What is root canal treatment?

Root canal treatment or endodontic treatment of a tooth is the procedure that treats diseases of tooth’s nerve (dental pulp). Endodontic treatment can perform general dentist or a specialist called endodontist.

When is root canal treatment needed?

Clinical examination of the tooth often reveals tooth decay, tooth decay under a dental filling or under artificial crowns. Sometimes, there can also be found intact teeth with the history of a trauma. All of these situations can lead into a need for a root canal treatment.

Is it necessary to do an x-ray before root canal treatment?

It is necessary to do an X-ray of a diseased tooth for an accurate diagnosis. The determination of the causal tooth is sometimes difficult, especially when pulpal disease is in the early stages and consequences of inflammation are not yet visible on X-ray or the disease has affected more teeth at the same time. X-ray imaging in the process of endodontic treatment are:
  • image before treatment started,
  • image during treatment, if treatment is complicated,
  • image after filling of the root canals,
  • image 6-12 months after the treatment has finished, and
  • image in 5 years time or periodic preventive orthopan.

When is root canal treatment considered difficult?

Endodontic treatment is time-consuming and difficult especially, when we have to deal with multirooted teeth which have more than one root canal or if tooth roots are curved. Another problem represents colonization of bacteria in the dentinal canals. Tooth root is composed of thousands of tiny dentinal channels that are large enough for bacteria to colonize them, but at the same time too thin to be reached with endodontic instruments. Some bacteria are more resistant to treatment and are more difficult to eliminate.

Is treatment of painless dead tooth necessary?

Dead tooth (avital tooth) is infected with bacteria, so it must be treated. Tooth has beside a main canal in the middle also a lot of lateral canals, which can also be filled with bacteria and their products. The purpose of the endodontic treatment is to remove dead or diseased dental pulp and bacteria. It is important to remove any dead parts of the pulp along the entire length and width of the root canal.

How is root canal treatment performed?

During the root canal treatment it is used bactericidal irrigation fluid together with endodontic instruments and after the completion of tooth’s irrigation and reshaping, it is inserted antibacterial agent in a form of a white paste. Endodontic treatment of the dead tooth comprises of a more visits. The first visit includes opening of the tooth, disinfection and insertion of antibacterial paste, which can take from 30 minutes to one hour or more, depending on the type of tooth. Work is usually painless. If a tooth is not completely dead before opening, local anesthesia is administered. At the second visit antibacterial paste is refilled. This painless procedure takes approximately 15-20 minutes. The third visit is also painless and takes 20-30 minutes. Root’s canals are permanently filled with biocompatible material, called gutta-percha.

Are treated teeth more fragile than healthy ones?

The fragility of a treated dead tooth it is not due to a loss of tooth’s nerve but due to the weakness of the remaining tooth structure. Many teeth before treatment had dental filling. During root canal treatment it is necessary to reshape canal and to remove even more tooth structure. And if there is not enough dental crown structure remaining, there may also be need for artificial crown which also needs a little bit of reshaping at the end of the root canal treatment.

What is the prognosis of a root canal treatment?

For the treatment success it is important a precise removal of bacteria from root canals and a tight filling. Due to the rapid development of science in dentistry, tooth extraction is today due to illness of tooth’s nerve or forming granuloma rarely necessary. Success rate of a root canal treatment is today more than 90%. Dentist can restore teeth and keep them in function for many years. Untreated dead teeth can cause problems, but we cannot tell when. It can happen sooner or later. So treating dead teeth is a must.

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