What is Endodontia?
Also called root canal treatment; is the complete removal of the dental pulp (the pulp is the internal tissue in the deep part of the tooth and contains blood vessels and nerves, being situated in the central part of the root), caused by inflammation or death, resulting out of factors like decay and injury that can become exposed and infected. In many cases there are not even signs of pain, but the decay has already infected the pulp in an irreversible way. The root canal treatment is the only alternative to save the teeth once the nerve is infected. Otherwise the teeth would have to be removed and replaced by a prosthesis, which in determined case could affect the healthy neighbouring teeth.
Occasionally the root canal treatment can be carried out in one single session, but generally two to three sessions are required to complete it. Although sometimes a little inconvenience can exist, in most cases, with the use of modern anaesthetics, the treatment is pain free. The pain that already existed before the beginning of the treatment is eliminated once the root canal therapy is commenced.
Root canal treatment process
Prior to the consultation we take a x-ray examination and establish the diagnosis. Subsequently we apply the local anaesthetic and we isolate the tooth.
First we carry out an opening in the centre of the tooth, the nerve of the crown and the root is removed; we expand the root canal to clean and disinfect it, at the same time it is given the shape that facilitates us to seal it up.
A medication can be placed directly in the root canal itself and according to the case, an antibiotic and analgesic may be prescribed.
A temporary filling is placed in the tooth during the time period between two appointments. When the tooth remains asymptomatic, the root canal is filled and sealed up with a material called “gutta percha”. To verify the result, it may be necessary to take x-rays in the different steps.
Once the root canal therapy is finished, a x-ray is taken to verify the sealing of the tooth and a temporary filling is placed inside the tooth. From that moment, you have to return as soon as possible to your dentist, so that he/she can carry out the adequate permanent restoration.
What should be expected after a root canal treatment?
During the first days after the treatment, it is normal to feel some discomfort that goes from light to moderate, especially if the treated tooth is used for chewing. The inconvenience may be greater if the tooth caused severe pain due to an infection or an abscess at the start of the treatment.
In most cases your dentist will prescribe some analgesic or anti-inflammatory medication to minimize the discomfort after the treatment. In case of a sharp infection he will also prescribe an antibiotic, if he considers this necessary.
It is very important to return to your endondontist after the root canal treatment has been finished, so that he can complete the dental restoration as soon as possible, to prevent infection or fracture of the treated tooth.
From time to time the existing infection will not disappear after the endodontic therapy has been carried out, then an additional treatment like an apicectomy may be necessary.
ROOT CANAL RE-TREATMENT
When the initial root canal treatment has not delivered the expected result, an additional treatment is necessary; this procedure is called root canal re-treatment.
Symptoms
A clinical evaluation has to be carried out, to identify if a previously endodontically treated tooth needs surgery or a root canal re-treatment. This is done by way of an x-ray examination.
If symptoms of infection, inflammation or persistent pain occur, the need for a root canal re-treatment needs to be evaluated. An expectant attitude of periodic vigilance is needed, if the tooth remains symptomatic.
Nevertheless, if the tooth requires a restoring prosthesis, then a careful evaluation is needed to determine if it is valuable to do a re-treatment.
Technique
The process is initiated by the removal of the root canal filling material, with different techniques and materials. Subsequently a new filling is prepared to correctly refill the root canal. It may be necessary to carry out x-rays to verify the different steps. In this way the tooth is being prepared for a restoration.
