It’s generally better to save a tooth than to lose it. Once a tooth is gone there are all sorts of implications for the neighbouring teeth, the gums and the bone it was anchored in (which will begin to recede).

The combined effect of losing a tooth is therefore hard to overstate; it’s likely to destabilise other teeth and thereby increase the risk of gum disease and further tooth loss, and it may affect the shape of the face. Losing volume in the jawbone can have a dramatically ageing effect on some people.

Teeth are miraculously designed to withstand a lifetime of chewing through food as long as they are looked after. It doesn’t help that we consume so much sugar these days but on the other hand we have developed excellent techniques for making up for it with fluoride toothpaste to restore minerals to our teeth. We also benefit from well designed tooth brushes and flossing devices to remove plaque.

Despite our best efforts, however, sometimes bacteria can make it through to the inside of the teeth, the area known as the pulp, whether that’s through damage via trauma or through an area of decay in the tooth or severe gum disease. When this happens the pulp, which is the blood and nerve supply, becomes infected and the long-term health of the tooth is compromised.

Often the immediate symptom of an infected pulp is a dental abscess which can be very painful and may cause swelling in the mouth and face. Root canal therapy is how we stop this process in its tracks to save the tooth before it’s too late.

If there’s an abscess, an infection in the dental pulp, this will cause pain and often an increased sensitivity to hot or cold. If the tooth has died then it may become discoloured and the gum may swell and feel sore — some people notice a metallic taste in the mouth. Occasionally though there are no symptoms at all, which is why it’s important to come in for a check-up if you have any concerns.

Root canal therapy can be a complex procedure due to a variety of different anatomical forms of the tooth. Our CT scanner allows us to see if there are any complicating factors such as a crack in the root that needs to be sealed or extra canals that harbour bacteria.

Then it’s a case of systematically cleaning and filling the tooth root to prevent re-infection, and either placing a crown or a white filling on top to cover the tooth and return it to full function.

Teeth treated with root canal therapy can remain in the mouth as long as a normal tooth but since they are no longer sensitive to pain they should be regularly checked to ensure there is no decay. At Aquae Sulis we check the dental history of our new patients to make sure we are keeping an eye on potential vulnerabilities like this.