The root canal treatment is carried out using very thin sawing and penetrating tools, as well as a microscope and an endometer, an instrument measuring the root canal length. A microscope allows the doctor to accurately observe the inside of the tooth chamber and the canals, while the endometer measures their depth. Another essential element of endodontics is also X-ray diagnostics.
What is the root canal treatment?
Root canal treatment, also known as endodontic therapy, is, for many patients, the only way to save a sick tooth. It is necessary when there is an irreversible inflammation of the tooth pulp – the richly vascularized tissue that fills the tooth chamber and its canals. The diseased pulp must be removed entirely from both the tooth chamber and the canals. During the procedure, the inside of the tooth is repeatedly and thoroughly disinfected, then the canals are filled with appropriate materials that seal them and prevent the growth of bacteria. With minor damage to the tooth, it can be rebuilt using composite materials. Large cavities may require a prosthetic reconstruction.
When is it necessary to start root canal treatment?
There are several indications of root canal treatment. In most patients, the most common cause is irreversible and very advanced pulpitis. It is usually a complication of untreated caries and bacteria in the cavity. In such cases, the tooth is sensitive to temperature changes and pressure, and you may experience moderate to severe pain. However, there are cases of chronic pulpitis without any obvious symptoms.
Endodontic therapy is also performed in patients with pulp necrosis and visible periapical lesions. Dentists also encourage root canal treatments when previous endodontic therapy has failed or is incomplete. Ignoring the problem may potentially spread the illness to other parts of the body. The repeated root canal treatment is advisable when:
- Root canals are poorly filled.
- Changes are visible at the root apex (on the X-ray image)
- The patient continues to feel pain.
Is Root Canal Treatment Painful?
Root canal treatment, although not the most comfortable method for patients, is virtually painless with the use of local anesthesia. The exception to this rule is when the inflammation is very extensive, and it is impossible to control it with anesthesia. In most cases, the pain relieves after the administration of anesthesia, allowing Dr. Van de Vyvr to carry out further treatment steps. A tooth with no pulp is no longer innervated. It does not conduct pain impulses, so it does not hurt.
Your tooth may be more sensitive for a short time immediately following the procedure. If the pain becomes worse, it may be a symptom of further developing inflammation.
The course of root canal treatment step by step
Before starting treatment, our seasoned dentist needs to know the shape and length of the tooth and the extent of the inflammation. To obtain that information, he will perform an X-ray or more advanced computed tomography. It also allows us to choose the appropriate anesthesia for your comfort and safety.
Once the patient is under anesthesia, the dentist can proceed with treatment. Many dentists use endodontic microscopes, which significantly increase the chances of successful treatment. Thanks to them, they can see all the canals, which allows them to be thoroughly unblocked and filled.
With the help of specialized tools, Dr. Van de Vyver removes all carious lesions to get to the tooth chamber and root canals. Then he removes the pulp (dead or living) and thoroughly cleans the inside of the tooth. During preparation, the canals are rinsed several times with a disinfectant. The widened, dried, and disinfected canals are sealed and filled to prevent bacteria from reaching the periapical tissues. When filling the canals, the dentist uses an endometer – a device that checks the working length of the tooth. After filling the canals, the dentist uses an X-ray to check if the canals are correctly filled.
After closing the canals, the dentist puts on a foundation (which separates the canals from the filling) and then begins to rebuild the tooth crown.
What are the contraindications for endodontic therapy?
Most often than not, there are no contraindications to primary root canal treatment.
Re-treatment of the root canal and treatment of teeth with necrotic pulp is contraindicated in patients with an increased risk of infective endocarditis (cardiac infection and inflammation):
- with an artificial valve in the heart or with a previously made valve repair using artificial material;
- after infective endocarditis;
- with congenital heart defects
Pregnancy and breastfeeding are not contraindications for treatment. Of course, in such a case, an appropriate anesthetic should be used and – if the patient is in advanced or at risk of pregnancy – consult the doctor in charge of the pregnancy.
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