When it throbs and hurts in the mouth, a hole in the tooth is often to blame. If caries has spread to the tooth nerve, often only a root canal treatment can save the tooth. With the right anesthesia, root canal treatment usually does not cause pain, even though such a procedure is of course not pleasant. Before treatment, it should always be clarified with the dentist whether the health insurance company will cover the cost of root canal treatment, because this is only a health insurance benefit under certain conditions.
When is a root canal treatment necessary?
A root canal treatment is usually performed by the dentist when caries has spread through the pulp to the tooth nerve and caused an inflammation there (pulpitis). The first signs of pulpitis are increased sensitivity to heat and cold and severe toothache. These occur because the tooth tissue swells and presses on the tooth nerve. In most cases, the inflammation leads to the death of the pulp (irreversible pulpitis). In rare cases, however, the inflammation can go unnoticed. This is particularly fatal, as it can cause the inflammation to spread to the jawbone. If the pulp is dead, the only choice is often between root canal treatment or complete removal of the tooth. Often, preserving the tooth through root canal treatment is the better alternative. This is because correctly performed procedures have a high success rate and give the treated tooth a long life.
Procedure of a root canal treatment
Root canal treatment usually takes place under local anesthesia. The area around the affected tooth is locally anesthetized, so the patient should not feel any pain during the root canal treatment. The treatment then proceeds as follows:
- Once the anesthetic takes effect, the dentist must first gain access to the root canal.
- There, he removes the damaged pulp, tissue and inflamed or dead nerve.
- Then the tooth canal is carefully cleaned and smoothed.
- After that, the canal is disinfected, filled with an antibacterial medication and temporarily closed.
In the next treatment, if there have been no complications, the tooth is then finally closed. Depending on the case, the dentist will choose either a normal filling, a pin anchorage or a dental crown. The latter is often used because a root-treated tooth is dead and is therefore no longer supplied with blood by the body. Since this usually makes it more unstable, a crown provides additional stabilization.
How long does root canal treatment take?
The duration of root canal treatment depends largely on the number of root canals as well as their accessibility. Furthermore, how many sessions at the dentist are necessary also depends on the healing process of the tooth. Only when the inflammation has completely subsided can the tooth be finally sealed. Depending on the healing process, at least two sessions are usually necessary until the root canal treatment is completed.
Advantages and opportunities of root canal treatment
The great advantage of root canal treatment is that, if successful, a diseased, inflamed tooth with dead pulp can be preserved in its normal functionality. Root canal treatment is successful in about 70 to 95 percent of all cases. After the treatment, the treated tooth differs only insignificantly in its life span from the other teeth. The likelihood of a positive outcome of the treatment depends, among other things, on the size and progress of the inflammation and on the anatomy of the patient’s teeth. For example, if the root canal is curved, this makes root canal treatment more difficult, but as things stand today, it is not a criterion for excluding treatment.
Risks associated with root canal treatment
However, root canal treatment not only offers opportunities, but is also associated with some risks. For example, the dentist’s fine instruments can break off when working on the tooth root and get stuck in it. It is then often difficult to remove the instruments. When hollowing out or smoothing the root, it can also happen that the tooth wall is accidentally drilled through. When the root canals are filled, they can also become overfilled, which can affect the nerves in the lower jaw.If not all bacteria are removed from the canals, a renewed inflammation may also occur. In some cases, the tooth may still be painful for a long time after the procedure, which is why regular check-ups are very important. As a rule of thumb, a root canal treatment should only be considered successful after two years without any complaints. If the dentist does not work carefully and thoroughly during the root canal treatment, blood residues may remain in the root canal. These are then decomposed by bacteria and the pigment hemoglobin contained in the blood can subsequently discolor the tooth grayish to dark.
Here’s how you can support healing
In order not to endanger the healing process directly after the treatment, you should refrain from coffee and nicotine as well as from sports activities during the first days. This is because caffeine drives up blood pressure and nicotine has a negative effect on blood flow and thus on wound healing. Sports activities should be left for the time being because of the increased risk of injury.
Health insurance and root canal treatments
The cost of root canal treatment is covered by health insurance only under certain circumstances. Thus, the services must be sufficient, appropriate and economical. Therefore, some techniques, such as microscopic root canal treatment, are paid privately. In addition, treatments that do not have a clear chance of success are not covered by the health insurance. Root revisions (treatment repetitions) are also not covered by the health insurance in most cases. In addition, it must be possible to fill the roots to the tips. However, this is not always the case with the frequently curved roots of the molars.
Cost absorption for molars
If a molar tooth is affected, other conditions must also be met for the health insurance company to cover the costs:
- The molar must be part of a complete row of teeth without gaps.
- Root canal treatment of the molar can prevent a free-end situation – a one-sided shortening of the tooth row backwards.
- Through the treatment of the molar tooth can be preserved already existing dentures.
If this is not the case with molars, the health insurance only covers the cost of pulling the tooth. Who still wants to preserve his tooth, can have the root canal treatment as a private service. The cost of such treatment is about 1,000 euros per tooth. For more information on financing root canal treatment, contact your dentist or health insurance company.
Root canal treatment: the 4 most common misconceptions
The four most common misconceptions that exist around the topic of root canal treatment, according to the German Society for Endodontology and Dental Traumatology (DGET), are:
- Root canal treatments cause pain. Root canal treatments do not have to be painful. If the dentist sets the anesthetic properly, you will not feel any pain during the procedure.
- Root canal treatments decrease the durability of the tooth. Root canal treatment does not significantly affect the durability of the tooth. A root-treated tooth is hardly different from a healthy tooth in terms of its “lifespan”. With proper care, it can be preserved for life.
- Root canal treatments make the teeth brittle. After root canal treatment, the teeth often need to be covered with a crown or partial crown. However, this is because the tooth has a greater loss of substance than healthy teeth. The resistance of the teeth, on the other hand, is not changed.
- Root canal treatments have a low success rate. With a qualified dentist and enough treatment time, root canal treatment success rates range from 70 to 95 percent.
