Treatment
Root canal treatment in Northampton
When the nerve inside a tooth is inflamed beyond recovery or has died, root canal treatment is what saves the tooth. The diseased tissue is removed from the canals within the roots, the canals are disinfected and sealed, and your dentist restores the tooth so that it can carry on working. For patients in Northampton and across Northamptonshire, every treatment is carried out under an operating microscope by Angel Ognemirov.
What goes wrong inside a tooth
At the heart of each tooth is a soft core of nerve and blood vessels — the pulp — running down narrow canals inside the roots. Decay that reaches it, a crack, a large or frequently replaced filling or a knock can let bacteria in. The pulp reacts with inflammation, which is when temperature starts to hurt, and then dies. Infection then escapes through the tip of the root into the jaw. That is the story behind most severe toothache and almost every dental abscess.
Root canal treatment removes the cause. The damaged tissue is cleared, the canal system is cleaned and disinfected to its full length and the space is sealed so that bacteria cannot return. The tooth remains in the jaw and, once restored, chews as it always did.
Signs the pulp is in trouble
- hot or cold sensitivity that persists for half a minute or more;
- pain that appears on its own, throbs or wakes you;
- a tooth that is tender to bite on or to tap;
- swelling of the gum or face, or a gum boil that keeps returning;
- a tooth that has darkened after an old injury;
- a shadow at the root tip on an X-ray with no symptoms at all.
Because several other conditions imitate these, nothing is proposed until a toothache investigation has confirmed which tooth is responsible and why — the guide why does my tooth hurt when I bite? walks through the usual suspects.
The appointment, stage by stage
- Anaesthetic and a test. The tooth is numbed and checked before anything else. Pressure and vibration are normal; sharp pain is not, and more anaesthetic is given immediately if any breaks through.
- Isolation. A thin rubber sheet is fitted around the tooth to keep saliva out and the disinfectant in. You can swallow and breathe normally behind it.
- Access. A small opening is made through the biting surface or an existing filling.
- Cleaning and shaping. Each canal is measured electronically and shaped with fine, flexible instruments while disinfectant is flushed through and activated to reach the side branches. The microscope reveals canals that would otherwise be missed.
- Sealing. The dried canals are filled with a rubber-based material and sealer and the opening is closed.
Most teeth are completed in one appointment of 60 to 90 minutes. A badly infected tooth, or one with complicated anatomy, may be dressed with an antibacterial medicament and finished at a second visit — the guide on temporary fillings between appointments explains what to expect in between.
How it feels
With the tooth properly numb, root canal treatment feels like a long filling — pressure, vibration and water, not pain. The real effort is keeping your mouth open for an hour, so breaks are offered. If dental treatment makes you anxious, the page on nervous patient care explains how the visit is adapted.
Recovery
The tooth and the gum around it feel bruised for two or three days, particularly on biting; ordinary painkillers are normally enough and the discomfort fades as the inflammation settles. Chew on the other side until the tooth has been permanently restored.
Protecting the tooth
A root-treated back tooth should have a crown or onlay, because without its pulp the tooth is more brittle and can crack under chewing forces; some front teeth are fine with a filling. Your own dentist fits the restoration, ideally within a few weeks, and receives a report with X-rays and a recommendation. Looked after this way, a root-treated tooth can last for decades.