepared by trimming it into a tapered form, which will extend up to the centre of the dental crown to be placed and thus provide stability.
•An impression of the tooth is then taken and is sent to the dental laboratory to prepare a custom made crown for the tooth.
•The prepared crown is then cemented into place.
Repeating root canal treatment
Generally, the positive outcomes of a root canal treatment last a lifetime. However, if infection does return the treatment can be repeated.
Are there any other alternatives to root canal treatment?
Tooth extraction is the only other alternative where you can have the tooth with the infected pulp removed. However, it is always better to retain your natural teeth than have them removed.
When does root canal treatment fail?
Signs of a failed root canal treatment
•Mild to severe tooth pain
•Slight to more pronounced tenderness or swelling in the gums in the area near the tooth that can either be in a persistent or transient mode following root canal treatment.
Factors influencing the failure of the treatment
•Shape of the tooth’s root canals – If they have branches or forks they may be difficult to detect and therefore are overlooked during treatment.
•Unexpected number of root canals – When a tooth has root canals that are tiny they may be overlooked during treatment
•Undetected cracks in the root of the tooth
•Defective or inadequate dental restoration allowing bacteria to seep into the inner core and recontaminate
•Disintegration of the tooth seal with the passage of time causing bacteria to recontaminate the tooth
•Tooth structure that has broken as a result of the treatment and require restorative work for stability
•The treated teeth are not impervious to tooth decay and gum disease, in which case if extra hygiene is not maintained it can result in the loss of the teeth
•Poor response of certain bacteria to the root canal treatment
What are the complications associated with root canal treatment?
•Breaking off of the dental instruments or files in the root canal while cleaning the pulp chamber. This can be removed later but only by a specialised endodontist.
•Infection as a result of incomplete treatment or filling as a result of the root canals being complex or not being detected on the X-ray
•Poor response of certain bacteria to the root canal treatment
