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When root canal treatment should be done

NHS ChoicesMedical Reference

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Root canal treatment is only required when it is clear that the soft tissue at the centre of the tooth, called the pulp, has been damaged by a bacterial infection.

Your dentist can test your teeth and use  X-rays to establish whether a bacterial infection has occurred. Dental X-rays use radiation to take images of your teeth to identify any problems.

Symptoms of a pulp infection

Pulp infection is usually caused by  tooth decay.

The symptoms of a pulp infection include:

  • pain when eating or drinking hot or cold food and drink
  • pain when biting or chewing
  • the tooth may become loose

As the infection progresses, these symptoms often disappear as the pulp dies. Your tooth then appears to have healed, but in fact the infection is spreading through the root canal system. Eventually further symptoms occur, such as:

  • pain when biting or chewing
  • swelling of the gum near the affected tooth
  • pus oozing from the affected tooth
  • facial swelling
  • the tooth becoming darker in colour

It is important that you see your dentist if you develop toothache.

Is there an alternative to root canal treatment?

If you have an infected tooth, the infected pulp cannot heal by itself. Leaving the infected tooth in your mouth may make it worse. There may also be less chance of the root canal treatment working if the infection within your tooth becomes established.

If you need root canal treatment, the only alternative is to have the tooth removed. However, this is not usually recommended because it is better to keep as many of your natural teeth as possible.

Antibiotics (medication to treat bacterial infections) are not effective in treating root canal infections. This is because the active ingredient in antibiotics can only work by reaching the site of the infection through your blood, and the bacteria that cause the infection are within the root canal system.

Repeated courses of antibiotics may also lead to bacteria adapting and finding ways to survive the effects of an antibiotic. They become antibiotic resistant, which means that the antibiotic no longer works. See the Antibiotic Awareness Campaign for more information.

Medical Review: July 10, 2012

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