Root canal treatments are required when deep decay, traumas or severe gum disease cause the dental nerve to be exposed, infected or to die. The treatment involves an accurate clinical and X-Ray diagnosis, the cleaning and disinfecting of the root canals followed by sealing and filling the canal entirely so that no space is left for the bacteria grow in the canal and infect the bone at the tip of the root compromising the treatment.
The treatment can usually be done in one stage if at the time of the treatment the nerve is still alive but has been damaged irreversibly (irreversible pulpitis). In this case under local anaesthetic the nerve will be accessed and the canal system will be cleaned, enlarged and filled entirely in the same appointment. The entire procedure will take on average 2 hours, depending on the tooth involved. Small and big back teeth will require at least 2 hours of treatment as they have 2-5 root canals and lots of very exact measurements of the canal which is a must.
Two or more stages of treatment are needed if the nerve has died and has caused an infection in the bone around the tip of the root. In this instance, after cleaning, the dentist will put a dressing in the canal which will disinfect the walls of the canals assuring that hidden bacteria in the walls will be wiped out. The tooth might need to be left open for 1 or 2 days if there is a continuous discharge out of the bone. This will happen in abscesses when you will also be given a combination of antibiotics to help clear the infection and to relieve pain quickly.
In the second appointment, if the rules of performing root canal fillings have been fulfilled (no pain, no moisture in the canal etc) the dentist will fill the canals and will give you options of restorative solutions in order to protect the root filling from the mouth environment in the best way possible. Otherwise, the disinfecting dressing will be replaced and you will have to attend a third appointment to receive the root filling.