Root canal treatment

Root canal treatment, also called endodontic treatment, consists of removing the vital part of the tooth, disinfecting the entire internal root canal system of the tooth, widening the main channels and filling them with a sealing material to seal them.

Following root canal treatment, it is recommended to restore the tooth to protect it. Ideally, the tooth will receive a complete crown with or without pivots. It is also possible, but less recommended, to place an amalgam or composite resin restoration, as these materials are not resistant enough to fractures.

The teeth have a variable number of main channels. Here is the number of channels that teeth usually have:

Central incisors: 1 canal;
Lateral incisors: 1 canal;
Canines (eye tooth): 1 canal;
First premolars: 1 or 2 canals (often two);
Second premolars: 1 or 2 canals (often one);
First molars: 3 or 4 canals (often 4, especially those at the top);
Second molars: 3 or 4 canals (often 3);
Third molars, or wisdom teeth: 3 canals (rarely treated endodontically).

Very deep cavity;
Irreversible pulpitis;
Necrotic tooth;
Tooth not restorable, because it is too damaged.

Advantages

Root canal treatment is sometimes the only way to save a tooth that would otherwise be extracted;
The treatment success rate is very high;
The treatment is painless, as it is performed under local anesthesia.

Disadvantages

Root canal treatment may require several sessions;
In complex cases, the dentist may have to repeat certain steps of the treatment if the results obtained are not satisfactory.

Risks and consequences of not treating

Increased pain or acute pain;
Tooth discoloration;
More widespread abscess and/or infection, which can spread to the rest of the body and even severely affect health;
Loss of tooth.

Processing steps and times

Clinical and radiological examination of the tooth;
Prescription of antibiotics;
Depending on the number of roots to be treated and the extent of infection, one to several appointments are necessary to complete the treatment;
Anesthesia of the tooth and gums;
Protection of the tooth’s environment by placing a dam around it;
Opening of the tooth from above;
Cleaning, disinfection and mechanical preparation of the pulp chamber and channels;
Sealing of the channels with a plastic material;
Closing the tooth with a temporary filling;
Final repair of the tooth with a crown.

After the procedure

Some pain may be felt when in contact with the tooth; it will disappear after 72 hours with the use of analgesics prescribed by the dentist;
Taking a prescribed antibiotic can control the swelling induced in the case of a previously infected tooth.

Cost

There are several aspects to consider when evaluating the cost of root canal treatment:

First, the cost of treatment depends on the number of channels the tooth has (from 1 to 4);
Second, the cost of root canal treatment at a general dentist includes the following procedures, spread over one or more appointments: the treatment plan, clinical procedures (cleaning, shaping of the canals and root canal filling) and x-rays;
Finally, the cost of root canal treatment excludes the final restoration of the tooth. It will therefore be necessary to add the cost of an amalgam or composite restoration. A crown can also be suggested. In this case, additional costs may be added, especially if a pivot is required for the installation of the crown.

In all cases, the fees are based on the Association des chirurgiens dentistes du Québec (ACDQ) Guide des tarifs et nomenclature des actes buccodentaires.

Restrictions

Tooth with a poor prognosis;
Periapical abscess on a wisdom tooth;
Accessory channels;
Calcified channels;
Root resorption;
Patient’s medical condition.

Alternative solutions

Extraction of the affected tooth;
Implant or bridge placement to replace the extracted tooth.