ROOT CANAL

As its name says is treat the root canal of the tooth that has been damaged in its inner part called the pulp (blood vessels and nerve) and aims to clean and seal the root canals to prevent the bacteria reaching the apex of the root which will produce an infection in the bone that, finally, leads to the loss of the tooth. The treatment is performed under strict sterile conditions with the use of several disinfectants and very fine instruments similar to needles of decimals of millimeters that allow to work along the root of the tooth until its apex. These instruments were used manually but today due to the industrial progress that led to improvements in working methods, and treatment is usually carried out with rotary instruments working at low speed and allows us to overcome such obstacles as ducts and curved roots, which finally produces an increase in success rates in Endodontics. In 2012, a new development of flexible and self-expanding instruments was launched in Israel, adapting itself to the width of the canal called SAF and bringing the ideal instruments on which we dreamed.

Which cases need root canal treatment?

1)in most cases due to dental caries, which causes great pain

2)due to necrosis of the teeth, and the development of infection around the root and inside the bone, some of which manifest without warning with swelling and pain, and others are casually diagnosed on routine examination through radiographs and without preliminary pain

3)due to trauma or fracture of the tooth, which is followed by pain, requiring an extensive reconstruction of the tooth’s crown.

4)Another reason is the rehabilitation to correct an aesthetic problem or to make a bridge that requires sacrificing a large amount of dental material that causes hypersensitivity in the tooth. It is therefore common in most cases to perform a preliminary root canal treatment before of rehabilitation.

What can happen if I do not want to do root canal treatment?

In cases where the pulp of the tooth is damaged, the pain will increase and eventually there will be a swelling in the face that is most likely to require dental extraction. In the event that the pulp is not damaged and the tooth is designed to receive a crown, it is sometimes considered to take a risk and not do a root canal treatment, which may require doing so in the future under non-optimal conditions through penetration through the crown, which may eventually lead to failure of rehabilitation. that case will be determined with the dentist’s recommendation because each case is different.

How is the treatment performed? At the beginning of the treatment, anesthesia is given so that the patient does not feel pain during the treatment. After that, access will be made to the root canal system, which includes caries removal, removal of old restorations in which cavities may exist beneath them, and at that time the tooth is ready for treatment. It is recommended to place a rubber dam that isolates the tooth from the oral cavity, which allows sterile and isolated conditions of bacteria from the mouth and saliva. At this stage, the treatment actually begins and aims to clean the canal to remove the remaining pulp, organic material and bacteria, with the use of instruments mentioned above, initially manually to access the root apex after with the use of rotating and flexible instruments. At all times during treatment, the tooth is disinfected with materials designed for this purpose, and the walls of the canals are smoothed and widened enough to be sealed and closed with a filler called Gutapercha and cement. And the end result is to get rid of bacteria to prevent bacterial infiltration of the oral cavity through a root canal to the bone and prevent infection and subsequent tooth loss. The sealants contain materials that are detected on the radiograph and ensure that the treatment has been performed correctly and reached the end of the root.

What are the side effects of treatment? Mild sensitivity, severe pain and swelling. And that will depend on the condition of the tooth and the area before the treatment, and will also be affected by the treatment process, most treatments do not require taking painkillers.

How many appointments are needed for the root canal treatment? it is advisable to perform the treatment in one session so that the chances of success increase, but it depends on the condition of the tooth before and during the treatment, sometimes the conditions do not allow it to be finished in one time.

Is this a one-time treatment? The success rates reach more than 90% in the first treatment, so there are cases in which the treatment will not be successful and will show an infectious process that will require retreatment or surgery to save the tooth. The failure of the treatment even in the most expert professional is usually not related to the dentist who performed the treatments but to the complexity of the canal system that is not always accessible with the tools available today.

Is the root canal treatment the end of dental treatment? Not because root canal treatment is performed in the root canal of the tooth and the sealing material is intended just for this purpose and not for tooth reconstruction. Therefore, a post reconstruction and a crown will normally be performed to avoid fracture of the tooth