Root canal treatment is considered a complicated and, depending on the clinical picture, a time-consuming procedure. The reason for a root canal treatment is an inflammation of the dental pulp. After a successful root canal treatment, the diseased tooth can be saved.
What is a root canal treatment?
Schematic diagram for treatment of tooth root inflammation or caries. Click to enlarge. During a root canal treatment, the dentist removes inflamed tissue inside the tooth through a canal. He then cleans the inside of the tooth, removes the diseased tissue, and finally seals the root of the tooth with a tight filling so that bacteria cannot enter the interior. The medical term for root canal treatment is root canal treatment or endodontic treatment. In many cases, caries bacteria are responsible for inflammation of the dental pulp (pulpitis), which consists of blood vessels and nerves. These can trigger the inflammation in the case of advanced infestation. However, reasons for root canal treatment also include a tooth fracture, where parts of the tooth have broken off or splintered, and treatment trauma, such as after grinding a dental crown. Root canal treatment is the only way to preserve the tooth.
Function, effect and goals
Before the actual root canal treatment, the dentist uses a local anesthetic to ensure that the patient does not feel any pain during the root canal treatment. This is because if the nerve has not yet died, pain can prevent successful root canal treatment. A rubber blanket protects the tooth from bacterial penetration and ensures that the patient does not swallow irrigation fluid or any of the small instruments used during root canal treatment. To gain access to the pulp, the dentist must drill out the diseased tooth. Since the root canals are not visible to the naked eye, the dentist uses magnifying glasses or a microscope and then feels the entrances to the root canals with fine instruments. To accurately determine the length of the root canals, the dentist inserts files into the canals. From special x-rays of the files together with the tooth, the length of the canals can be read. After that, the dentist can clean even bent canals with a lot of tact and flexible instruments and possibly remove the dead nerve. Additional irrigation kills any bacteria present in the root canal. Since a tooth can have up to four canals, the root canal treatment sometimes has to be spread over several appointments. To complete the root canal treatment, the dentist dries the root canal and fills it with an elastic biomaterial that expands throughout the canal system by heating. Further X-rays check the success of the treatment and show whether the filling is sufficient or whether a crown is necessary. The primary goal of a root canal treatment is the complete removal of all germs and bacteria as well as the cleaning of the root canals from inflamed tissue residues. In addition, a tight closure of the canals should ensure that no further germs can infect the pulp. Successful root canal treatment thus prevents inflammation of the root tip, which can even penetrate into the jawbone.
Risks and dangers
Despite its good chances of success of up to 90%, root canal treatment’ remains a complicated treatment method that involves some risks. For example, the fine instruments may break during root canal treatment, injure the side of the root canal or the nerve. If the inflammation does not subside or reappears several weeks after the root canal treatment, either the root tip of the tooth must be cut off or the tooth must be removed completely. Complications with root canal treatment occur especially when treating a tooth that has already received a root filling. The risk of the instruments damaging the root canal is greater than with a tooth that is still untreated. After root canal treatment, swelling may form around the treated tooth, but it should subside after about a week. The same applies to pain: if it becomes unbearable or does not disappear after a few days, the patient should see his dentist. He can decide what causes the pain from the root canal treatment and indicate appropriate treatment options.
