Introduction
If a root canal treatment is to be performed on a tooth, patients often feel the need to be well informed about the upcoming treatment. In order to be able to prepare for the treatment if necessary, one would like to know how exactly the dentist proceeds and what else is worth knowing about root canal treatment. A root canal treatment can be necessary for various reasons.
The most common reason for a root canal treatment is an untreated deep caries, which leads to an inflammation within the tooth pulp and the death of nerve fibres. Even with “still living” teeth, root canal treatment can often be the only solution to preserve a tooth that has been severely damaged by inflammation and prevent the inflammation from spreading to surrounding structures. Also for the tissue traumatic events such as a fall directly onto the tooth can be the trigger for the discomfort.
Procedure of the root canal treatment
The procedure of a root canal treatment is quite simple. In the past, when a root canal treatment was performed, a so-called cofferdam was placed before the actual treatment. This means that a metal clamp, around which a clamping rubber is placed, is attached to the tooth to be treated.
The cofferdam serves to shield the tooth, so that saliva and the bacteria present in it cannot enter the tooth. Since the application of a cofferdam is very uncomfortable for the patient, nowadays it is usually done with relative draining. The tooth is therefore only protected from saliva by cotton rolls and the teat.
It goes without saying that the risk of saliva and bacteria penetrating the tooth is much higher with this relative isolation. Now the affected tooth is anesthetized and then opened with the “drill”. The next task in the course of the dentist’s root canal treatment is to remove the pulp from the root of the tooth, including the nerve fibres within it.
He does this with the help of root files of different lengths and thicknesses (Reamer, Hedstrom or K-files). As anaesthesia is often a bit difficult in the case of severely inflamed teeth, it may be necessary for the dentist to apply a further anaesthetic directly into the tooth pulp. From this point on, the root canal treatment is in most cases absolutely painless.
The root is now prepared, i.e. hollowed out. The already mentioned root files are used in an orderly sequence (the diameter increases). Afterwards an alternating rinsing with different solutions is carried out.
The solutions used are hydrogen peroxide (H2O2), anti-inflammatory, antibacterial chlorhexidine (CHX) and sodium hypochlorite. From this point on, the course of the root canal treatment depends on the condition of the tooth. In less inflamed initial situations the root can be filled quickly.
If the tooth pulp was highly inflamed, the dentist will in most cases first introduce an antibacterial, anti-inflammatory drug into the tooth root and let the tooth rest for a few days. As soon as the tooth root is sterile and dry, it is filled with so-called guttapercha points and a dense cement. The guttapercha points are rubber-like material that fills and seals the hollow tooth root. As a rule, after the root canal treatment has been completed, an X-ray control image is taken to check whether the root is filled to the tip (apex) and the tooth is then sealed.
