Everything you need to know about root canals
Abscess – An abscess is the body’s response to infection at the end of the root of the tooth. The abscess could be acute or chronic. If it is acute you will have swelling or pain locally as well as a “fat face.” Immediate attention is required. See your dentist or an Endodontist.
Analgesics – We recommend that patients who are in discomfort should take over-the-counter painkillers, (analgesics), usually Paracetamol or Neurofen. But please discuss with your Endodontist before taking any medication.
Anaesthesia – There are several ways of making patients comfortable when they need endodontic treatment, from a pain-killing local anaesthetic injection through to sedation.
Antibiotics – Patients are only prescribed antibiotics when a tooth has a serious infection. Too often patients are prescribed antibiotics without a correct diagnosis having been made.
Apex – The tip of the root of the tooth.
Apical Foramen – The opening at the end of the root through which the nerves and blood vessels pass.
Apex Locator – A device used to determine the length of a root canal. Also known as an electronic root canal measuring device (ERCMD).
Apical Periodontitis – This is the commonest terminology for the disease process that requires endodontic treatment. It’s an acute or chronic inflammation caused by bacterial invasion of the tooth’s pulp. Apical periodontitis leads to an abscess at the end of the root.
Apicectomy – When infection persists in the bony area around the end of your tooth, your Endodontist may carry out a surgical procedure known as an apicectomy.
Aseptic – Free of any potential infection. All root canal treatments should be carried out in aseptic conditions.
Avulsion – When a tooth is lost due to trauma – it can sometimes be re-implanted and will invariably need root canal treatment.
Bacteria – There are many types of bacteria in the mouth. When bacteria penetrate the enamel of a tooth and enter the pulp, they cause inflammation or infection and root canal treatment will be required to save the tooth.
Biofilm – Bacteria cluster together to form biofilm in the mouth. This is the sticky plaque which needs to be cleaned from teeth regularly in order to prevent decay. Biofilm can exist inside the root canals of teeth.
Bleaching – A popular cosmetic treatment for whitening teeth. In the context of endodontics, it’s possible to carry out internal bleaching once a tooth has been root-filled to prevent it going grey.
Bruxism – Grinding of teeth, usually stress-related, which can cause wear leading to stress fractures and potentially the need for endodontic treatment.
Buccal – The part of the mouth nearest the cheeks.
Canal – Each tooth has at least one root and each root has a canal at the centre. Within the canal is the pulp of the tooth which may be inflamed or infected. When a tooth needs root canal treatment, it’s important to clean out the pulp or its remnants from the canal and fill it with a synthetic filling. Successful treatment involves identifying and treating all the canals.
Caries – Better known as tooth decay, caries is the most common disease of the Western world, normally associated with a diet of too many sugary foods and drinks. Once a tooth has caries, it will often require a filling. Further caries and filling will allow bacteria to penetrate the pulp, and a root filling will be required.
Cementum – The hard tissue similar to enamel which surrounds the root of the tooth.
Chlorhexidine – Antiseptic medication used as a rinse to prevent the spread of bacteria. Often used inside root canals to destroy bacteria.
Condensing Osteitis – Inflammatory disease in the bone surrounding the root of the tooth, although not serious, indicates an inflamed dental pulp and the need for root treatment. The condition is usually seen on a radiograph (X-ray) and shows up as a pale area (radiopacity).
Cone Beam Computed Tomography (CBCT) – Endodontic treatments require radiographs or X-rays but sometimes, CBCT can be useful. CBCT builds a three dimensional model of the tooth and its roots providing information over and above a standard X-ray. This valuable information aids diagnosis and treatment planning. CBCT is now widely regarded as the optimum standard of care before many endodontic treatments are undertaken. The Endodontist would advise if this was necessary.
Core – When large portions of a tooth are missing due to decay or fillings and a crown is required for strength, a core is the build-up material which is placed before a crown is added. Most root treated teeth require a core build up and crown after root canal treatment.
Crowns – Made by laboratory technicians, a crown provides complete coverage of a tooth. Most root canal treated teeth will require a crown afterwards for protection and strength.
Curettage – A surgical procedure to remove diseased tissue around the root, usually associated with apicetomy. The endodontist may send this tissue for a biopsy to assess its exact histological make up.
Cyst – There are many forms of cyst that can occur in the head and neck. If a dental infection at the end of the root is left “unchecked” it can become a dental cyst. Removal of a cyst may require surgical intervention (apicectomy).
Debridement – The removal of damaged tissue. This term is synonymous with curettage. Dental pulp tissue or its remnants are debrided from the root canal as part of the endodontic procedure.
Dental Abscess – An abscess can be chronic or acute and is a response to a bacterial infection. The most common type of dental abscess occurs at the apex of the root. This is known as a periapical abscess and is a by-product of a diseased tooth.
Dentine – The semi-hard part of the tooth below the enamel which encases the pulp.
Dentinal Tubules – Microscopic tubes within the dentine which carry dentinal fluid and connect with the dental pulp.
Desensitise – When a tooth or teeth become sensitive, they need desensitising treatment.
Disinfection – Elimination of bacteria, a process that takes place once a tooth has been opened up for treatment and before it has been filled.
Distal – Furthest from the centre, in dental terminology the part of the tooth nearest the back of the mouth.
Electrosurgery – A technique for shaping and cutting soft tissue, often for aesthetic reasons.
Enamel – Surrounds the dentine of the tooth and prevents decay from entering the dentine and eventually the pulp. It can be attacked and penetrated by sugar and bacteria generated acids and then the decay sets in.
Endodontics – The branch of dentistry concerned with the pathology of the dental pulp and surrounding tissues. Dentists should undertake an additional two years of training to be an Endodontist and are then accepted onto a General Dental Council specialist list.
Endodontist – A dentist with two or more years of advanced training whose practice is limited to Endodontics. The role of the endodontist is to help patients keep their teeth functioning and healthy. As specialists, they are usually equipped with the latest technology, such as an operating microscope.
(Root canal) File – Used to enlarge (shape) the root canal so that the irrigating solution moves all the way to the apex maximising its disinfecting effect. Files can be manipulated by hand or in a special dental hand piece.
Fistula – This is an abnormal passage from an endodontic infection at the root end to the surface of the gum adjacent to the infected tooth. It allows the discharge of inflammatory or suppurative material. A fistula usually indicates that endodontic treatment is required.
Healing – Eliminating apical periodontitis is the ultimate aim of endodontic treatment. When this is seen clinically and radiographically “healing” has occurred.
Hypersensitivity – Occurs in teeth when the dentinal tubules are open and react to hot or cold drinks and foods.
Private Dentistry Award for Julian Webber
Julian Webber was recently recognised for his “Outstanding Contribution to Private Dentistry” at the Private Dentistry Awards. With over 35 years dedicated to Endodontics, his role in developing this specialty in the UK has been acknowledged with this prestigious national award.