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Root canal treatment (endodontics) is carried out in order to remove bacteria from the centre and root of a tooth which has become infected. Following the removal of bacteria, the tooth is thoroughly cleaned and disinfected before the root(s) are filled and the surface sealed, allowing the tissues to heal. Root canal treatment has changed greatly over the past 10 years, it is a well established, safe and predictable way to save a tooth. At Pont Steffan, we are delighted to be able to offer appointments with Dr Gareth Thomas, who specialises in root canal treatments.

About Dr Gareth Thomas

Gareth graduated with honours from Cardiff Dental School in 2008. Upon graduation he completed vocational training in practice in the South Wales Valleys. It was in this year his passion for endodontics developed with an enthusiasm for further training.

Following completion of the Royal College of Surgeons MFDS examinations in 2010, Gareth completed a year-long Advanced Endodontics Certificate at the University of Warwick followed by a 3-year MSc in Clinical Endodontics at the University of South Wales. These courses combined to provide scientific theory and practical training in completion of complex endodontic treatment by leading restorative and endodontic academics.

Since completion of his MSc in 2015, Gareth has developed considerable experience in the management of patients requiring complex endodontic treatment. He spent a year working as a Speciality Dentist in Endodontics at the Royal London Dental Institute. At present he works as 'Gareth Thomas Endodontics' at various practices, with positions as a Speciality Dentist in Endodontics for the Abertawe Bro Morgannwg Health Board and Powys Health Board. He also lectures on the topic of endodontics to dentists and students for Health Education and Improvement Wales, University of South Wales and Kings College London.

Gareth accepts referrals for:

Routine Root Treatments

Complex Primary Treatment

Re-treatment

Instrument/Post Removal

Management of Trauma/Perforation Repair

Microsurgical Endodontics

Gareth Thomas Endodontic Treatment
Gareth Thomas Endodontist

How did my tooth become infected?

Natural bacteria live within our mouths and oral cavity, whilst the skin of the mouth protects the body from these bacteria.

The outer structure of your tooth also acts as a barrier from bacteria, protecting the body from infection. If this protective structure has been lost due to tooth decay, tooth fracture, acid erosion or gum disease, bacteria can enter inside your tooth and cause infection within the tooth root and/or jawbone. Infection can also occur if a tooth has had a traumatic injury.

Abcess, decay tooth illustration

What happens if the infection continues?

Depending on the amount and type of bacteria that is present within the tooth, you may or may not experience pain. Over time this bacteria can become more established and increasingly potent, eventually leading to symptoms that can include pain, swelling, abscess and tooth discolouration.

If an infected tooth is left without treatment, bone around the tooth will be destroyed by bacteria, which can lead to the tooth becoming loose, and possibly coming out. Bone loss around the tooth can also affect neighbouring teeth, as well as potentially affecting the reliability of any future treatment options.

Signs of bone destruction that has been caused by infection can be seen on the x-rays below:

Xray before root canal treatment

Before root canal treatment – dark shadow showing destruction of bone surrounding the end of root indicating diseased tooth

xray after root canal treatment

6 Months following treatment – dark shadow has now infilled with bone indicating healthy tooth

What are the options?

To effectively treat an infected tooth, there are two options; a root canal (endodontic) treatment or an extraction. We believe it is preferable to save a tooth rather than having the tooth extracted and an artificial replacement. Once a tooth has been extracted, the space can either be left or replaced with a denture, bridge or dental implant.

 

Partial Denture Picture

Partial Denture

Dental Bridge

Bridge

Dental Implant

Root Canal Treatment Option

Root canal treatment is one of the most technically demanding in dentistry. Although all dentists are trained to provide root canal treatment, some dentists undertake further studies and training in order to specialise in a field, like endodontics.

More complex tooth root problems such as canal curvature, calcification or previous unsuccessful attempts at a root filling, will require the intervention of a specialist endodontist. If you need a more routine root canal treatment, you may choose, or your dentist may recommend having the treatment completed to a specialist standard, this is to maximise on a successful outcome.

Typically, a root canal is less than one tenth of a millimetre in diameter and those who specialise in treating root canals will use microscopes, advanced equipment and specialist techniques. This will increase the success of treatment when compared to that of a general dentist.

General dentist view of tooth's root canals

General dentists view - unable to find all root canals in an upper second molar

Endodontist view of tooth's root canals using microscope

Endodontist view using high magnification - Gareth is able to locate and successfully treat the three canals in the tooth

What's the long-term outcome?

When root canal treatment is completed in an ideal standard by a specialist, the success rates are above 80%. Once completed, it is important that the surface of the tooth is fully repaired, protected and maintained by your general dentist to fully maximise long-term success.

Prior to root canal treatment, the tooth will be thoroughly assessed to ensure a good prognosis is achievable and cost effective. Sometimes a problematic tooth is unable to be saved by root canal treatment, unfortunately in such a situation the tooth will require an extraction, but can be replaced with an artificial tooth.

How Much?

Due to the specialist equipment, attention to detail and time consuming nature of providing high quality root canal treatment. A consultation costs £150 while the cost of treatment starts from £685.This will depend on the complexity of your individual case.

Following review of a referral or consultation, you will be provided with a bespoke written report which will inform you of costs involved prior to any treatment. Root canal treatment is nearly always cheaper than having an extraction and replacing the tooth with a bridge or dental implant.

 

What's involved in treatment?

Root canal treatment being completed to the highest possible standard, requires a significant amount of attention to detail, which requires more time. Some simpler cases can be completed in a single visit, with a more complex case, it may take two visits of an hour and a half each. This will be discussed with you, and presented in your treatment plan before any treatment goes ahead.

During treatment you will be made as comfortable as possible, using a local aesthetic to numb the mouth. Once treatment has been completed, and the anaesthetic has worn off, there may be some mild tenderness but nothing that should disrupt your day to day activity. You will be provided with a post operative instruction sheet to advise you of any required aftercare.

 

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