| The Oral Health Clinic |

Root Fillings

What are they?

Teeth are held in the jaw by their roots. Front teeth normally have one root but further back have more.

Inside, the tooth the pulp should be alive, with nerves and a blood supply in the root canal. Decay or injury can destroy this living part and might also cause an abscess at the end of the root.

Root filling means removing damaged or dead pulp and filling the space left. The remaining tooth can then be repaired.

A root filling where damaged pulp has been removed

What does my dentist do?

An X-ray can show the shape of the root canals, and also signs on infection in the surrounding bone. Some tooth roots are easier to fill than others, because of their shape. The dentist will discuss the X-ray with you if it suggests that a root filling isn’t going to be successful;
To keep root canals dry during treatment the dentist may stretch a sheet of thin rubber round the tooth, on a metal frame outside the mouth. This shouldn’t be uncomfortable;
The dentist uses narrow files to find a root canal and remove the dead pulp;
Another X-ray can show whether all the dead pulp has been removed;
Roots are filled with rubbery materials and with pastes that set hard.

A root filling could need more than one visit. You might not need a local anaesthetic for a root filling if the pulp is dead, but the tooth could still be tender for a day or two afterwards. You might need to take a pain killer.

An X-ray after a root filling

What are the benefits?

Pulp damage can cause painful toothache but the pain will usually end very quickly when the root canal is cleaned out;
Without a root filling a tooth with a dead pulp would probably have to be taken out;
First-time root-fillings are usually successful and can last many years. Re-treatment is also possible.

Apicectomy

What is it?

Sometimes there can be a painful infection (an abscess) at the end of a tooth root, in the surrounding bone. During “apicectomy”, the dentist cleans the infected area to save the tooth.

An apicectomy will usually be carried out on a tooth which has already been root-filled.

What will my dentist do?

They will:

Give you a local anaesthetic to numb the mouth around the infected tooth so that the procedure is painless;
Make a small cut in the gum, well away from the tooth so they won’t be a scar afterwards or around the infected tooth on the other side;
Move a small flap of gum to one side to uncover the infected area;
Clean out the infection;
Put a small filling at the end of the root canal to stop any more infection; and stitch the gum back in place.

You may feel some pressure and hear instruments been used by you should not feel any pain during an apicectomy.

After treatment you will need to keep the area clean.

For the first day, rinse with warm salt water several times a day, especially after meals. Use half a teaspoon of salt in a glass of water.
Brush the teeth normally but be very careful not to disturb the cut.
On the next day, continue rinsing and begin to gently the teeth next to the cut.

Their may be some bruising and swelling for two or three days afterwards. There will also be some discomfort but it shouldn’t be too bad – an ice pack or a packet of frozen peas can help. It usually takes about a week for an apicectomy to heal.

What are the benefits?