Root Canal Treatment

This is the procedure in which the pulp (nerve) of a tooth is removed and the root canal of a tooth is filled with material. 

In order to do this, the dentist will take x-rays of the tooth and use files and reamers to cleanse the root canal system.

Once inside the tooth, the dentist will clean out the damaged tissue from the root canal system before it is sealed with filling material to prevent re-infection.

When a dentist is providing root canal treatment, the first step is to give the various options for different types of treatment and obtain consent. Alternatives include extracting the diseased tooth and replacing it with an implant and crown. 

T G Baynes can pursue a Dental Compensation Claim on your behalf on a No Win No Fee (CFA) basis meaning that you pay effectively no legal costs should your claim fail on your behalf.  To contact us email us on info@tgbaynes.com or call 020 8301 7777

Common reasons for a root canal

Any trauma or infection to the canal will result in the need for root canal therapy. Common reasons for this include: 

  • Tooth decay invades the tooth, penetrating through the enamel and then the dentine into the pulp.
  • A tooth has become abscessed and infected.  
  • Trauma, such as a chipped or broken tooth occurs and results in the exposure of the nerve.  
  • A tooth is slowly dying due to ageing or past trauma that did not result in the need for treatment at the time of the injury

The root canal procedure

Root canal treatment can be performed in single or multiple visits. The dentist should advise you of the number of appointments necessary to complete the canal. If you have an infection or abscess in the tooth, you may be given a course of antibiotics before completing the root canal. You will normally be given a local anaesthetic before the dentist commences work. He will also take an x-ray of the tooth.

The dentist will place a rubber dam over your mouth, to keep the tooth isolated from your saliva. The dentist will then begin the procedure by drilling a small hole through the tooth into the area known as the pulp chamber and this is where the nerve of the tooth is located. The dentist will begin using tiny files to remove the nerve from the tooth. During the procedure, your dentist must ensure that the entire nerve is removed to prevent toothache after the procedure and re-infection of the tooth, which may result in the need for re-treatment or extraction of the tooth.

Once the dentist is confident that the entire tooth has been cleaned out, the rubber material is placed inside the tooth which it seals. The dentist removes any remaining decay from the tooth and will decide to either put a temporary filling on to close your tooth or proceed with placing a permanent filling.

Unfortunately, sometimes things can go wrong. The dentist can root fill the wrong tooth or he can perforate the root. If the root filling material is not positioned at the correct length, it is either too short or too long, the tooth infection can return. Occasionally the instrument can fracture whilst accessing the root canal. Small files or reamers are normally used by hand or in a rotary instrument and during the cleaning and widening procedures of the root canal, these reamers or files can fracture, leaving some of the instrument left in the root canal.

The fracture of a file or reamer during root canal therapy is not in itself below an acceptable duty of care. However, broken root canal instruments are notoriously difficult to remove and any reference to an instrument left must be contemporaneously recorded on a patient’s dentist record card. What is regarded as below an acceptable standard of care is the failure to inform the patient that an instrument has fractured in the canal. Not only must the patient be informed of this occurrence, but also be told the treatment options such as to leave it in situ or offer a referral to an endodentist – someone who specializes in root canal work.

If an instrument used during root canal procedures is inhaled and a rubber dam is not in place to protect the airway, then this may lead to a successful claim. Swallowing or inhalation of an instrument will also lead to successful claims.

Another reason for a claim may involve when sealing materials pass through the apex of the tooth. Some sealing materials can cause adverse reactions if the material passes through the apex of a tooth, for example, immediate swelling could result in cellulitis. Some sealing materials have led to damage to the inferior dental nerve which could lead to ongoing paraesthesia or numbness.