Root canal treatment

Root canal treatment is needed for teeth with irreversibly damaged pulp (nerves, blood vessels).

The damage is usually caused by bacteria that have penetrated the nerve of the tooth, either through a deep cavity or a diseased gingival pocket.

A tooth that is likely to need root canal treatment is very sensitive to hot/cold meals/drinks or is tender when biting.

Chronic, asymptomatic inflammation sometimes occurs under already treated teeth. To diagnose this, a panoramic dental X-ray is performed.

The aim of root canal treatment is to clean the root canal system of pathogens and to fill the canal cavity tightly to prevent bacteria from returning.

Find out more about root canal treatment – https://www.youtube.com/watch?v=TnV5NeC4UDI

Root canal is a thin, narrow passageway in the root of the tooth, which houses the nerves, veins, arteries and lymph vessels of the tooth. Depending on the number of roots, a tooth can have 1 to 4 root canals, sometimes more.

A microscope is the best tool for a dentist performing root canal treatment since it enables to see the root canals inside the tooth and to find very narrow canals that cannot be seen with the naked eye.

Reasons why a tooth hurts (and needs root canal treatment):

Inflammation of the dental nerve or pulpitis: Occurs when dental caries is left untreated. Bacteria/microbes reach the dental nerve and cause inflammation, which can be acute (painful) or chronic (painless).

If pulpitis is not treated in time, inflammation of the surrounding tissue of the root of the tooth or periodontitis develops. This can also be acute (painful) or chronic (painless). At this stage, it is usually possible to see changes in the bone tissue around the tooth on an X-ray.

Acute periodontitis (acute inflammation of periodontal tissues that surround the tooth root):

Symptoms are severe toothache, tenderness when biting (eating) or when under pressure. Initially, the pain is constant, throbbing and the tooth causing the pain is easily identifiable. As the disease progresses, the pain becomes more severe and may radiate to the area of the adjacent teeth. The gum in the area of the root tip of the tooth may be swollen and a “pustule” may develop.

Chronic periodontitis (chronic inflammation of periodontal tissues that surround the tooth root):

May progress without symptoms, without pain. Occasionally, a fistula may form on the gum in the area of the root tip of the tooth, secreting some pus. Periodontitis can be diagnosed from an X-ray. It will show changes in the tissue surrounding the root tip. Such a tooth will definitely need treatment, even if it does not cause any symptoms.

People with cardiovascular disease or people who have artificial joints should pay particular attention to chronic inflammations of teeth.

Usually, during the first visit, the tooth is cleaned of carious tissue (soft dental tissue); if necessary, the tooth walls are rebuilt to place a dental dam (a special rubber sheet that protects against bacteria entering from the mouth to the tooth, and medicines and rinses from entering the patient’s mouth) on the tooth, and the root canals are expanded, after which antibacterial medication is placed in the tooth and the cavity is sealed tightly with a temporary filling.

At the next visit, a root canal filling is made, to tightly close the root canals in the tooth. After root canal treatment, the tooth is restored with either a filling or a crown (depending on how much of the crown of the tooth has been damaged).

Root canal treatment is not always successful

There can be many reasons for this. For example, the dentist may not have been able to find all the root canals. As a result, untreated root canals may contain bacteria that cause inflammation to reoccur. The mouths of some root canals are so small that they cannot be seen with the naked eye. In such cases, a microscope is an indispensable tool.

Sometimes an instrument used to clean the root canal can break and its tip remain in the root canal. Removing the broken instrument from the root canal is difficult and a microscope can be used to make it easier, but it is not always possible under the microscope either.

During the treatment, the tooth that is treated may initially become sensitive or even painful. The symptoms usually disappear within a few days. Painkillers can be taken if necessary. After root canal treatment, it is very important to restore the crown of the tooth hermetically, in order to prevent microbes coming into contact with the root canal filling again.

Read more about our other dental treatment services here.