Endodontic Treatment (Root-canal treatment)
What is Endodontic Treatment (Root-canal treatment)?
Unfortunately, there are times when decay and trauma can affect the nerve inside the tooth, which can result in the tooth dying and causing pain and infection.
When properly treated, a tooth can be preserved by undergoing root-canal treatment after a thorough assessment of adequate prognosis.
When is a Endodontic Treatment (Root-canal treatment) needed?
Pulpitis: Including irreversible pulpitis, patients will experience significant pain that continues unabated, even without external stimuli. Swelling and sensitivity to hot and cold may also occur. If pulpitis worsens, it can lead to more severe conditions like dental abscesses, at which point a root canal is necessary.
Severe tooth decay: When tooth decay has caused irreversible pulpitis, or when decay has penetrated deeply into the pulp, allowing bacteria to infect the pulp, a root canal is required as filling the tooth can no longer repair the damaged nerve.
Necrosis of the pulp: This is also a common reason for a root canal. If pulpitis is left untreated or if trauma prevents blood flow to the pulp, the pulp tissue will die. While there may be no symptoms or only tooth discoloration, bacteria can multiply and cause more severe issues like periapical periodontitis, necessitating a root canal.
Is Endodontic Treatment (Root-canal treatment) painful?
During treatment: The entire root canal procedure is performed under local anesthesia. Once the anesthesia takes effect, patients usually won't feel significant pain, though there might be slight discomfort or a sensation of pressure.
After treatment: For the first few days after treatment, there may be temporary soreness or sensitivity around the tooth. This usually subsides within 3-5 days. Dentists typically prescribe painkillers to help alleviate discomfort.
Root canal and crowns selection
Generally, after a root canal, teeth become brittle and less able to withstand biting forces, making them prone to cracks or fractures during chewing. A crown protects the tooth from further damage and restores its shape and function. It's especially recommended for back teeth and severely damaged teeth.
Types of crowns: Dental crowns mainly include metal crowns, porcelain-fused-to-metal crowns, and all-ceramic crowns. Metal crowns are strong and durable but less aesthetically pleasing, suitable for back teeth. Porcelain-fused-to-metal crowns are both strong and attractive, meeting most patients' aesthetic needs.
Procedure of Endodontic Treatment (Root-canal treatment)
1. Examination and assessment: X-rays are taken to determine the location, extent of tooth decay, and the severity of pulpitis, assessing whether the pulp is infected and if the tooth is suitable for a root canal.
2. Local anesthesia: A local anesthetic is injected into the gum to numb the tooth and surrounding tissues, ensuring a pain-free procedure.
3. Opening a cavity and removing pulp: Using a dental drill, a hole is made in the crown to access the pulp cavity. The infected or necrotic pulp tissue, including nerves, blood vessels, and connective tissues, is removed.
4. Cleaning and disinfecting the root canal: Special solutions and tools, such as sodium hypochlorite, are used to thoroughly clean out residual tissue, bacteria, and debris from the root canal and disinfect it to prevent lingering or recurrent bacteria.
Filling the root canal: After drying the root canal, biocompatible materials like gutta-percha are used to fill it, sealing the entire system to block bacterial re-entry.
5. Filling or crown placement: Depending on the tooth's damage, either a filling is done directly or a crown is placed to protect the tooth and restore its normal shape and function.