Q.Root Canal Treatment: Frequently Asked Questions.

A.

I created this section of the website to answer the most common questions all my patients ask, when they are told they need a Root Canal. It does not have the ambition of being a scientific text book, and I expect that some collegues will not agree with everything I write. I just intend to provide some basic information about what is involved in a RC procedure and I will try to update it on a regular base.

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Q.Can a Root Canal fail?

A.

Very often patients show unreasonable scepticism about Root Canal Treatment, because they had one in the past and it ended with an extraction; others expect to be guaranteed a 100% success rate to give consent to the procedure.

What are the realistic chances of success?

The purpose of a Root Canal procedure is to remove completely from the tooth the affected dental pulp (the nerve) and all the bacteria and toxins associated with its degenerative process. This is achieved through the sequential use of mechanical instruments and the generous irrigation of the canal space with powerful disinfectants. With the proper equipment ( rubber dam, apex locator, magnification etc.), and the right skills and experience, it can be done most of the time.

The variable of the equation is the internal anatomy of the single tooth: straight large canals can be cleaned with consistency. Calcified canals, severely carved canals, canals splitting in the last mm, lateral canals, canals obliterated by previous root filling materials (retreatment), often pose a tough challenge even for the expert clinician. Statistically success is very high (more than 90%) when the pulp is inflamed but still vital, drops when the nerve is necrotic (dead, therefore with a bigger number of bacteria), and is the lowest in case of Root Canal Re-treatment.

Often the Root Canal Treatmentitself is successful , but the removal of tooth structure to achieve the goals of the procedure, or the lack of a proper restoration (dental crown), cause a fracture and an extraction at a later stage.

It is essential that you discuss with your dentist the realistic chances of long term success for your single case, in comparison with alternative procedures.

I offer a 15 mins FREE ROOT CANAL CONSULTATION, no strings attached, to get a honest opinion at no cost.

Q.Root Canal Treatment VS Implant.

A.

This issue is controversial to say the least, and often spark animated debates in the dental community. Therefore generates a lot of confusion among patients, who often are told a totally different story visiting different dentists.

So what is the best solution?

It depends on the case and on several other factors:

FINANCIAL COST: Generally RCT and a crown is cheaper than an implant and a crown. In my practice about half the cost.

SUCCESS RATE: RCTs and Implants, when executed by skilled hands, and in absence of anatomical complications, have both more than 90% of success. This statistics drops significantly if there are technical difficulties, such as severe root curvature, calcified canals, failed pre-existing Root Filling et for RCTs, mostly lack of bone, to be compensated with unpredictable and expensive bone graft procedure, for Implants.

LONG TERM SURVIVAL: I agree that Implants, when they do not fail during the initial integration period, have a much longer life, due to the simple fact that, being done of metal, do not get decay.

TIME INVESTMENT: As an average RCT requires a couple of visit, to be followed by another couple of appointments for the crown restoration. They can be booked at weekly intervals. Implants, if risky protocols such as post-extractive placement or immediate loading are avoided, require an extraction, an healing time of a couple of moths, the implant placement, another healing break of 2/3 months, and finally the crown restoration.

You should have a frank discussion with your dentist regarding pros and cons of the two options when it comes to decide what best suits you.

That is why I offer a 15 mins FREE ROOT CANAL CONSULTATION, no strings attached, to assess if Root Canal Treatment is the right course of action for my patients.

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