Root Canal Treatment

Root canal treatment can save an inflamed tooth from subsequently forced extraction. As a result of advanced tooth decay, bacteria can reach deep into the tooth where its nerve is located. If it is not treated early it can have serious consequences. In an attempt to avoid it the doctor (endodontist) applies root canal treatment.

What is a root canal?

In the center of each root of the tooth passes a canal where the nerve and blood vessels are located. The front teeth have one root and one canal, the premolars have one or two roots and canals, and the molars have three or more canals.

When the dental pulp is infected or damaged, root canal treatment is required. This procedure will preserve the tooth and restore its normal function. The treatment is performed in several stages. First, local anesthesia is applied and the tooth is opened, then the contents of the root canals are cleaned, the nerve and pulp are removed and the tooth is sealed.

Why do root canals get infected?

There are many causes that can lead to infection or damage to the dental pulp. According to the Singapore dental portal Dentaleh, these are the most common causes that require root canal treatment:

  • Periodontitis of the tooth. Periodontitis often requires root canal treatment. This disease occurs when the dental pulp dies and a pocket of pus forms around the root of the tooth. The pus collects in the area of the killed nerve tissue that is infected with bacteria. Untreated periodontitis of a tooth leads to infection of the bone around the tooth root. The infection can spread to the surrounding bone and tissue and develop into an abscess. Although antibiotics can limit the spread of the infection, the only way to eliminate it is to perform root canal treatment.
  • Tooth decay. When the tooth decay is progressing it is reaching and infecting the dental pulp with bacteria. When this happens, the dental pulp becomes inflamed and painful. Sometimes this is painless, but the only way to get rid of it is by performing root canal treatment.
  • Trauma to the tooth. If a tooth is hit hard, the nerve can break at the end of the dental canal and die as a result. This can happen immediately after a traumatic accident or after years as a result of old trauma.
  • Fracture or breakage of a tooth. Root canal treatment of a fractured tooth may be necessary when the fracture is deep and reaches the dental pulp. 
  • Multiple tooth treatments. Repeated treatment of the tooth can lead to tension on it. Sometimes repeated cleaning of the tooth with a dental machine can cause infection of the dental pulp. In these cases, it is necessary to assess the dentist whether the inflammation is recoverable or not.

The most common symptom that indicates the need for root canal treatment is a toothache. Normally, this pain is very specific. If the tooth is alive, it is very sensitive to heat or cold. Sudden pain may occur at night, and sometimes when you eat, drink or touch your tooth.

In the past, the only treatment for such situations was tooth extraction. Nowadays, root canal treatment is an extremely valuable opportunity f which allows you to preserve your teeth and to use them effectively for many years.

How is root canal treated?

Root canal treatment or endodontics is performed in the following steps:

  • Applying anesthesia to numb the tooth;
  • Isolating of the tooth with a small shield to keep the area dry and clean;
  • Opening through the crown of the tooth and into the pulp chamber;
  • Putting fluid in the canals to kill any bacteria and help rinse out debris; 
  • Removing the pulp by using small instruments;
  • Cleaning and shaping of the canals;
  • Filling the root canal space with canal fillers and sealing the root canals. 

How long does a root canal take?

It depends on several factors:

  • The number of tooth canals – one or more canals;
  • Straight or curved canals. The more curved they are, the harder it is to work;
  • Location of the tooth in the dentition. The front teeth are easier to work with. The upper molars are the most difficult due to very difficult access to them;
  • Beginning of the inflammatory process. The older the infection, the longer it takes to eliminate the various bacterial colonies.

In some milder cases, all stages of root canal treatment are performed in one visit. More often it requires 2 or 3 visits and a follow-up period. Each case has its individuality and should be assessed on the spot by the dentist.

Why is a root canal done in 2 visits?

Root canal therapy is normally done in 2 visits. Numerous visits are necessary in case there is inflammatory fluid or bleeding from the root canal, limited endurance of the patient, common diseases requiring shortening of the treatment process, and other complications during the treatment. Some diagnoses definitely require more visits. For example, the treatment of acute and chronic periodontitis is multi-stage and is completed when there is no pain, the root canal is dry and the tooth is functionally fit.

  • First visit. After anesthesia, the tooth is sharpened to provide access to the dental canals. The canals are widened with special tools with increasing diameter. If there is no infection, they are filled immediately. A control X-ray is mandatory. If one of the canals is not filled well, it is filled again. If the canals are infected, the filling is delayed until the infection is controlled.
  • Second visit – tooth restoration with filling or crown. The treated teeth are more fragile than healthy ones. They no longer have blood vessels and dentin, their main tissue is missing in the central part of the tooth. Most often, the posterior teeth after canal treatment have two thin and high walls, which are at increased risk of fracture. Normal fillings do not stabilize the tooth. Therefore, it is recommended to make a structure such as a crown that will not only restore the lost tissue but also provide protection against future fractures.

How painful is a root canal?

The treatment is performed with local anesthesia that reduces pain. The most important thing is to see a doctor as soon as pain occurs. With the development of edema and the presence of severe pain, it is difficult to perform a completely painless root canal treatment. This is because advanced inflammation creates increased acidity in the tissues. This acidity does not allow the anesthetic to function normally and completely anesthetize the area. Untimely consultation can lead to pain during the treatment process.

Is crown necessary after root canal?

Root canal treatment requires extensive cleaning of the inside of the tooth. This makes it prone to breakage. That’s why it is recommended this tooth to be restored with a dental crown. This will protect it from the subsequent breakage of the tooth walls.

How much does root canal cost in Singapore?

The cost of a root canal treatment varies depending on which tooth needs it. You can typically expect to pay somewhere around $500 – $1000. Molars are significantly more expensive than premolars and front teeth because they normally have more canals. Here are some of the average prices of a root canal treatment in Singapore:

  • Front teeth – $300 – $500;
  • Premolars – $500 – $800;
  • Molars – $800 – $1000.

According to CPF root canal treatment is a non-surgical dental procedure which means that it is not Medisave claimable.