Category: Dental

Root canal surgery can seem intimidating to those unfamiliar with the procedure, but it is often essential for treating complex infections or saving a tooth when standard root canal treatment is not sufficient. In Singapore, this specialised procedure is widely available and performed by qualified dental professionals. Here is an in-depth look at what it involves, its benefits, and what you should expect if you require this treatment.

What Is Root Canal Surgery?

Root canal surgery, also known as an apicoectomy, is a minor surgical procedure that targets the infected or damaged pulp in a tooth. Unlike standard root canal treatment, which is a non-surgical approach, root canal surgery involves accessing the root of the tooth through a small incision in the gum. This surgery is typically recommended in cases where there is persistent infection at the root tip that standard treatment cannot fully resolve. The goal is to save the tooth, eliminate infection, and restore dental health without requiring extraction.

Difference Between Root Canal Treatment And Root Canal Surgery

Understanding the difference between the two can help you determine which procedure might be appropriate for your situation:

• Root Canal Treatment (RCT) – This is a non-surgical procedure that involves removing the infected pulp inside the tooth and cleaning the root canal. Dentists perform RCT as the first line of action for treating pulp infections or inflammation. During RCT, the infected pulp is removed, the canal is thoroughly cleaned, and the space is sealed to prevent future infection. Most standard cases of pulp infection can be successfully treated with RCT.
• Root Canal Surgery (Apicoectomy) – Root canal surgery is a surgical procedure performed when an infection persists despite RCT or if there are complications at the root’s tip (apex). In this surgery, the dentist makes an incision in the gum to access the infected area directly at the root tip, removing the infected tissue and any affected bone. This surgical approach is also suitable for patients with complex root canal structures or severe infection that cannot be resolved with standard RCT.

In summary, root canal treatment is the initial, non-surgical approach, while root canal surgery is a secondary, surgical option used when more invasive intervention is necessary.

Why Would You Need Root Canal Surgery?

The need for root canal surgery may arise if you experience a recurring infection in a tooth that has already undergone RCT, or if there is a difficult-to-access infection in the root. This procedure is often recommended for cases involving:

• Persistent pain and sensitivity after RCT
• Complications at the root tip that prevent successful treatment with RCT
• Complex root canal structures or blockages within the root canal
• Small fractures or other damage near the root that standard treatment cannot address

Root canal surgery allows the dentist to thoroughly remove infection and address issues at the root level, preserving the tooth for the long term.

How Does The Root Canal Surgery Procedure Work?

1. Examination And Imaging – The process begins with a thorough examination, often including X-rays or other imaging techniques to assess the exact location and extent of the infection.
2. Local Anaesthesia – The area is numbed with local anaesthesia to ensure a pain-free experience during the surgery.
3. Incision And Accessing The Root – The dentist will make a small incision in the gum to expose the tooth root and surrounding bone. This allows direct access to the infected area at the root tip.
4. Removal Of Infected Tissue And Root Tip – The infected tissue and the tip of the root (known as the apex) are removed. In some cases, the dentist may need to treat the surrounding bone if the infection has spread.
5. Sealing The Root – After cleaning the root and removing infected tissue, the dentist will seal the end of the root to prevent further infection.
6. Suturing The Incision –The gum tissue is sutured to close the incision, and the area is allowed to heal.

Benefits Of Root Canal Surgery

Root canal surgery offers several critical benefits for patients with persistent infections or complex dental issues:

• Preserves The Natural Tooth – By treating the infection at the root level, root canal surgery can save the natural tooth and avoid extraction.
• Pain Relief – Removing the infected tissue eliminates pain and discomfort that may persist after standard root canal treatment.
• Prevents Further Infection – Sealing the root after surgery prevents bacteria from re-entering the tooth, reducing the risk of future infections.
• Effective for Complex Cases – This procedure is specifically designed to address cases that RCT cannot resolve, providing a comprehensive solution for difficult-to-treat infections.

What Is The Recovery Process Like?

After root canal surgery, it is common to experience some mild discomfort, swelling, or sensitivity in the treated area for a few days. Dentists often recommend pain relief medication and advise patients to rest and avoid chewing on the affected side. Maintaining good oral hygiene and following the dentist’s post-operative care instructions are essential for a smooth recovery.

Costs Of Root Canal Surgery In Singapore

The cost of root canal surgery in Singapore typically starts from about S$2,000, depending on factors like the complexity of the procedure and the tooth involved. Additional fees may apply for consultation, imaging, and follow-up appointments. It is best to consult your chosen clinic for detailed pricing information. Currently, root canal surgery is the only endodontic procedure that is claimable under MediSave.

Consult Our Preferred Doctor On Your Root Canal Surgery

Dr Johnathan Wee is the Clinical Director at Advent Endodontics Inc and a consultant endodontist in Singapore. He focuses on managing dental trauma, endodontic retreatment techniques, and post-endodontic restorative outcomes. He is also formally trained in the use of the surgical operating microscope (SOM) since 1998 as an enabler in his clinical delivery of high quality treatment.

Frequently Asked Questions About Root Canal Surgery

Is Root Canal Surgery Painful?
With local anaesthesia, root canal surgery is generally a painless procedure. You may feel mild discomfort or soreness during recovery, but this can usually be managed with prescribed pain medication.

How Long Does The Surgery Take?
Root canal surgery often takes around 90 minutes per session. In complex cases, multiple sessions may be required.

Will I Need A Crown After Root Canal Surgery?
In most cases, a crown is recommended to protect the treated tooth. Since the tooth may be more fragile after surgery, a crown helps restore its strength and functionality.

Key Takeaway

Root canal surgery is an effective solution for treating complex tooth infections and preserving the natural tooth in cases where standard root canal treatment is not enough. In Singapore, patients can rely on highly skilled endodontists and dental professionals who use advanced techniques to ensure a safe and successful experience. If you experience persistent tooth pain or an infection after standard root canal treatment, consult a specialist to determine if root canal surgery is the best option for you.

What Is Root Canal Retreatment?

Root canal retreatment is a follow-up procedure performed when a tooth that has previously undergone root canal treatment becomes reinfected or encounters further issues. During retreatment, a dentist reopens the tooth, removes the previous filling, and carefully inspects the root canals for any remaining infection or structural problems. The canals are then thoroughly cleaned and resealed to prevent future infection.

Why Might Root Canal Retreatment Be Necessary?

Although a root canal treatment is generally highly effective, retreatment may be required in certain cases, including:

• Persistent Infection – Bacteria may remain in the root canals or reinfect the area, causing ongoing pain or discomfort. Retreatment allows the dentist to remove any residual infection.
• Complex Canal Anatomy – Some teeth have complex canal structures that can be difficult to clean entirely during initial treatment. Retreatment enables a more thorough examination and cleaning.
• New Decay Or Cracks – New decay or fractures in the tooth can expose the root canals to bacteria, requiring retreatment to prevent infection.
• Incomplete Seal – If the initial filling did not fully seal the tooth, bacteria could re-enter, leading to infection and the need for retreatment.

Is Root Canal Retreatment Painful?

Concerns about pain can make root canal retreatment seem daunting, but modern dental techniques and anaesthesia ensure a relatively comfortable experience.

Pain During The Procedure

Local anaesthesia is administered to numb the affected area during root canal retreatment, ensuring that you do not feel any significant discomfort. While you may notice slight pressure or movement, the procedure itself should be painless.

Pain After The Procedure

After the anaesthesia wears off, mild soreness or sensitivity around the treated tooth and gums is common. This discomfort should ease within a few days and can be managed with over-the-counter pain relievers, such as ibuprofen. If pain continues beyond a few days or becomes more intense, consult your dentist, as prolonged pain could indicate other underlying issues.

Steps Involved In Root Canal Retreatment

Root canal retreatment is a detailed process aimed at thoroughly cleaning and disinfecting the root canals. Here are the main steps involved:

1. Examination And Imaging – The dentist will begin by examining the tooth and may take X-rays or use other imaging tools to assess the infection or damage. This helps them plan the retreatment procedure.
2. Administering Anaesthesia – Local anaesthesia is applied to numb the area, ensuring a painless experience during the retreatment.
3. Accessing The Tooth And Removing The Filling – The dentist reopens the tooth by removing the crown or filling placed during the initial treatment. This provides access to the root canals.
4. Cleaning And Disinfection – The dentist carefully removes any residual infection, damaged tissue, and debris. Antimicrobial solutions may also be used to disinfect the area and prevent future infections.
5. Refilling And Sealing – After the canals are cleaned and disinfected, the dentist refills them and seals the tooth to prevent further infection. In many cases, a new crown or filling is placed to restore the tooth’s structure and functionality.

Managing Pain And Discomfort After Root Canal Retreatment

Mild pain or soreness following root canal retreatment is normal. Here are some tips to help manage any discomfort:

• Use Pain Relievers As Advised – Over-the-counter medications, like ibuprofen or paracetamol, can effectively reduce pain and inflammation.
• Avoid Hard Or Crunchy Foods – Opt for soft foods for a few days to avoid putting pressure on the treated tooth, which can reduce discomfort and promote healing.
• Maintain Good Oral Hygiene – Brushing gently and rinsing with a saltwater solution can keep the area clean and help with healing.
• Follow Aftercare Instructions – Your dentist may provide specific aftercare guidelines. Adhere to these closely to ensure the best recovery.

Cost of Root Canal Retreatment In Singapore

The cost of root canal retreatment in Singapore varies depending on factors like the complexity of the case, the tooth involved, and whether additional procedures, such as a crown, are required. Generally, the cost starts from around S$2,000. CHAS currently does NOT allow claims for root canal retreatment. It is best to consult your chosen clinic for detailed pricing information.

Consult Our Preferred Doctor On Your Root Canal Surgery

Dr Johnathan Wee is the Clinical Director at Advent Endodontics Inc and a consultant endodontist in Singapore. He focuses on managing dental trauma, endodontic retreatment techniques, and post-endodontic restorative outcomes. He is also formally trained in the use of the surgical operating microscope (SOM) since 1998 as an enabler in his clinical delivery of high quality treatment. Contact us on Whatsapp to find out more

What Is A Root Canal, And Why Is It Necessary?

A root canal is a procedure that removes infected or damaged tissue, known as pulp, from the centre of a tooth. The pulp contains blood vessels, nerves, and connective tissue that help the tooth grow during its development. However, once a tooth is fully mature, the pulp is no longer essential for the tooth’s function, making its removal a viable option when it becomes infected or damaged.

If a tooth becomes severely decayed or experiences trauma, the pulp can become inflamed, causing significant pain and discomfort. This infection can eventually spread to the surrounding bone and other teeth if left untreated. The treatment removes the damaged pulp, cleans the area, and seals it to prevent further infection, ultimately preserving the tooth.

Key Reasons For A Root Canal: When Should You Consider One?

Recognising the signs of pulp infection or damage can help you seek a treatment before complications arise. Consider a root canal if you experience the following:

1. Persistent Pain

Pain is the most common sign that something may be wrong with the pulp. Persistent tooth pain, particularly when chewing or applying pressure, is a typical sign of pulp inflammation or infection.

2. Sensitivity To Hot Or Cold

Sensitivity that lingers after exposure to hot or cold foods or drinks can indicate pulp inflammation. This discomfort may worsen over time if the pulp becomes infected.

3. Swelling Or Tenderness In The Gums

Swelling or tenderness around the affected tooth, or the presence of a small bump or abscess, may suggest a severe infection requiring this treatment.

4. Darkening Of The Tooth

A dark or greyish colour change in a tooth can indicate pulp damage, especially after trauma.

Alternative Treatments: Why Root Canal Is Often Preferred

There are alternative treatments to root canals, but they may not always be as effective or suitable for preserving a natural tooth. Here are a few other options often considered:

• Tooth Extraction – Extracting a tooth can be a quick solution, but it leads to gaps that may affect your bite, jaw alignment, and the overall appearance of your smile. Replacing an extracted tooth with a bridge, implant, or denture can also be more costly and time-consuming.
• Antibiotic Treatment – In cases of mild infection, antibiotics may temporarily alleviate symptoms. However, antibiotics alone cannot eliminate infected pulp. Without removal of the infected tissue, the infection may persist or worsen.
• Pulp Capping – Pulp capping is a preventive procedure used when tooth decay is near the pulp but has not yet infected it. This treatment is beneficial for minor issues but does not help in cases of severe infection, where a root canal is necessary.

The goal of a root canal is to save the natural tooth and avoid more invasive treatments or tooth loss, which can have lasting effects on dental health and function.

Steps Involved In A Root Canal Treatment: What To Expect

For patients, understanding the process can ease any anxiety associated with the procedure. This treatment includes the following steps:

1. Diagnosis And Preparation – The dentist will examine the tooth, take X-rays, and discuss your symptoms to determine if a treatment is necessary. This step also includes administering local anaesthesia to numb the area and ensure a pain-free experience.
2. Removing The Infected Pulp – After numbing, the dentist creates a small opening in the tooth to access and remove the infected pulp. Special tools are used to clean out the entire pulp chamber and root canals thoroughly.
3. Cleaning And Shaping – Once the pulp is removed, the canals are cleaned, shaped, and disinfected to ensure no remaining bacteria could cause future infections.
4. Filling And Sealing The Canals – The canals are then filled with a biocompatible material called gutta-percha, which seals the tooth and prevents bacteria from re-entering.
5. Final Restoration – In most cases, a crown or filling is recommended after the root canal to protect and strengthen the tooth. This final step is crucial for restoring the tooth’s full functionality.

Benefits Of Choosing A Root Canal Over Extraction

Choosing a root canal over extraction offers several benefits, particularly for maintaining long-term oral health. Some advantages include:

• Preserving Natural Tooth Structure – Retaining your natural tooth helps maintain the jawbone’s density and prevents adjacent teeth from shifting.
• Preventing Future Dental Problems – A root canal removes the source of infection without compromising the neighbouring teeth, reducing the risk of future dental issues and keeping your bite intact.
• Avoiding Tooth Replacement – Replacing an extracted tooth can be expensive and may require additional procedures. By choosing a root canal, you save both time and money on potential replacements.

The Cost of A Root Canal In Singapore

In Singapore, the cost of root canal treatment may vary depending on the tooth’s condition, the location of the clinic, and the complexity of the case. On average, the treatment may cost anywhere between S$1,000 to S$2,500. The cost of this procedure can be offset in part if the patient has CHAS eligibility. It is advisable to check with your dental provider about costs and payment options, as some clinics may offer financing plans or accept insurance.

Maintaining Oral Health After A Root Canal

Good oral hygiene is essential after treatment to maintain the health of the treated tooth and prevent further complications. After the procedure, be sure to:

• Brush and floss regularly.
• Avoid hard or sticky foods initially.
• Schedule regular dental check-ups.

Key Takeaway: Root Canal as a Solution for Dental Pain in Singapore

A root canal is an essential dental procedure that saves damaged teeth, relieves pain, and prevents the need for extraction and tooth replacement.

If you suspect you may need a root canal, consult a dentist as soon as possible. Early treatment can help you avoid complications, reduce pain, and preserve your smile for years to come. Contact us to schedule an appointment!