The aim of Root Canal Treatment (RCT) is to remove infective bacteria from the internal canals of the tooth. Every effort is made to ensure this procedure is successful, and that most of the infection is removed. However, bacteria being invisible and cunning in their defences can sometimes escape even the most rigorous cleaning procedures. Bacteria can hide inside tiny caves and even smaller canals, well out of reach of the medicines. Sometimes these bacteria sit quietly for decades never causing a problem.
Sometimes they become active and cause problems such as pain.
Many factors determine how successful RCT is, such as;
How infected the tooth is to start with,
How many canals there are in the tooth,
How curvy the canals are, How small the canals are,
Sometimes (rarely) instruments break and need specialist intervention,
How clean the dentist is able to keep the tooth during treatment,
How clean the patient is able to keep the tooth after treatment,
How strong the final filling is,
How strong the tooth is. Cracked teeth have a higher chance of failure.
For these reasons not all teeth can be saved. If the difficulty of the RCT is beyond the dentist’s ability then referral to a specialist may be offered. Sometimes complications are not known until the dentist has begun treatment.
Whether the specialist completes the treatment, or the dentist, it may be recommended that the tooth have a crown to improve the chances of success. Without a crown, the tooth may fracture and the whole RCT could fail, and the tooth may need removing.