Root Canal Treatment
About the Proposed Treatment
Root canal treatment, also called Endodontic treatment, is prescribed to relieve pain/discomfort when the nerve tissue (pulp) in the middle of the tooth has been infected or damaged as a result or due to injury. After the tooth has been numbed, access to the infected pulp in the tooth and its root(s) can be reached by drilling through the biting surface of the tooth. Small delicate metal files are used to remove the pulp. The canals are cleaned, enlarged & shaped to prevent further infection. Each empty canal is sterilized and filled with a “rubber like” material to prevent bacteria from getting inside. Several radio graphic images (x-rays) will be taken to check progress during the course of treatment. Depending on the pulp’s conditions, 1 to 4 visits can be expected. The opening in the tooth is closed with a temporary filling. At a later appointment a permanent restoration (such as a build-up or crown) will need to be placed. If the infected pulp cannot be totally removed because of a curved or blocked root canals, symptoms worsen &/or the tooth does not heal, an additional procedure called an “Apicoectomy” (root tip amputation) may be required to seal the root canal.
When the root canal therapy is completed, the tooth tends to be brittle and the temporary seal will last only a short time. Failing to return as directed to seal & protect the tooth with a permanent restoration can lead to further decay, infection, gum disease, or fracture requiring an extraction (even when the root canal treatment was successful).
Application of Medicament/MTA
Placement of medicament will be determined during the course of treatment. They are used to ensure the success of treatments, minimize patient discomfort, and reduce the risk of relapse of infection. Medicament provisions are placed on & as needed which may entail additional cost to the patient not covered by an insurance. In some instances such placement is used as an alternative initial treatment to root canal therapy on teeth which have not fully developed. Such treatments will aid in subsiding symptoms and will allow for a long-term temporary treatment while the tooth matures further. The treatment is provisional and does not replace the necessity for root canal therapy. The initiation of root canal therapy will be determined over the course of time by the treating Endodontist.
Patients with Existing Cast Restorations
Patients presented for treatment that have existing permanent restorations need to be advised that provisions to keep existing restorations intact are unlikely. In most cases your current restoration will either be accessed through or cut off during the course of treatment to complete the necessary therapy. In this event, you will be advised to return to your general dentist for a new permanent restoration. The restorative treatment will be at the sole expense of the patient.
Benefits And Alternatives
Root canal treatment is meant to save your tooth for a longer period of time, in order to maintain your bite and jaw functions. Removal of your tooth is the most common alternative and may require replacement with a removable appliance, fixed bridge, or an implant.
Soreness, pain, and infection that may occur for several days during & after treatment can be relieved with pain medication or antibiotics. Do expect some sensitivity after each visit as the infection resolves.
Stiff or sore jaw from holding your mouth open during the treatment may temporarily make it uncomfortable for several days afterward.
Broken file tips may occasionally occur in curved or blocked canals. Depending on its location, the fragment (sterile, non toxic, & stainless steel that causes no harm) may be retrieved or used to seal the canal. It may be necessary to perform an Apicoectomy to seal the root canal.
Overfill occurs when filling material extends beyond the root canal into the surrounding bone and tissue. This happens when an opening at the root tip or an abscess prevents the sealing for the root canal.
Discontinued or failed treatment due to your resistance to infection, perforation of the tooth because of decay, undetected root fracture (present & future) or non restorative conditions of the tooth due to unforeseen conditions.
There is a chance that root canal treatment will not resolve your pain even though the success rate is high. In such instances other procedures such as re-treatment, Apicoectomy, or an extraction may be necessary to resolve your pain. If these circumstances arise these procedures may result in an additional cost to you. Consequences of not performing treatment may lead to continued discomfort, risk of serious infection, abscesses in the gum and bone surrounding your teeth and eventually, the loss of the tooth.
Please initial the following statements that you agree with.
I read and write English and give my consent for the proposed treatment as described above ________.
I understand that upon completion of Endodontic treatment permanent restorative treatment will be necessary____________.
As a patient being referred I understand that I will need to return to my primary dentist for permanent restorative treatment in a timely manner _______ .
Every reasonable effort will be made to treat your condition properly, although it is not possible to guarantee results of this treatment. By signing below you have read this document, understand the information about the proposed treatment, and have all your questions fully answered.
Patient/Patient’s Guardian Signature Date:
Doctor Signature Date