Root canal treatment ( endodontics ) involves the removal of the dead, or irreversibly inflamed tissue in the tooth and root canal space. Some teeth have one canal (upper incisor and canine teeth, some lower incisor teeth). Some have 2 canals (first premolars and some second premolars, some lower incisor teeth) Some have 3 canals (upper premolars occasionally, some molar teeth) and some have four canals (upper first molar teeth, some upper second or third molar teeth and some lower molar teeth).
The tooth is anaesthetised as for a normal filling. Rubber dam is placed to isolate the tooth to prevent contamination of the tooth by saliva, which contains normal bacteria. The dam also allows the use of antibacterial chemicals to disinfect the canals and kill bacteria. Without the rubber dam it is not possible to use the chemicals safely in sufficient quantities.
The number of canals is identified from the xrays, from experience and by using an operating microscope, which affords a much greater image making it significantly easier to identify all the canals and tissue spaces which are harbouring bacteria.
When all the space inside the root canal has been shaped and cleaned this space is then sealed ( obturated ) with heated gutta percha, a natural material which is used to compact a sealer against the walls of the canals and spaces. This is sometimes done at the first treatment visit or alternatively if more time is required to better clean and disinfect the root canal, then the obturation is done at a subsequent visit.
There is no discomfort during this procedure as this is always done under local anaesthetic. After a root canal visit many patient s experience little or no discomfort. Those that do experience some discomfort should take anti-inflammatory medication such as Nurofen and/or painkillers such as Paracetamol. Only very rarely will a patient experience an increased inflammatory response, known as a flare up, and as well as significant discomfort there may also be some swelling. As stated, this is rare and the treatment is again anti-inflammatory medication (Nurofen +/- Paracetamol). If you should experience a flare-up you should contact the surgery and additional painkilling medication can be prescribed