Endodontics literally means “the study of the interior of a tooth” and is a branch of dentistry that deals with diseases of the pulp-dentin complex. The aim of any endodontic treatment is to preserve the affected teeth. If bacteria cause inflammation of the tooth root and pulp, this can cause severe pain in the patients. The therapy of choice in this case is root canal treatment. The following sections provide you with the most important information about root canal treatment.
Advantages of root canal treatment
The root canal treatment as an effective option for the treatment of diseased teeth offers you these advantages:
- Preservation of natural teeth
- Aesthetically pleasing result
- Healthy tooth as support for bridge that may be necessary later on
- No extensive treatment or expensive dental prosthesis necessary
When is a root canal treatment necessary?
In order to understand when treatment of the tooth root is medically indicated, we, as specialists in this field, will give you a brief insight into the course of the disease. First of all, basic knowledge of the anatomy of the teeth is helpful. The inside of the tooth cavity is filled with pulp. The pulp runs from the pulp cavity in one or more root canals towards the root apex. This in turn has an opening which contains nerves and blood vessels.
If bacteria penetrate the body – usually as a result of caries – an inflammation develops. The bacteria can also migrate into the pulp due to a traumatic crack in the tooth. The blood circulation in the area of the tooth root is increased, the vessels expand and compress the nerve fibres. This can cause severe pain. The dentist should now intervene as quickly as possible – if the inflammation spreads to the jawbone and the soft tissue, a purulent abscess can develop. From this focus, the bacteria can scatter into the heart or brain and cause severe damage there. Prophylactic root canal treatment can also be carried out as part of dental prosthesis treatment with almost exposed pulp.
Symptoms of pulp and root inflammation
Do you feel an occasional hypersensitivity of a tooth to heat and cold stimuli, for example while eating and drinking? This could be a first sign of inflammation. At an advanced stage of the disease, patients often complain of severe, sometimes sudden pain in the tooth. If no appropriate treatment is given, the inflammation can spread to the jawbone. If the abovementioned abscess forms, this manifests itself in a purulent and painful swelling. It is also conceivable that you will not show any symptoms despite the presence of pulpitis.
Root canal treatment procedure
Depending on the findings, we carry out the root canal treatment in one or more sessions. The individual steps include the following points:
1. opening the tooth
The affected tooth is first anaesthetised locally; then Dr. Kossel or Dr. Krebs carefully opens the tooth. Now the inflamed pulp tissue must be carefully removed. It is very important to cover all root canals. Instruments for optical magnification, such as magnifying glasses, can be useful. In addition, the so-called rubber dam, an elastic cloth made of rubber or plastic, shields the tooth to be treated from the rest of the oral cavity. This endodontic aid enables an aseptic environment and clean work on the tooth.
2. length determination of the root canals
The exact determination of the length of all root canals is very important for optimal treatment results. In addition to conventional x-rays, more modern, computer-assisted measuring procedures are available in our practice today. Innovative endometry devices such as the Raypex length measuring device enable us to record the length of the root canal and the exact position of the root tip with the utmost precision.
3. cleaning the root canals
We use a special preparation procedure to thoroughly clean all root canals. Our highly flexible files are equipped with a nickel-titanium alloy and a reciprocal mechanical drive. This means that file breakage is extremely rare. Due to their flexibility, the rotating instruments also allow the cleaning of highly tortuous and complicated root canals. A strict rinsing protocol with alternating rinses ensures sufficient disinfection of the canals. In addition, the bactericidal effect of a laser can be used in endodontics: If the laser light is introduced directly into the inflamed root area, it specifically kills the pathogenic bacteria there.
4. filling the root canals
Once the cleaning and shaping of the root canals has been completed, the filling of the root canals follows. Prefabricated posts made of gutta-percha, the dried, rubber-like latex of the tropical gutta-percha tree, are used for this purpose. The introduction of the so-called sealer, a cement-like material, can compensate for micro-unevenness between the gutta-percha pins and the inner wall of the ducts. In the same treatment step we carry out, if necessary, an adhesive composite build-up in the crown area. If the hard substance of your teeth is very badly destroyed, we can remedy the situation with a glass fibre pin glued into the canal.
Do not hesitate with a root canal treatment
Do you have concerns about root canal treatment? This is what happens to you like to many other patients.
Thanks to the modern and sophisticated techniques of endodontics, a branch of dentistry, the treatment is very gentle. However, local anaesthesia usually ensures complete freedom from pain during the procedure. Slight pain after the treatment is evidence of the sensitivity of the tooth due to the previous inflammation; these complaints can also be contained with medication.
Do not hesitate to visit your dentist for root canal treatment. The earlier you use our help, the higher the probability that a root canal treatment is not necessary. If the pulp and root of the tooth are only inflamed at an early stage, other endodontic treatment methods can often be used. We do everything in our power to make the treatment pleasant for you.
Possibilities of endodontics – Root tip resection
For some patients, conventional root canal treatment is not sufficient. In these cases, endodontics offers an alternative solution: root tip resection (WSR). If there is a chronic inflammatory process in the area of the root apex of one of your teeth that does not subside after a root canal treatment, we will discuss the possibility of a WSR with you.
Also special tooth injuries, abnormal conditions of the tooth root or cysts can speak for a WSR. The standard surgical procedure for tooth preservation includes the removal of the root apex and the inflamed tissue. The tip of the tooth root is shortened by two to three millimetres. The root canals are then widened, disinfected and filled. Once the bacteria-infiltrated tissue has been completely removed, the remaining soft tissue can be sutured. A tight closure of the canals is essential to prevent a new infection with bacteria.
Which costs are covered by the health insurance?
The statutory health insurance only bears the costs for root canal treatment if the tooth in question has been classified as worthy of preservation. Particularly for the posterior molars, certain conditions exist. Otherwise, it is possible to invoice the root canal treatment as a private benefit. Root tip resection, in turn, is covered by the SHI for teeth in the anterior and posterior regions.