Endodontic treatment

Cause of tooth inflammation

Why would I need an endodontic treatment?

The soft tissue in a tooth is called dental pulp. It consists of nerve fibers, blood and lymphatic vessels and connective tissue. The pulp may become inflamed and infected by bacteria due to a deep-seated cavity, a crack in the tooth, a broken off tooth or a gap between tooth and filling. The tooth may react to cold or heat causing sudden or lasting pain. Nevertheless, the infection could also stay unnoticed until discovered on an x-ray or during a sensitivity test while at your dentist.

If the inflammation is not treated, bacteria might destroy the entire dental pulp and spread into the jaw-bone causing bone-loss, purulent inflamma-tion, weaken the general immune system or trigger diseases in other parts of the body.

The only possibility to permanently keep the in-flamed tooth without risk of disease is through endodontic treatment (from the Greek endo ‘inside’ and odons ‘tooth’), i.e. a root canal treatment. To-day, a root canal treatment will save a tooth which formerly could not have been saved.

What is an endodontic treatment?

Root canal treatment is a procedure that can save a diseased and infected tooth for many years to come. First, the dentist removes the infected or dead nerve tissue. Then the hollow space in the root is cleaned and disinfected thoroughly to the tip, eliminating bacteria and other germs. The canals are then filled and sealed, minimizing the risk of new infection.

Root canal treatment may take one or several visits. The sequence is usually as follows:

What actually happens in detail?

1. Opening the tooth

First, the tooth to be treated is numbed. With a rubber dam, it is isolated to prevent saliva from reaching the tooth and rinsing solution from entering the oral cavity. When the dentist has opened the tooth, the canal entrances must be found and accessed and the pulpa has to be removed thoroughly. For the treatment to be successful, it is important to find all canals so the bacteria can be removed. Optical magnification with a dental loop or microscope can be very helpful in the search.

2. Determining the canal length

For optimal cleaning, the length of the root canal must be determined correctly. In addition to the traditional x-ray imaging, modern computer assisted electrical devices are available to ascertain the root canal length with precision that x-rays alone are not able to achieve.

3. Cleaning the root canals

Once the length of the root canals is determined, they are either cleaned with very fine hand instruments or very flexible rotary instruments made of a nickel/titanium alloy. The highly flexible nickel / titanium instruments make it possible to treat even complex and strongly bent canals. This modern preparation method provides treatment results of a quality unthinkable just a few years ago. Thanks to these instruments, endodontic treatment, one of the most difficult procedures in dentistry, becomes easier, safer and more predictable.

[Translate to English:] 4. Desinfizieren der Wurzelkanäle

[Translate to English:] Während und nach der Kanalaufbereitung werden die Wurzelkanäle mit desinfizierenden Spülflüssigkeiten, deren Effizienz durch Ultraschallaktivierung erhöht werden kann, gründlich gereinigt.

5. Filling the root canals

There are several methods and materials for filling the root canals. In most cases gutta-percha, a natural and elastic material, is used in combination with an adhesive. Warm gutta-percha is introduced into the canal to fit the canal anatomy and to fill the hollow spaces and lateral canals. Gutta-percha may also be introduced in the canal coldly. It is important to completely and hermetically fill the canals to prevent bacteria from re-entering and causing a new infection.

6. Sealing the tooth

Once the root canals are filled, the opening in the crown of the tooth will be sealed with a stable and dense filling.

My own teeth – for all my life

Patient information: My own teeth – for all my life

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