Purpose of treatment
If a diagnosis of one or more teeth has been made indicating that there is infected, dead, or dying nerve tissue within a tooth, then root canal treatment (RCT) has been recommended in order to prevent the tooth from becoming a source of continued pain and/or infection. RCT involves cleaning out the inside nerve space of a tooth, enlargement of this space, and finally filling the interior with a dense, non-irritating rubber material. This space is filled so that no irritants remain within the tooth. RCT may take between 1 and 4 visits to complete, depending on the difficulty of the tooth and how quickly infection is relieved. Success of RCT also relies upon a person's immune system functioning well.
Endodontic surgery may also be required when conventional RCT will not or has not completely eliminated infection. This involves a small exposure of the tip of the root of the tooth and both removal of residual infection around the tip and the sealing off directly of the root tip.
Benefit of Treatment
RCT allows a person to keep a tooth that may otherwise need to extracted due to the presence of infection within the tooth caused by a diseased nerve, or to help attach a complex restoration such as a crown to a tooth that is severely broken down structurally. Loss of teeth can result in decreased ability to chew and to speak, as well as a change in appearance.
Alternatives to RCT
No treatment may result in continued or worsening infection and/or pain which can lead to destruction of bone around the tooth or spreading of infection through the jawbone or the tissues of the head and neck. The only alternative to RCT which relieves pain and/or infection is removal of the entire tooth (extraction). Antibiotics only help the body to control the size of infection but will not cure an infected tooth.
Risks of Treatment:
1. Difficulty locating and working in all suspected canals
2. Incomplete filling of all canals
3. Perforation or penetration of the surrounding bone or tissue with RCT instruments
4. Breakage of RCT instruments within the root during treatments
5. Bad response of the patient's body to some materials used during cleaning, disinfection, and filling of roots
If any of the above occur, treatment may continue with the knowledge that a lesser prognosis is expected, or the tooth may be removed right away. A return of problems in the future may require re-treatment or endodontic surgery.
Anaesthetic
Although best attempts are made to anesthetize the tooth, in rare cases some discomfort during RCT can occur, and this is often related to an inability of local anesthetic to get through infection around the tip of the root. Discomfort after RCT is also common and can be managed with certain analgesic medications.
Potential Additional Treatment
Teeth that have received RCT are somewhat weakened because of the loss of tooth substance and therefore may require more complex restoration afterwards, such as an onlay or a crown. Sometimes RCT is done so that a predictable and strong filling can be attached to a tooth to support a crown restoration with a good long term lifespan.
Important
Root fillings can and do sometimes fail, with re-infection of the root canal occurring. This can usually be treated by re-doing the root canal treatment, specialist referral or by endodontic surgery.
Although unlikely, it is possible for the very fine files and rotary instruments used to clean the root canals may fracture during treatment. If any unforeseen difficulties/complications such as this arise during treatment it may be necessary to refer you to an Endodontist to complete the treatment.
Acknowledgement
I have provided as accurate and complete a medical and personal history as possible including antibiotics, drugs, or other medications I am currently taking as well as those to which I am allergic. I will follow any and all treatment and post-treatment instructions as explained and directed to me and will permit the recommended diagnostic procedures, including X-rays.
I realize that in spite of the possible complications and risks, I do not have to proceed with the treatment should I choose not too. I am aware that the practice of dentistry is not an exact science, and I acknowledge that no guarantees, warrantees, or representations have been made to me concerning the results of the procedure.
I have read this form and have been provided with ample time to ask any and all questions I had in relation to the treatment that has been proposed. I understand and accept the potential risks and complications associated with the treatment.
I wish to proceed with Root Canal Treatment.
