Endodontics
4 February 2020 2514Views
Endodontics

Endodontics is a branch of dentistry that deals with the teeth problems that have progressed to the dental pulp. An endodontist is a dentist who have taken additional theoretical and practical theoretical education on root canal treatments.

What causes dental pulp inflammation?

Thousands of harmless bacteria resides in every individual’s mouth. Some of these bacteria release acid to metabolize sweet foods and beverages. These acid damages the enamel and dentin and cause caries to develop. If the caries are left untreated, the bacteria progresses to the pulp tissue and inflammation occurs. The main factor in dental pulp inflammation are the bacteria. Another factor is tooth's exposure to trauma. A strong force can cut blood circulation on the tooth, hence nutrients cannot reach the tooth and the tooth loses its vitality over time. Grinding/ clenching, too high fillings and restorations can cause trauma and may cause inflammation of the pulp.

When is root canal treatment applied?

  • Deep caries extending to the pulp or recurrent caries under old fillings, crowns or prosthesis
  • Pain despite having filling or crown
  • Crown or root fractures from trauma
  • When pulp is proven to have lost its vitality
  • Damaged dental pulp as a result of parafunctional habits such as grinding /
  •  If dental pulp is damaged as a result of non-functional movements such as teeth grinding or chewing habits
  • Damaged pulp due to gum disease/ gum treatment operation

How is root canal treatment applied?

The root canal treatment procedure approximately last for an hour. Before starting the root canal treatment, anesthesia is applied so that the patient feels no pain. Then the doctor isolate the tooth from the sorrounding structure using a rubber cover. The cavity is opened to access the root canals. The dead or dying pulp is completely removed. The length of the canal is then measured and shaped. The root canal cavity is cleaned and disinfected with various solutions and the treatment is completed by filling the canals with special filling materials until the end of the root. It can be usually completed in a single session. In cases where tooth has lost its vitality, the root canal is cleaned, shaped and filled with disinfection agent called Ca (OH)2. This agent needs to stay on the root canals within 7-10 days before re-visiting the clinic. This process can be repeated for several times depending on the condition of the tooth.

Is root canal treatment a painful treatment?

If the tooth and surrounding tissues to be treated are effectively anesthetized, the patient will not feel pain during treatment.

When should I used antibiotic before a root canal treatment?

It is not necessary to use antibiotics in cases where the pulp is still functional provided that the patient doesn't have any systemic disease. However, if the patient has heart valve problems or taking any immunosuppressive medication, the patient should take antibiotics, as prescribed, before the treatment begins. In addition, patients experiencing fever, paiin, redness and swelling on the face should also take antibiotics as instructed by the doctor.

Is root canal treatment a multi-session treatment?

Root canal treatment for a live pulp can be completed within a single session. However, if the tooth has lost its vitality, if there is an infection at the end of the root or it is a retreatment (repeated root canal treatment), it may take two or more sessions depending on the condition of the tooth.

Does the life of the root canal treated tooth decreases?

The removal of the pulp tissues that provides vitality to the tooth makes the treated tooth become more susceptible to fractures. It is important to carefully decide whether to put a filling or a crown on top of the treated tooth. Nowadays, digital porcelain filling system is used to protect the root canal treated tooth. Porcelain fillings produced with the CAD/CAM system is more effective in terms of supporting and protecting the tooth. Restorations are very important in keeping the tooth healthy.

Is there a pain after a root canal treatment?

Since the pulp is removed during the root canal treatment, it should not be sensitive to external stimuli such as hot and cold.  If the pulp is still alive, a puncture wound is created at the tip of the root during the removal of the pulp. It is therefore normal to experience pain when chewing until the wound heals. If there is pain or inflammation in the teeth before the treatment, you will still feel slight pain when pressure is applied (e.g. pressure from chewing) few days after the treatment.

Can a root canal treated tooth contract inflammation again?

The success rate of a well applied root canal treatment is around 90-95%. The treated tooth can re-contract inflammation when bacteria from new caries or fracture of the dental filling leaks into the root canal.

What to do in case of root canal treatment failure?

Root canal treatment is a procedure that can be repeated. When the treatment fails, the root canal filling is removed, reshaped, disinfected and re-filled. Because of the complexity of this process, patients should be informed in advance regarding the repetition of root canal treatment. The success rate is lower but this does not that it will fail. A root canal treatment can be repeated several times. However, if there is a fracture in the tooth or if there is too much bone loss at the end of the root, root canal retreatment will not be beneficial. It is therefore important to evaluate why the root canal treatment failed in the first place. If it is performed by a qualified endodontist, failure will be unlikely.