GOTHENBURG, Sweden: Although overall oral health in Sweden has improved significantly, root canal treatment is still a common procedure. Since few studies on root canal treatment in the general dental practice have been undertaken, a study conducted at the University of Gothenburg for a doctoral thesis investigated which factors influence the outcomes of such procedures. It was found that the majority of patients would choose the same treatment again if in need, although pain and discomfort around the tooth are common.
Dr Emma Wigsten from the Institute of Odontology at Sahlgrenska Academy at the University of Gothenburg. (Image: Caroline Ardbo)
In her doctoral thesis, a compilation of different component studies, Dr Emma Wigsten from the Institute of Odontology at Sahlgrenska Academy at the University of Gothenburg investigated various aspects of root canal treatments performed in Swedish general dental practice.
One cohort group studied was a sample of 243 patients who had started root canal treatment at one of 20 public dental clinics in the Västra Götaland region and had been followed up for one to three years. Most of the root canal treatments examined had been prompted by toothache in teeth with caries and large restorations, which had led to root fillings within one year. Molars proved to be an exception: only slightly more than half of the root fillings had fulfilled their purpose, resulting in the extraction of many of the molars.
Dr Wigsten commented in a university press release: “It seems harder to get a good result in treating the molars, despite time and resources invested. Root canal treatment is complicated: You’re working inside the tooth where you can’t see anything, and the further back you go in the mouth, the more difficult it becomes.”
She added: “Root canal treatments of molars involve significantly bigger challenges than other tooth groups. So it may be important to investigate whether root canal treatments of molars should be performed to a greater extent by dentists specialising in root canal treatment.”
Patient satisfaction
In a questionnaire, half of the patients stated that they had had mild pain or discomfort from their root-filled tooth during the follow-up period of up to three years. Nevertheless, the majority (87%) responded that they did not regret their decision to receive root canal treatment instead of a tooth extraction.
Another cohort group consisted of 85 patients who had been treated in six public dental clinics in the Västra Götaland region and who had either started root canal treatment or had had a tooth extracted. Patients who had started root canal treatment were found to have a better health-related quality of life than those who had undergone tooth extraction.
Dr Wigsten concluded: “The studies show that the patients’ quality of life benefited from root canal treatment. On the other hand, it’s unclear whether the treatment is cost-effective compared with tooth removal, especially where molars are concerned.”
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