Advantages of root canal treatment at a glance
- Tooth can be saved very often
- Cheaper than many alternative supplies
- Quick restoration of chewing function
What exactly is an endodontic treatment? What can I expect?
We would like to answer these and other frequently asked questions about endodontics on the following pages and show you that it is worth preserving your teeth.
Your teeth should last a lifetime. However, illnesses or accidents can damage your teeth or tooth roots and an endodontic treatment, also called root canal treatment, may become necessary.
Why do I need endodontic treatment?
The soft tissue in a tooth is called tooth pulp. It consists of nerve fibres, blood and lymph vessels and connective tissue. This pulp can become inflamed and infected by bacteria. This can be caused by deep caries, cracks in the tooth, a broken tooth or gaps between the tooth and the filling. The tooth can then react pain sensitively to cold or heat or suddenly start to hurt for a long time. However, the consequences of the inflammation can also go unnoticed and can only be determined during your dentist’s examination on the basis of an X-ray or sensitivity tests.
If the inflammation is not treated, the bacteria can destroy the entire dental pulp and then penetrate unhindered into the jawbone. This can lead to bone resorption, purulent inflammations, a general weakening of the immune system or to illnesses in their parts of the body.
The only way to leave the inflamed tooth permanently in the mouth without danger is to treat the endodont (Greek: “Endodont” means “the condition of the tooth”), i.e. a root canal treatment. Nowadays it offers the chance to preserve teeth that could not be treated successfully in the past for a long time.
What is endodontic treatment?
Root canal treatment is a measure by which a diseased and bacterially infected tooth can be preserved for many years.
First, the dentist removes the inflamed or dead nerve tissue. The cavities in the root are carefully cleaned and disinfected up to the tip to remove bacteria or other pathogens. The canals are then filled and sealed to minimize the risk of re-infection.
What happens in detail?
Treatment can take place in one or more sessions. The following steps are performed:
- Opening the toothThe tooth to be treated is first anaesthetized. Insulation by means of a clamping rubber (suitcase dam) prevents saliva from entering the tooth and rinsing fluids from entering the mouth. The dentist then opens the tooth and removes the pulp tissue. To do this, the individual canal entrances must be found and opened. For a successful treatment it is important to find all existing channels of a tooth in order to be able to remove the bacteria there. An optical magnification such as magnifying glasses or a microscope can be helpful in the search.
- Determining the root canal lengthExact determination of the root canal length is particularly important for optimum cleaning. In addition to traditional X-rays, modern computer-assisted electrical methods for determining root canal length offer a degree of precision that cannot be achieved with X-rays alone.
- After determining the canal length, the root canals are cleaned with the finest hand instruments or very flexible, rotating instruments made of a nickel-titanium alloy. The high flexibility of the nickel-titanium instruments allows the treatment of complicated and strongly curved root canals. This modern reprocessing technique allows treatment results of a quality not conceivable a few years ago. These instruments make endodontic treatment, one of the most difficult in dentistry, easier, safer and more predictable.
- Disinfecting the root canalsDuring and after canal preparation, the root canals are thoroughly cleaned with disinfecting rinsing liquids, the efficiency of which can be increased by ultrasonic activation.
- Filling the root canalsThere are various filling methods and materials available for filling the canals. Gut tapercha, an elastic natural material, is usually used in combination with an adhesive. Warmly inserted into the root canal, it adapts to the canal anatomy and fills cavities or side canals. Gutta-percha can also be introduced cold into the canal. It is important that the canal is dense and filled up to the wall in order to prevent the growth of bacteria and thus reinfection.
- Closing the toothWhen the root canals are filled, the opening of the tooth crown is closed with a stable and dense filling.
Will I have pain during or after the treatment?
Modern techniques and anaesthetics almost always allow painless treatment today. However, in individual cases the tooth can react sensitively for a short time after the treatment. If necessary, painkillers can help to reduce these complaints. In case of severe or prolonged pain, please inform your dentist.
What happens to my tooth afterwards?
A root-treated tooth should be checked by your dentist at regular intervals. Since many root-treated teeth are at a higher risk of breaking under heavy stress, it makes sense in a number of cases to treat the tooth with a crown or partial crown. This applies in particular to teeth that have only a small amount of residual tooth substance. In such cases, it may also be advisable to use a root pin.
What is the life expectancy of root-treated teeth?
The German Society for Dental Preservation puts the success rate of keeping an endodontically treated tooth in the mouth for a longer period of time at 95% for uncomplicated first treatments. More complex cases or a repetition of the treatment (revision) reduce the chances of success. However, they are still given as 80%.
Modern treatment methods and techniques help your dentist to achieve the best possible prognosis for your tooth. However, no medical treatment can guarantee 100% success.
What are the alternatives to endodontic treatment?
The alternative to root canal treatment is the removal of the tooth. Often, the missing tooth results in problems such as tooth migration, bite position shifts or cosmetic problems. In order to replace the tooth, to restore the chewing function and to prevent malpositioning of the neighbouring teeth, an implant, a bridge or a prosthesis must be inserted.
How much will the treatment cost?
The cost of a root canal treatment depends on the anatomy of the tooth, the number of canals, whether an endodontic treatment has already been performed, and which materials and equipment should be used. Depending on your expenses, your health insurance will not cover all costs incurred and techniques used.
Copyright: Courtesy of VDW/Munich, Germany