What is root canal treatment? Why is endodontic treatment necessary? When can root canal treatment fail?
What is root canal treatment?
Firstly its is worth to briefly focus on tooth anatomy. Our teeth consist of a crown and roots. In the correct situation, in the oral cavity, we only see the crown, and the roots hide under the gum in the bone. Inside the crown there is a chamber that connects to the canals inside the roots. These spaces are not empty. Inside, there is a pulp, i.e. a tissue made of blood vessels, nerves and cells specific only for this place – odontoblasts. This pulp has numerous functions:
- development – participates in the production of dental tissues,
- nutrition – a network of blood vessels provides the necessary substances and minerals to an already mature tooth,
- protection – healthy pulp together with hard tooth tissues is a barrier against the penetration of microorganisms into the body,
- sensation – thanks to the presence of nerve fibers, we feel the influence of external factors on the teeth, such as large changes in temperature (which can damage the pulp). Unfortunately, this part of the tooth is also responsible for unpleasant ailments such as hypersensitivity or pain during inflammation.
How is the root canal treatment performed at the Smile and Care Medical Center?
Endodontic treatment at the Smile and Care Medical Center begins with collecting a detailed history and conducting a complete examination of the oral cavity. The doctor then walks patient through the individual treatment plan, makes specific recommendations, and answers questions about the treatment. After the patient has received the full information, it is time to proceed to with the appropriate treatment.
Often patients wonder if it is painful. The endodontic treatment is performed under local anesthesia, so you should not be afraid of additional pain.
The aim of root canal treatment is to clean the entire tooth from bacteria, and in particular the root canal system. The dentist first cleans the tooth from all carious lesions, as they are the main habitat of bacteria. Before the root canal treatment, the doctor prepares the treatment area using a “cofferdam”. It is a coloured gum that is applied to the tooth and covers the entire mouth. It enables the isolation of the treated tooth from saliva, but also prevents the ingress of disinfectants into the oral cavity, improving the patient’s comfort during the visit.
The proper endodontic treatment begins with finding all canal openings and determining their length. The number of channels depends on the number of roots, but there are some exceptions. In the incisors and canines, respectively, one can expect one, occasionally two canals. In premolars, the presence of two canals is much more frequent, and there are also three canals. In contrast, four canals should be expected in molars.
Then the doctor cleans the canals using special files and disinfectant fluids, and when the canals are properly prepared, he fills them permanently with the appropriate material. A tooth treated in this way is prepared for the final restoration.
At the Smile and Care Medical Center, we pay great attention to quality and precision, each endodontic treatment is carried out using a microscope. Our doctors have at their disposal complete and modern equipment and high-quality dental materials. Dental chairs in our offices are equipped with tips dedicated to endodontic treatments and X-ray, which allows to maintain the highest standard of treatment and to assess the effects of work at each stage. In addition, to increase the precision of the procedure, the doctor has a computer tomography at his disposal, which enables treatment also in the most difficult cases.
Why was it necessary to undergo endodontic treatment?
Root canal treatment is performed primarily when there is inflammation or necrosis of the pulp filling the chamber and the canals. The most common cause of pulp inflammation is a significant loss in the tooth crown. The pulp, apart from the mechanical cover in the form of hard tooth tissues, has a limited ability to protect against bacteria. Prolonged infection with bacteria or their toxins can lead to increased inflammation. There is also a possibility of bacterial infection due to widespread inflammation of the gums, which is why regular inspection and professional cleaning of the surface of the teeth and gums from plaque is so important.
It happens that dental injuries can lead to the necessity of endodontic treatment. It is also carried out preventively, e.g. before prosthetic or surgical treatment, in which there is a high risk of pulp damage, which could lead to its subsequent necrosis and gangrenous decay.
What influences the prognosis of endodontic treatment?
First of all, the prognosis is adversely affected by the delay in starting treatment or the delay in continuing the treatment already started. This behavior spreads the infection and can expose you to serious complications, including bacterial infection of the kidneys and heart. In addition, despite the use of the latest technology, such as surgical microscopes and computer tomography, it happens that the anatomy of the root canal makes it impossible to clean it thoroughly. The canals of the teeth are very complicated in structure, often with numerous branches off the main canals. Unfortunately, it is not always possible to reach all canals mechanically, so we always pay attention to the use of an appropriate amount of disinfectants.
How can we be sure that the treatment has been successful?
Currently, the only way to check whether all microscopic and deep canals have been cleaned are follow-up visits. During them, an X-ray examination is performed to assess the occurrence of inflammatory changes in the bone surrounding the treated roots. If the primary treatment fails, re-treatment may be considered. Although endodontic re-treatment is initially burdened with a higher risk of failure, performed by an experienced doctor gives a very good chance of therapeutic success and allows you to save the tooth from extraction.
lek. dent. Kamil Kikowicz
