Life

Ask The Dentist: The truth about root canal treatments

Lucy Stock, dentist at Gentle Dental Care in Belfast, on how root canal treatment can potentially save even the worst molar when it goes 'bad'

The bacteria involved in a tooth abscess makes your face swell and creates a head-banging toothache
The bacteria involved in a tooth abscess makes your face swell and creates a head-banging toothache The bacteria involved in a tooth abscess makes your face swell and creates a head-banging toothache

ABOUT 18 years ago I made one of the best decisions of my dental career – I gave up doing root canals: take it from me, they just weren't my calling. But for other dentists they are their creme de la creme and they are exceptionally good at them. Dentists that mainly train in root fillings are called specialist endodontists.

A molar tooth is like a tripod with a tube running down the inside of each leg. Inside this tube is the nerve and the tooth's blood vessels. When you get a tooth abscess it's due to the nerve and blood vessels dying. The bacteria involved start creating loads of pus which makes your face swell and gives that characteristic head banging toothache.

The tripod analogy is actually very oversimplified: the nerve tube can have lots of tiny interlinking branches off it, sort of like fan coral. Because of these intricate shapes, it can be very difficult to clean out the tubes. It often requires a high skill level to get the root filling right so that the tooth can be saved.

Nerve canals don't always behave themselves. Over the years they can become narrower and narrower: in some cases blocking completely. Roots can even decide to start dissolving from the inside out.

Yet even when a tooth looks hopeless, with the help of supercool microscopes and a good dollop of experience endodontists can miraculously find the seemingly non-existent tubes and patch up dissolving roots.

Endodontists have other flicks and tricks up their sleeves for stubborn teeth where the infection doesn't clear right away. They can surgically remove the root tip along with any remnants of abscess or even divide the tooth in half, leaving the better half in the mouth to give something to bite with.

As with so much in life, there's lots of scare mongering on the web: claims that if you receive a root canal treatment you're more likely to become ill or contract some awful disease. These false claims are based on long-debunked and poorly designed research conducted nearly a century ago, long before modern medicine understood the causes of many diseases.

There is no valid, scientific evidence linking root canal treatment to disease elsewhere in the body.