Endodontics / Root canal treatment

Endodontic treatment (root canal) is a way of preserving a tooth that has lost its vitality either from caries, injury, or periodontal disease. The purpose of treatment is to restore the health of the tooth in order for it to function properly inside the patient’s mouth. In some cases, it may be necessary to use endodontic treatment in order for the tooth to be repaired prosthetically.

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Why does a tooth need endodontic treatment? 

Inside each tooth there is a small chamber and one or more root tubes containing a living tissue called “pulp”. The pulp is often mistakenly referred to as the “nerve of the tooth”, but in fact it also contains a network of blood vessels, and other elements. 

If a tooth has a deep cavity of caries or a fracture, germs from the oral cavity can reach the pulp and cause it to become infected. Without any treatment, the infection progresses and leads to the destruction of the pulp as well as the bone surrounding the root of the tooth (e.g. abscess).

Pain (often very intense) can occur at any stage of the above procedure.

How is endodontic treatment performed?

The purpose of the treatment is to remove the germs from the interior of the tooth and to disinfect the root canals. For this reason a hole is made in the tooth, root canals are identified, measured, cleaned and enlarged using microscopic tools.

Is the treatment painful?

All treatment is performed under local anesthesia and additional measures are taken to make the patient feel comfortable during the procedure. After treatment, the patient is informed that there is a possibility of pain. This pain, when present, is usually mild, is of short duration, and is effectively treated with common painkillers.

In summary, these are the stages of treatment:

The tooth must first be isolated, the chamber opened, and the root canals identified.  Then the wall of the root canals is enlarged with special tools, to make them suitable for occlusion with a special sealing material called gutta percha.

At the same time, chemical preparation is carried out with a solution of hydrogen peroxide, chlorhexidine and saline.

How long does endodontic treatment last?

The timing of treatment varies depending on the type of tooth, the complexity of the root canals, and problems that may arise from previous treatment attempts. In some cases treatment can be completed within a single 60 to 120 minute session. In other cases a second or even a third session may be required.

Is the success of the treatment certain?

Endodontic treatment has a high chance of success. However, it should be noted that it is impossible to guarantee the success of any medical or dental treatment. Even after the completion of the best possible treatment, there may be no cure due to conditions beyond the control and responsibility of the dentist. If this happens, further treatment may be needed to remove the infection.

What happens after the endodontic treatment?

The tooth is often weak and for its protection, it should soon be restored by the dentist. The construction of a crown or onlay is often preferred. This is necessary because teeth after receiving endodontic treatment usually get dehydrated and therefore lose their elasticity and become brittle. Until the restoration, it is preferable that the patient does not bite hard with this tooth, while afterwards it may be used normally.

Can antibiotics cure tooth inflammation on their own?

Antibiotic therapy is helpful in this case, but not curative. When pulp necrosis occurs, the antibiotic cannot get there because there is no blood flow due to necrosis.

Antibiotics are administered by dentists only when an acute inflammation of the jaw needs to be treated. When the acute symptoms have passed, the endodontic treatment will be completed in order to keep the tooth in the mouth and prevent the need for extraction.

Why root canal and not extraction straight away?

The general principle of dentistry is to maintain the tooth in the mouth and not to remove it. It is important to emphasize that no prosthetic work can completely replace a natural tooth.

Is a root canal painful, at all stages?

Endodontic treatment is painless, since local anesthesia can be performed at any stage. There may be some discomfort after the treatment or between sessions. In these cases, the dentist will administer the appropriate treatment to relieve any annoying symptoms.

How many years can a tooth with a root canal remain in the mouth?

The tooth that has undergone endodontic treatment can theoretically remain in the dentition for many years and be functional. However, like all teeth, it is vulnerable to diseases that can occur in the mouth (caries, fracture, trauma, periodontal disease).

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