Treatment procedure of a root canal treatment

If a molar tooth requires root canal treatment, several sessions are usually necessary. First, an x-ray is taken to examine the course of the root canals and the extent of the inflammation as a whole. Next, the affected area is drained with small cotton rolls to prevent saliva and bacteria from entering the tooth during treatment.

In addition, saliva is removed with the suction cup.Alternatively, a cofferdam can be used for absolute drainage. The tooth is then anaesthetized with a local anaesthetic, otherwise the treatment would be too painful. The drugs used are lidocaine, mepivacaine or bupivacaine.

Any allergies, medications taken or intolerances must be reported to the doctor before the treatment. The local anesthetic is usually mixed with adrenaline, which causes narrowing of the blood vessels and prevents bleeding. To open the tooth, the dentist uses a drill.

This enables him to remove the affected pulp with the nerve fibres from the root. This requires special root files of different lengths and thicknesses, so that the right one can be found for each tooth. Especially in the molar region, the difficulty arises that the teeth have several roots, which all have to be treated individually.

Also, the root ends are often more curved, making it difficult to hollow out the tooth all the way to the tip. After hollowing out, the canal is rinsed with different solutions. These solutions are chlorhexidine (anti-inflammatory and antibacterial), hydrogen peroxide (disinfection, hemostasis) and sodium hypochlorite (for disinfection).

How the treatment continues now depends on how inflamed the molar tooth was. If it was a lighter inflammation, the filling can be started directly. If the procedure is more severe, an antibacterial and anti-inflammatory drug must first be placed in the tooth and left to rest for a few days.

The paste used contains calcium or cortisone with an antibiotic. When the time comes for the filling, either directly or after the paste has taken effect, a material is filled into the canal, which resembles a rubber-like mass. It is called gutta-percha and it is supposed to seal the canal tightly.

In addition, a sealer is used, which is similar to the enamel in its material. It is also known under the term dense cement. Then an X-ray of the molar tooth must be taken for control.

Based on the X-ray image, the dentist can check whether the root is completely filled and sealed. If this would not be the case, a treatment step would have to be repeated. A leaky filling would not be acceptable. Afterwards, control appointments are arranged, which should be followed up to check the current state of healing. Due to the bacterial infestation there is an increased risk of new inflammation during root canal treatment, which can be caught early with thorough aftercare.