Endodonti - Private Eliz Dent Oral and Dental Health Polyclinic

Endodontics is the branch of dentistry that deals with the treatment of root canals in teeth. No artificial tooth can fully replace a natural tooth, which is why all dental treatments aim to keep teeth healthy in the mouth for as long as possible.

During dental procedures, the goal is to preserve tooth vitality whenever possible. However, if it’s not possible to keep the dental pulp alive and healthy, root canal treatment is performed.
Under the enamel and dentin layers of the tooth lies the pulp—containing blood vessels and nerves—that keeps the tooth alive.

Within the crown of the tooth, there is a “pulp chamber” that extends to the tips of the tooth roots. If the pulp becomes inflamed for any reason, it’s necessary to remove the nerve of the tooth, sterilize the canals, and then fill them. Root canal treatment can be done in a single session for vital (living) teeth, while non-vital (dead) teeth generally require multiple sessions.

WHEN IS ROOT CANAL TREATMENT NEEDED?

Everyone has bacteria in their oral cavity. When these bacteria combine with many of the foods we eat, they produce acids in our mouth. If we neglect oral hygiene, these acids damage the tooth’s enamel layer, leading to decay. If the decay in the enamel layer is not treated, it progresses to the dentin layer.

Although the dentin layer causes pain to alert us, if the decay is still not treated, microorganisms then move toward the pulp. At this stage, the pulp tries to protect itself by sending pain signals. But if the tooth is still not treated, microorganisms will destroy the blood vessels and nerves in the pulp over time, causing infection.

If decay is not treated, it gradually progresses until it reaches the tooth’s nerve and causes pulp inflammation.

Pulp inflammation eventually leads to the slow death of the pulp (necrosis). Necrosis can also develop as a result of trauma. Following a sudden trauma, the blood vessels entering the root tip of the tooth might rupture or become compressed, preventing the pulp from getting proper nutrition and leading to necrosis over time.

After a certain period, microorganisms start to reproduce within the necrotic pulp. Over time, these microorganisms affect the tissues around the root of the tooth, causing an abscess at the root tip.
Periodontal (gum) disease can also lead to deep gum pockets, allowing bacteria to enter through lateral canals in the tooth and infect the pulp.

Another way in which the pulp can become inflamed is through trauma. A blow to a tooth can sever the nerves and blood vessels entering the root tip, causing the tooth to lose its vitality. Once microorganisms invade the site, pulp inflammation results. A long-term periodontal disease around the tooth is another route of infection for the pulp.
In the above situations, preserving the pulp in a healthy, living state is not possible. Therefore, root canal treatment is performed.

HOW IS ROOT CANAL TREATMENT PERFORMED?

• Taking radiographs (X-rays) to identify the problematic tooth.
• If the tooth is still vital, administering local anesthesia to eliminate sensitivity in the tooth and surrounding tissues.
• Cleaning out decay in the enamel and dentin layers to create an opening that accesses the pulp.
• Determining the working length using electronic devices and confirming with radiographs.
• Using rotary instruments to remove infected dentin and microorganisms within the root canal.
• During the use of rotary instruments, various canal disinfectants are employed to eliminate bacteria.
• Until the tooth has fully healed, the canal and tooth are sealed with temporary filling materials between sessions.
• Once complete healing has been achieved, the canal is filled up to the root tip with appropriate filling materials.

Root canal treatment can be completed in a single session or may require multiple sessions depending on the condition of the tooth.
After root canal therapy—especially when performed on a vital tooth—there can be mild, tolerable pain for a few days or pain upon biting. This is a normal post-treatment symptom. The pain typically resolves shortly if you protect the treated tooth.

HOW LONG DOES A TOOTH WITH ROOT CANAL TREATMENT LAST?

Although a tooth that has undergone root canal treatment is considered “non-vital” and may be viewed as weaker, if it is properly restored and the patient maintains good oral hygiene, it can remain in the mouth for a lifetime.