All About Root Canal Treatment in Dentistry

Watch Dental Video about Root Canal Treatment

A root canal has to be performed if the dental nerve (Latin: Pulpa) has died and/or is infected.

As a patient, you may or may not experience pain leading up to a root canal. Some causes for the pulp dying are:

  • Deep-seated caries
  • severe heat during the cutting of a tooth
  • and/or chemicals used by the dentist (e.g., white fillings, called composites)

The commonly referred to “dead” tooth can lead to acute, even life-threatening complications at any time, because the necrotic dental nerve tissue can cause acute infections, called abscesses. More on that in the video entitled “Abscess.” The objective of a root canal is to completely remove the destroyed tissue (which may also be infected with bacteria in some cases) from the interior of the tooth, so that the infection is prevented from spreading to the bone. The tooth is connected to the bone through numerous small canals at the end of the root.

Dental Abscess

Dental Abscess

Since a complete cleaning of the interior of the tooth is never 100% successful, the dentist attempts to close the “pulp cavity” tightly with a special compound so that any remaining bacteria don’t have space to multiply. This means that absolute cleanliness and a sterile working environment are a prerequisite for any root canal treatment.

In order to facilitate this in the mouth, it is imperative that the dentist works with a dental dam, because this is the only way to prevent saliva from reaching the interior of the tooth. More on that in the video entitled “Dental dam.” Saliva contains many different bacteria that can endanger the success of a root canal treatment. Here you see a cofferdam insulating the tooth from the tongue, other teeth, saliva, and blood.

Furthermore, it is important to work with sterile instruments. However, in most cases, root canal work is performed with unsterile instruments. Instruments are placed openly in simple foam rubber racks. With the aid of sterile instruments, the dentist begins to clear and clean the interior of the tooth. Special solutions are used intermittently for rinsing in order to remove tooth chips, cell debris, and bacteria. It’s important that all canals are reconditioned.

Most teeth have several canals, therefore, a precise dentist always works with magnification such as medical magnifying glasses or a microscope. The dental canal must be reconditioned all the way to the root end. The length of the root is ascertained by means of X-rays and measuring aids.

Dental Dam used in Root Canal Treatment

Dental Dam used in Root Canal Treatment

Only a well reconditioned tooth filled all the way down to the root end can be preserved permanently. If the tooth smells, if pain is experienced, or if there is severe bleeding from the interior of the tooth, then a final filling of the tooth’s interior should not be done. In such cases, medication is rotated into the tooth, which is then tightly sealed for a couple of days.

However, the temporary sealing material must be absolutely saliva-proof as it keeps the tooth tight for about one week. Another session must take place no longer than a week after the initial session. Otherwise, bacteria from the saliva would enter the interior of the tooth and the entire previous procedure will have to be repeated.

Once the tooth’s interior is clean and the tooth no longer causes any discomfort, then the interior of the tooth is tightly sealed with a special compound. The tooth should also be tightly sealed from the top, i.e., from the access, because only then is it guaranteed that bacteria can no longer enter.

In the video “Root Canal Treatment” you see an X-ray of a tooth with a good root canal treatment. The interior of the tooth has been filled homogeneously and tightly down to the root end. On the X-ray, it’s the light strip within the interior of the tooth. Such a tooth is able to provide valuable service for an entire lifetime.

On the right, you see an example of a tooth with a badly executed root canal. The root in the front was not filled at all, while the rear root was only filled half way. Such teeth can cause trouble even after many years and can lead to, for example, conditions such as an acute bone infection or an abscess. In this case, a root end resection and/or a tooth extraction would be necessary.

The only alternative to a root canal is a tooth extraction. Prevention is the best alternative!

Endobox

Endobox

The risks of a root canal are:

  • Instruments breaking during root canal treatments
  • the dentist missing root canals
  • a perforation of the canal and the dental crown
  • over-instrumentation with respective possible consequences such as, e.g., maxillary sinusitis

You can learn more about the complications of root canal treatments in the video entitled “Root Canal Problems”.

Click here to see the video: Root Canal Treatment

 

This post is also available in: German

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