1Why can my own dentist not carry out this “root canal work?”
All dentists are trained to undertake root canal work and some are perfectly capable of doing so to a high standard. Others are not comfortable with the possible complications and lack the appropriate expertise and equipment to achieve the best results, so prefer to refer to a recognised specialist. In particular, if the tooth has been root treated before and inadequacies have become apparent, dentists may seek the assistance of a specialist.
2How long will it take?
We can only offer an approximate time schedule until we have investigated the tooth ourselves but in general, a vital tooth, ie: one that has not been root treated before, should require less time but factors such as the number and calcification of the canals and the restorative status will influence the time we require. For anterior and premolar teeth, expect 2 to 3.5 hours of treatment in either single or multiple appointments. For complex molars, multiple appointments will be required and the time involved may be up to 4.5 hours. A consultation and scan appointment will generally last up to 1 hour.
3What is an apicectomy/root canal surgery?
There are situations where it is preferable not to disturb the coronal restoration or it is not possible to renegotiate the root canal system and the problem should be addressed from the root end upwards. This is achieved surgically through the elevation of a small flap of gum tissue and consequent exposure of the root tips.
4Would it not be simpler to extract the tooth rather than spend all this time and effort?
Each patient will have a varied dental history and dentition and in some cases, given the cost and limited prognosis for restoring the tooth after root canal therapy, we will recommend extraction and replacement either with a bridge restoration or implant. If however, a particular tooth is vital to your overall dentition or occlusion, we believe it is worthwhile to endeavour to preserve it. For some patients, retention of natural teeth is always their first choice. We will discuss your personal options and dental status until you feel confident to make the choice appropriate for you.
5Can treatment be completed in a single session?
If there is evidence of active infection in your tooth or the potential for a flare up, it is always advisable not to complete treatment in a single appointment. If however the tooth has a viable blood supply and is not infected, we may well offer to complete treatment in a single session.
6Is root canal therapy preferable to an implant?
The choice will again depend on the balance of your dentition and the quality of the remaining tooth structure of the teeth involved. A natural tooth provides a better degree of function and movement than the more vulnerable and static implant and whilst implants may offer a lifespan of twenty years and may well be the only option in your case, they do depend on the quality of the bone into which they are placed and in many cases prolonged infection will have compromised the required bone levels and eliminate an implant from your restorative options.
7Why do I need a new crown after root canal therapy?
Root treated teeth have had their nerves removed and as a non-vital tooth may be considered slightly more prone to fracture so in some cases, it is deemed preferable to restore the remaining tooth structure with a well-fitting crown to guarantee the best prognosis. In some cases, it is sufficient to merely restore the access cavity like a normal filling and simply keep the tooth under review.
8Why can you not access the tooth through the current crown?
Depending on the quality and age of the crown, it may be damaged irrevocably by the creation of an access cavity so a root canal treatment may be facilitated by the prior placement of a provisional crown and when therapy is deemed successful, a fully protective coronal restoration can be constructed.