Root Canal Treatment
Root canal treatment may be necessary if the nerve in the tooth has died, or following a dental trauma which has damaged the nerve in the tooth. Lingering sensitivity to heat, or spontaneous toothache which lasts more than several minutes, requires pain killers, and prevents sleep, are often signs that the nerve in the tooth is irreversibly inflamed, requiring treatment with either root canal treatment or extraction.
A back tooth which has been root canal treated may need a crown to protect it from further breakdown. Back teeth receive higher biting forces than the front teeth, which can be even greater once the nerve has been removed from the tooth, as there is no sensory supply to protect it from a high load being applied by the bite. The risk is that a ‘catastrophic fracture’ can result, leaving no option but to extract the tooth.
Referral to a specialist endodontist may be offered if the tooth appears to have a complex anatomy, such as twisted or curved roots, or an ‘open apex’, whereby the nerve in the tooth has died before the root has finished closing in at the top, making it difficult to predictably fill the root.