So your dentist has suggested you need a root canal treatment. And since the news broke it’s been playing on your mind.

Few treatments strike fear in a patient the way ‘root canal’ does. (Tooth extraction is another biggie.) But the anxiety people feel in the run-up to this pretty standard procedure often stems from a lack of understanding. So we’ve created this guide to give you the information you need about root canals and alleviate some of that fear.

In this guide we’ll explain:

• what root canals are
• what the treatment involves
• why you may need a root canal
• how the process is performed – step by step.

We’ll also talk about root canals and pain. As dentists, we know a major reason people fear certain treatments is they’re worried about how uncomfortable it will feel.

By the end of this guide you’ll have an impressive amount of endodontic treatment knowledge. (That’s posh, dentist lingo for ‘root canal’.) And hopefully your upcoming treatment will seem far less intimidating.

What is a root canal and why do you need this treatment?

A root canal contains the pulp, tissue and blood vessels found inside the tooth. It sits below the tooth’s crown, enamel and dentin.

Dentists suggest endodontic treatment when the pulp inside the root canals become infected (usually from bacteria getting inside the tooth). Infection may be a result of:

• tooth decay
• severe gum disease (considered a combined periodontal and endodontic infection)
• a broken filling
• a chipped or cracked tooth
• weaker teeth due to ageing.

The best way to save the tooth and stop the spread of infectious bacteria is to remove the infection with root canal treatment.

Signs you might need root canal treatment

When a tooth becomes infected, you may notice one or more of these symptoms.

• Toothache, and increased pain when eating, drinking or biting down on anything.
• Tooth sensitivity to hot and cold temperatures, and the sensitivity sticking around even after the sensation has gone.
• A darkening of the tooth and possibly the gum surrounding it, which suggests decay.
• The tooth being loose and wobbly.
• Swollen and tender gums around the infected tooth.
• Pus oozing out close to the infected tooth.

These symptoms aren’t exclusive to an infected tooth. You may be experiencing another oral health challenge, such as gum disease. To confirm the cause of your tooth or gum pain you’ll need to see your dentist. They’ll diagnose the problem and let you know whether you need root canal treatment.

Tooth decay and infection needs to be diagnosed by a dentist. Root canal treatment may be the best way to get rid of the infection and save the tooth. 

What if root canal treatment is recommended but you don’t want to go through with it?

As is the case when you see your GP, when your dentist identifies an oral health challenge they should discuss all available treatment options with you. In the case of an infected tooth, only a handful of options are available.

Root canal treatment is one option.

Tooth extraction is another, and may be more realistic if the tooth is beyond saving.

The final option is to do nothing.

But putting off root canal treatment or doing nothing increases the risk of the infection spreading. It may start affecting other teeth, your gums and even your jaw. In severe cases, the infection from your tooth can spread to other parts of your body, especially if there’s swelling. This can lead to serious illness and the need for antibiotics.

However, that happens only in extreme cases. And chances are you’ll never face that worst-case scenario because you’re seeing your dentist for regular checkups. That puts you in a strong position to avoid any sort of infection. And if there is one we’ll catch it early so it doesn’t become a major issue.

The 5 steps of a root canal procedure

Step 1: Pre-procedure planning

If you come in complaining of toothache, or your dentist identifies signs of a tooth infection during your regular check-up, they’ll take some x-rays to get an understanding of the shape of your tooth and the root canals. They’ll also test the responsiveness of the nerve within the tooth.

You’ll then be asked to make an appointment for endodontic treatment.

Extra tip: On the day of your root canal, make sure you have something to eat and drink before coming in. It might be a while before you get to eat again. And having a full tummy will help reduce the risk of dizziness or feeling faint. 

Step 2: Getting you comfortable

On the day of the procedure, the dentist will first numb the area with local anaesthetic. They’ll also work with you to come up with a non-verbal signal you can use if you need a break.

Step 3: Isolating the tooth

A small rubber dental dam is placed over the infected tooth to isolate it from the rest of your mouth while still allowing you to breathe normally.

This helps keep the area as sterile as possible, and minimises the risk of bacteria from your saliva getting into the tooth and worsening the infection. It also stops the irrigants used to clean the tooth from getting into the mouth. (Take our word for it when we say they taste horrendous.)

Step 4: Drilling and cleaning the root canals

Once we’ve confirmed the area is numb, we’ll drill a hole in the top of the infected tooth. We’ll then use an endodontic file in a back-and-forth motion to remove the infected pulp and tissue from the tooth’s canals.

When the file comes out clean, we know we’ve removed the infected pulp. We can then disinfect the canals using sodium hypochlorite and ethylenediamine tetraacetic acid (EDTA).

As well as removing bacteria, the endodontic file shapes the canal. It’s then possible to fill it with a malleable, plastic material called gutta-percha (a natural plant resin from a Malaysian tree called a percha).

Step 5: Filling and capping

The final step is to seal the tooth and repair the drilled hole with a regular filling. (We use Glass Ionomer Cement as a base, and then restore the tooth with composite resin.)

Most premolars and molars will need an onlay (a covering of the tooth’s surface) or a crown. This helps protect the rest of the tooth, and minimises the risk of another infection.

How long does root canal treatment take?

How long treatment takes can depend on the number of canals the tooth has. And the number of canals a tooth has depends on the type of tooth.

Canines usually have one, premolars may have one or two, upper molars can have up to four, and lower molars can have three or four. But there are many variations on this. It can also vary from person to person. Your dentist won’t know how many canals your tooth has until they start the root canal treatment.

In certain cases (e.g. when the infection is minor), your root canal treatment can be done in one appointment taking an hour or less.

But this treatment is normally completed over two or three appointments.

• Appointment 1 is usually an emergency appointment where the nerve is removed to prevent further discomfort.
• Appointment 2 is where the canals are cleaned and shaped.
• Appointment 3 is where the canals are filled and sealed with the gutta-percha, and a filling is placed on top.

This may sound long-winded. But it ensures you are comfortable, and don’t spend any more time in the treatment chair than you can handle.

Healing after a root canal procedure

When the anaesthetic has worn off your tooth and gums around the treatment site will feel sore and tender.

The discomfort should last only a day. However, for some patients it can feel sensitive for up to a week. Before you leave the practice your dentist will discuss pain relief options with you, and let you know how to care for your tooth as it heals.

Ideally you shouldn’t eat or drink anything for at least an hour after treatment. This minimises the risk of accidentally biting your lip or cheek as the anaesthetic wears off. After this time, you may find it more comfortable to eat using the side of your mouth that wasn’t treated.

Worried you need a root canal treatment?

Root canal treatment is one of the most common dental procedures in the world. From a dentist’s standpoint, this isn’t great. They’d much prefer everyone to have healthy teeth and gums and not need the treatment. But if it is on the horizon for you, take comfort in the fact you’re not alone. It’s a well-practised, well-established treatment that tens of thousands of people have done each year.

If you’re experiencing toothache or swollen gums, or can see signs of tooth decay, then don’t put off making an appointment.

Come and see us (if you’re in the Yeppoon and Rockhampton area) or your closest dentist. With a quick look, your dentist can diagnose what’s causing your discomfort and recommend treatment. And while that may be a root canal, it may not.

If you have dental implant treatment in Australia there’s a 4-10% chance of it failing. That’s phenomenally low. But as with all medical treatment, there is a chance it won’t work. So before launching teeth-first into the process, it’s a good idea to understand why some dental implants fail. You’ll then be in a stronger position to decide whether they’re right for you.

Dental implant failure – a medical definition

A dental implant is classed as having failed if:

• it comes loose
• it falls out completely
• the titanium screw (the implant) is visible beneath the gum line.

And depending on how soon it happens after surgery, it will be classed as either an early or late implant failure.

Early implant failure is any time in the first 24 hours of treatment through to the time it takes for the bone and implant to fuse. (This can take 3-6 months, and is called implant osseointegration.) If an implant is destined to fail, this is when it’s likely to happen.

Late implant failure is when an implant falls out after osseointegration. It could happen a year, 3 years or even 10 years after the implant was put in.

Whether an implant fails early or late depends on a few things, such as:

• the quality of the implant
• your lifestyle choices
• any changes in your health.

Let’s look at some of the most common reasons for implant failure, and what you can do to minimise the chances of your rather expensive implants making an early exit.

Common reasons an implant will come loose or fall out

It didn’t get a healthy start

Gums showing signs of disease are in a weakened state, which isn’t a great starting point for dental implants. And in severe cases, when the gum disease has advanced so much that it’s weakened the jaw bone, trying and fitting an implant is futile enough, let alone expecting it to survive 10-20 years.

It develops a case of peri-implantitis

This is when bacteria grow in gaps around the gums, implant and crown. It’s specific to people with dental implants and is a lot like gum disease. According to one study, peri-implantitis is responsible in 38% of cases where implants have failed.

Peri-implantitis usually occurs when the implant isn’t kept clean (i.e. not brushing or flossing the area). And just like gum disease, it’s possible to treat peri-implantitis and save the prosthetic tooth (as long as it’s spotted early enough).

Poor pre-procedure planning

The bone supporting an implant needs to be strong. If you think about the amount of force we put on our teeth when we eat or play sports, it has to deal with a lot. An implant going into weak bone won’t last long.

To check bone density and strength, your dentist will take detailed scans and x-rays of your mouth. If the bone looks weak, you may need a bone graft or sinus lift—procedures that strengthen the area of the jaw where the implant will be placed.

Your dentist will also use these images to create a surgical map so they know exactly where to drill and position the implant. Depending on your dentist’s facilities, they may print the map on a 3D printer and lay the surgical guide over your mouth to place the implant in the strongest part of the jawbone.

It’s rejected by the body

Known as ‘natural rejection’, your body simply decides it doesn’t like the foreign thing you’ve put into it and refuses to heal. Only a small number of dental implant patients encounter this, but signs it’s happening to you include:

• inflammation of the treatment site
• pain and tenderness that lasts longer than the expected 5-7 days
• the wound looking as fresh as it did on the surgery date, despite it happening 2 or more weeks ago.

An infection crops up

Swelling in the mouth, redness, and pain when there wasn’t any before are all signs you may have a post-surgery infection. It sounds serious and, if left untreated, could go that way. If you suspect an infection has developed, book an appointment to see your dentist right away. They’ll assess whether you need antibiotics, and explain how to keep the treatment site clean to treat the infection and stop it from getting worse.

Medications and treatments

Medications and treatments that weaken bone or contribute to dry mouth can increase the risk of implants falling out (just as they can cause natural teeth to fall out).

When a patient comes to me because their implant has failed, or is about to, it’s usually for one of these reasons. And even though implant removal is rare (and a last resort) it’s sometimes necessary.

Setting you up for dental implant success

If you’re thinking of getting dental implants or about to start treatment, there are some simple things you can do to set yourself up for a smoother ride.

1. See your dentist for regular checkups so any existing oral health challenges are identified and treated.
2. Once you’ve got an implant, follow your dentist’s instructions about how to look after them. This may involve using particular toothbrushes or flossing tools, and avoiding certain foods while you heal.
3. Keep your dentist informed about any changes in medication, treatments or your overall health that may affect bone strength.

Delivering dental implant treatment and care in Central Queensland

Getting dental implants isn’t something you decide on a whim. Treatment costs, expected outcomes and time needed all need to be understood, evaluated and planned for before hitting ‘Go’.

Whether you’re at the start of your dental implant journey or ready to take the next step, Keppel Dental can help. Using the latest digital dentistry technologies and high-quality dental implant products, we can deliver the best dental implant care possible for patients in Central Queensland and beyond.

Contact us, and one of our friendly staff will book your free first consultation with me, Dr Luke. We’ll discuss your concerns, the procedure, the timelines, and the estimated cost for your treatment.

Curious about dental implants?

Contact us and our friendly staff will book your free first consultation with Dr Luke.

He’ll talk to you about your concerns, the procedure, the timelines, and the estimated cost for your personalised treatment plan.

With all the information on the table, you can then choose when and how to continue the journey.

Maintaining good oral hygiene and going to the dentist regularly are two easy ways to avoid gum disease and keep your teeth in good nick. But as with most services, the cost, the waiting times and even the trip to and from the dentist takes more planning and preparation when you live with disability or care for someone with a chronic health condition.

Roughly only half of Australians under 65 who have disability have seen a dentist in the past year. That’s about 1.2 million people. Why is that? Well, there are the barriers we’ve already mentioned. There’s also a shortage of dental health professionals with the skills to care for patients with disability.

These barriers are beyond frustrating, especially considering that people who live with disability tend to be more vulnerable to oral disease.

Dental care is all the more important because:

• medications can dry the mouth
• sticking to a good at home care routine can be difficult
• swallowing may be hard or uncomfortable
• not being able to physically brush or floss means relying on others.

Seeing a dentist can minimise the impact of all these factors. We also now know that good dental hygiene is linked to overall health.

Whether you have disability or care for someone who does, this guide is all about dentists and disability. We’ll be talking about:

• how to find dental care
• preparing for your dental appointment
• what to expect during the appointment (based on what we do here at Keppel Dental)
• how you can access affordable dental care in Australia.

Our aim is to cover as much information as we can and help you get to a dentist.

Dentists specialising in care for patients with disability

After they become qualified, dentists can specialise in a particular area of dentistry. Orthodontist, dental surgeon and paediatric dentist are a few examples of dental specialisations. And so is becoming a special needs dentist (SND).

While we understand the term ‘special needs’ isn’t appropriate language, ‘special needs dentist’ is what you’ll need to type into Google if you’re looking for a dental professional specifically trained to treat patients with a physical, mental or learning disability.

Admittedly, there’s a shortage of dentists in Australia who specialise in this field. (Apparently there are only 25 in the entire country.) As a result, most dentists in Australia can treat patients with disability. However, their ability to treat you may depend on a few things.

To successfully treat patients with disability, the practice must be equipped to meet their needs. For example, patients with high-level anxiety or severe autism, or who need a hoist to help them into the treatment chair, will need to check whether dental professionals within the practice can help as needed.

If the practice can’t meet the patient’s specific needs, the patient will be referred.

How to find a dentist

Finding a dentist is the first step. You might search the internet by typing in your suburb, town or city followed by ‘dentist’ or ‘special needs dentist’. Visit the website of any practices you like the look of. And read any reviews you find to get a feel for whether any of the practices are right for you.

You could also ask friends, family, neighbours or carers about their dentist. What’s the name of their dentist? Did they have a positive experience when they went in for treatment? If they did, you might want to contact the practice to see if you can register as a new patient.

If you know the treatment can’t be performed in the dental chair, or that you’ll need a general anaesthetic, you may need to be treated at a dental hospital (or search for ‘community dentists’). Sadly, the waiting lists mean you—or the person you care for—may have to wait years for an appointment.

What a dentist needs to know before providing care

To get the care you need, it’s important to give your dentist as much information as possible about your disability, your medical history, and any medication you’re currently taking.

You may also want to let them know about any support or care plans you have in place. This will help them create your personalised dental care plan, and prepare their treatment room for your appointment. (For example, they can bring in an extra chair if a carer is with you, or try to keep light or noise to a minimum if you’re sensitive to either.)

When you register as a new patient you’ll also be asked for:

• your doctor’s details
• the details of any specialists or health care professionals you’re working with
• your Medicare card details
• your health fund details (if you have one)
• any concessions you’re entitled to.

These are all routine questions for new patients.

Planning your appointment and your trip to the dentist

Patients who have positive experiences will keep coming back. And so your practitioner will do all they can to keep you as calm and comfortable as possible when you’re with them. But there are steps you can take when arranging your appointment to make the experience as smooth as possible.

Here are some things to consider.

• The day you book your appointment for. If you have routines, appointments and prior commitments on particular days, organise your dental appointment for a day when you’re less busy.
• The time of day you come in. Medication times (and how they affect you) and your general energy levels may influence whether to book a morning or afternoon appointment. If you experience anxiety, making your appointment time as early as possible is a good idea. This way it’s over and done with early, and will have less of an impact on the rest of your day.
• Items you might want to bring. You may want to bring sunglasses (if you don’t like bright lights), headphones (if you’re sensitive to sounds), or even something you can hold to comfort you. Your dentist should be able to accommodate all of these during your appointment.
• Parking, practice access, and assistance to get there. If the practice’s website doesn’t mention access for wheelchairs or mobility aids, call for clarification. If you don’t (or can’t) drive, or need help getting from a vehicle into the practice you’ll need to either organise this or let the dental practice know. They may be able to help.

At Keppel Dental we can organise a taxi and assistance service on your behalf to help you get here. Just let the receptionist know you’d like this service when you book your appointment.

What to expect during your appointment

What you can expect during your dental appointment will depend on:

• the practice you’re being treated at
• what you’re seeing the dentist for
• your disability, and the level of support you need.

With so many variables, we can’t tell you exactly what to expect during a dental appointment when you have disability. But speaking from our own experience, here’s what tends to happen.

1. On the day of your appointment, arrive 15 minutes before you’re due to see the dentist. Thiswill give you (or your carer) time to complete a new patient form. (Our reception staff are also on hand to help if needed.)
2. When it’s time for the appointment, your dentist (and sometimes the dental assistant), will meet you in the waiting room for a chat if you (or they) feel it will help you relax. When you’re ready, you’ll be invited to come to the treatment room.
3. The treatment room will be set up to accommodate your needs. For example, we’ll turn the lights down as low as possible to decrease stimulation. We may also play music to help you relax. And if you need someone to stay with you during the exam, we’ll have a space for them next to the treatment chair.
4. Once you’re lying back in the chair, the dentist will ask to look inside your mouth using a small mouth mirror. They’ll count your teeth, and check for tooth and gum disease.
5. Next, the dentist may take a few quick x-rays of your teeth, jaws and gums. This helps us identify any oral diseases we can’t detect just by looking.
6. At this point we’ll take a break and speak with you about the condition of your teeth and gums, and any treatment you need. If we can do the treatment right away (e.g. giving your teeth a clean, fixing a tooth with a filling), we’ll get on with it. But if we find something like a tooth that needs removing, we may ask you to book an appointment for another day. We’ll discuss all of this with you as we create your personal treatment plan.

And that’s basically it. At the end of the appointment, you’ll be taken back to the reception area where our staff will help you settle any costs and book your next appointment.

Dental care costs

Almost 28% of Australian adults under 65 with disability cite cost as the main reason for not seeing a dentist or delaying their oral health care. Cost is a major barrier for many Australians. Unfortunately, until it’s fully or partly covered by Medicare (which we strongly believe should happen) we can’t see that changing any time soon.

What we can do in the meantime is:

• help you understand the average cost to see a dentist in Australia, which may help you plan and budget before your appointment
• highlight any benefits or grants you may be able to access as a person with disability
• let you know about some great dental care initiatives that are working to cut dental care waiting time for those who rely on the public health system.

How much does it cost to see a dentist in Australia?

Many dental practices are privately owned, which means they can set their own treatment prices. How much a dentist charges for treatment will be influenced by:

• their experience level as a qualified dentist
• where their practice is located
• whether or not they’re a specialist
• the current cost of materials.

Every few years the Australian Dental Association (ADA) runs a fees survey. This gives us a snapshot of what dentists around Australia are charging for various treatments.

The latest fees survey reveal the average cost for a new adult patient check-up is $219 in Australia. (These prices may be slightly lower for minors.)

It’s always worth asking whether the dental practice has a payment plan policy that will make it easier for you to manage your dental costs.

Dental care concessions you may be eligible for

Eligible children and adults can claim some essential dental services on Medicare. But to access them you’ll need to meet the criteria.

For children, Medicare offers the Child Dental Benefits Schedule, which you can find out more about in our article Caring for your child’s oral health.

Each state and territory has public and community dental services for adults and children. You can find a list of these public dental facilities on the Health Direct website. Generally, adults must have a Health Care Card or Centrelink Pensioner Concession Card to use them. Unfortunately, these dental services also have long waiting lists.

The National Disability Insurance Scheme (NDIS) doesn’t cover dental care either. But NDIS funds can be used to train carers so they can implement any at-home care plans your dentist puts in place.

Dental care initiatives for people with disability

When it comes to giving people with disability access to the dental care they so desperately need, the system is far from perfect. But there are individuals and organisations working tirelessly to try and improve the situation.

OneOneTwelve – This pro bono initiative is working to recruit dental practitioners to care for people with disability for 12 months in exchange for extra training in SND. As someone with a chronic health condition, you can apply to receive free dental treatment for 12 months.

Australian Dental Foundation (ADF) – Promoting good oral hygiene for all Australians, ADF delivers accessible resources to make caring for your teeth easier. They’re also working on a tele-dentistry program, which some people with a disability may find preferable to going into a practice.

Filling the Gap – Getting access to dental care to those who need it most, Filling the Gap prioritises people experiencing homelessness, refugees, and those with mental health issues.

In Central Queensland and need a disability-friendly dentist?

If it’s been a while since you last saw a dentist, we hope the information and resources we’ve shared in this article have inspired you to make an appointment. Or at least given you a place to start as you look for the right dentist for you.

Live in the Yeppoon and Rockhampton area? Looking for a friendly, gentle, calm family dentist with experience of treating patients with a disability? We may be able to help. Get in touch with us using the form below or by calling (07) 3130 0806, let us know you’d like an appointment, and we can go from there.