ENDODONTICS

Endodontics is a branch of dentistry that deals with prevention, diagnosis and treatment of diseases of the pulp, the soft tissue inside the tooth, also known as the “nerve of the tooth”.

Endodontic treatment (“root canal treatment”) is necessary when the pulp becomes irreversibly inflamed or necrotic (it dies). If pulp infection, initially located inside the tooth, is left untreated, it can spread in time to the jawbone and the soft tissues around the tooth. This pathological process causes persistent pain due to pulp inflammation, irritation of tissues surrounding the root, bone damage, swelling and deformation of neighboring tissues. Only endodontic treatment consisting in cleaning and disinfections of root canals may eliminate in the long term the infection.

During endodontic treatment, the dentist removes swollen or necrotic tissues, cleaning the entire system of canals inside the root of organic debris and bacteria, which he then fills in with a biocompatible substance before he seals it.

During endodontic treatment, the tooth must be completely isolated from the patient’s oral cavity with a rubber dam. This consists of a small frame over which a one time use rectangular sheet of latex is stretched. The rubber dam has one hole that matches the tooth the dentist is working on and is kept on it with a metal clamp. In this way, the dentist sees only the tooth he is working on.

This isolation system displays several advantages:

saliva and bacteria cannot penetrate from the oral cavity into the tooth,
canals may be kept clean and dry,
foreign substances cannot get into the patient’s oral cavity,
the risk of swallowing the small tools is eliminated,
the patient may swallow his own saliva, and we no longer need the aspiration device which unpleasantly dries the buccal mucosa,
the cheeks, tongue, lips and gums are protected from sharp cutting instruments,
bad taste or caustic irrigation solutions do not come in touch with the patient’s oral cavity, seeing very well, the dentist may focus better during delicate maneuvers of the endodontic treatment.

In conclusion, the use of this isolation system guarantees a comfortable and efficient treatment.

A correct endodontic treatment keeps the root healthy and maintains the tooth in good condition for a longer period of time, sometimes during the patient’s whole lifetime. But first of all, for this to happen one mandatory condition must be fulfilled: the crown restoration of the tooth (filling, crown, etc.) must be carried on in due time (maximum one month from the completion of the endodontic treatment) Thus we can prevent the penetration of saliva into the canals and their infection.

Radiological examination offers additional essential data for the diagnosis as well as during the endodontic treatment proper. Moreover, the evolution of the case cannot be monitored without radiological examination. As a rule, 3-4 small dental radiographs (retroalveolar) are required before, during the treatment and immediately after its completion. The high technology radiological equipment used at present exposes the patient to a far smaller ratio of radiation, which does not damage his health.

If we have to retreat a tooth whose previous endodontic treatment has failed, first we need to remove the crown restoration (filling, cover crown, dental post); then we remove previous treatment materials (filling materials, cement, etc.). Sometimes we need to perform special maneuvers to remove blocks, repair cracks, remove fractured pieces of equipment inside the canal, etc. At the same time, we have to identify and treat additional canals (if present) that were overlooked during the previous treatment.

If the patient visits the dentist on a regular basis (at least once a year) and strictly follows the rules of oral hygiene, he himself will make a significant contribution to the success of the treatments and preservation of his dental health.

Even though there are very good and efficient prosthetic solutions to replace teeth, nothing is better that your natural teeth! Money and time investment in keeping them healthy will be fully profitable in the years following the treatment, when you will enjoy a functional and healthy set of teeth!