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Root canal treatment

With a root canal treatment, the dentist removes the inside of the tooth root, the pulp, under local anesthesia. Every tooth has one or more tooth roots with a root canal in which the pulp runs. This tissue is very much alive because it contains nerves and blood vessels that supply the tooth with vital nutrients. Dentists also call root canal treatment root canal treatment, tooth root treatment or tooth root canal treatment.

When do you need a root canal treatment?

While pulling a diseased tooth is easy and takes a few minutes, it is not the best option. If the doctor classifies the affected tooth as worthy of preservation , a root canal treatment is necessary in order to make the tooth functional again for chewing in the long term. It is also important to renovate the structures around the tooth root and keep them healthy for as long as possible .




When a root canal treatment takes place, dentists decide on the basis of the following criteria:

  • If the pulp is inflamed, pulpitis is present. The most common cause of this is tooth decay , in which bacteria have worked their way from the hard tooth substance into the pulp. Because of the inflammation, the blood vessels expand and press on the tooth nerve. It causes pain and people are sensitive when they consume hot or cold foods. Bacteria that have penetrated to the root tip can spread from there to the bones and the soft tissues of the face and neck, which is expressed in swellings such as a thick cheek. In the worst case, the pathogens get into the blood and spread further. Without a root canal treatment, the dental nerve does not recover and dies.
  • At the tip of the root an inflammation of the gums, the periodontitis , has developed.
  • The pulp is exposed because the tooth is damaged. Such tooth fractures often occur after accidents.
  • Fillings, crowns or inlays are leaking and bacteria have penetrated the pulp.
  • Even a dead tooth can often still be saved with a root canal treatment.

What does root canal treatment mean?

A root canal treatment takes place in several steps with the help of irrigation and special instruments. The doctor (dentists in Germany can do further training as endodontists. Endodontics is a field of dentistry that deals with the interior of the tooth.) In doing so, the infected tooth pulp with the bundle of vessels and nerves is completely removed. After a root canal treatment, the tooth must be free of bacteria.

If not all germs are removed, there will be further inflammation - there is a risk of tooth loss. Once the infection is completely eliminated, the inflammation will also heal again. This usually affects not only the tooth root, but also the bone in which the tooth is anchored.

Basically, the root canal treatment can be carried out on the molar, incisor or wisdom tooth. Because every tooth has at least one root, it is possible in principle on every tooth.

The course of a root treatment

What happens during the root canal treatment? First of all, root canal treatment is a laborious process for which you (and your dentist) need to allow some time and be patient. One step - as with tooth extraction - is not enough. The dentist prepares the tooth extremely carefully, because after the root canal treatment it must be completely free of germs. Normally you will not feel any pain during the entire process of the root canal treatment because the dentist works with an anesthetic (local anesthesia).

Root canal treatment - what is done?

The root canal treatment process can be divided into several steps:

  • Before the root canal treatment, dentists take an X-ray . It shows how many roots the tooth has, how far the inflammation has progressed and whether a root canal treatment is even possible and useful.
  • The actual root canal treatment process usually begins with anesthesia, because without the local anesthetic, the root canal treatment would be too painful. It is different when the tooth is dead. In principle, treatment without anesthesia is possible if you wish. Dentists advise against it, because usually not only the tooth root, but also other areas around the tooth are painfully inflamed.
  • The dentist isolates the tooth from the oral cavity with the help of a rubber cloth made of latex or silicone (rubber dam). In this way, it prevents saliva and bacteria from entering the tooth during the root canal treatment. The rubber dam also ensures that you do not accidentally swallow an instrument or that disinfectant solutions get into your mouth or throat.
  • The dentist drills a hole in the chewing surface of the tooth from above. This gives him access to the inside of the tooth and the root canals.
  • Measurement of the root canal: With the help of special measuring needles or electrical measuring probes, it determines how long the root canals are. The comparison with the X-ray image supports him in this. The filling must not be too short, otherwise bacteria will remain in the tooth and the inflammation will not heal. If the filling is too long, it irritates the bone and causes inflammation there.
  • Then the preparation of the root canal follows. The dentist uses special, very fine instruments for this. Examples are small, flexible files in various sizes. So he tries to expand the often very fine structures and canals and to completely cleanse them of inflamed, dead tissue and bacteria.
  • During cleaning with the root canal instruments and afterwards, the dentist disinfects the entire root canal system with various liquids. This rinsing with disinfectants is extremely important for the success of the root canal treatment. Because disinfection fights germs, kills them and slows down the infection.
  • Only now does the root canal filling follow. The dentist seals the cleaned and disinfected cavity with a special filling material. He closes the access in the occlusal surface with a tight and stable plastic filling. It prevents bacteria from penetrating the inside of the tooth again. If too much tooth substance has been lost, a root post stabilizes the plastic filling.
  • The last step in the treatment process of the root canal treatment is that dentists usually place a crown on the root canal treated tooth. This strengthens it so that it can withstand even greater chewing loads. In addition, the crown ensures that the tooth remains securely locked.

 

1. The healthy tooth: Under the very hard enamel and the slightly less hard dentin layer there is a soft tissue: the pulp. It contains blood vessels, nerves and connective tissue.

2. The diseased tooth root: If the pulp becomes inflamed, severe pain and damage to the jawbone can result. Root canal treatment is therefore necessary if there are signs of infection.

 

3. Expansion of the canals: First, the endodontist opens the tooth crown . Then he widened the branched and curved root canals with rotating mini files made from a nickel-titanium mixture.

4. Disinfection and cleaning: the dentist injects disinfectant into the root canals with a small cannula to remove all germs. It rinses out the inflamed tissue and sucks off the rinsing fluid.

 

5. Filling the cavities: Once all the root canals have been rinsed, they are sealed with filling material. The treated tooth is then closed with a temporary restoration.

6. Final crowning: Only after a few months does the dentist decide on permanent crown or partial crown restoration. It is important to completely restore the chewing function of the tooth.

Anesthesia during a root canal treatment

If the tooth has died, a root canal treatment without anesthesia is in principle also possible. However, dentists usually recommend local anesthesia. Because even if the tooth nerve is dead, pain can occur.

Root canal treatment under local anesthesia:
Dentists usually numb the diseased tooth with an anesthetic that has a local (local) effect. This type of anesthesia is also called regional anesthesia, local anesthesia or local anesthesia. Doctors call the anesthetic itself a local anesthetic. Patients receive it through a syringe into the tissue around the diseased tooth. The anesthetic temporarily blocks the transmission of pain signals to the brain. Patients usually feel no pain, but they do feel pressure, which the dentist exerts mechanically during root canal treatment. Because the "pressure sensor" does not switch off the anesthetic.

It is rare that the tooth cannot be anesthetized or only incompletely. This is the case, for example, when the tooth is extremely inflamed. The lip, tongue and other tissues feel numb, but the tooth is still sensitive to pain.

Root canal treatment under general anesthesia:
General anesthesia for root canal treatment is usually not necessary, but makes sense in special cases, for example for anxious patients. An anesthetist (anesthetist) then monitors vital functions, such as the heart's activity or blood pressure. Some practices offer treatment under general anesthesia, in a dental clinic this is always possible. The statutory health insurance companies usually do not pay for general anesthesia.

Duration of a root canal treatment

The duration and frequency of a root canal treatment depend on various factors. Examples are:
• The extent of the inflammation: If the inflammation has spread significantly, the root canal treatment is often carried out in several sessions. In between, the dentist places insoles with medication in the tooth, which also kill germs. The tooth calms down and the inflammation can subside. Only then does the root canal treatment continue. • The number of roots in the tooth that the dentist has to prepare and make sterile: The more roots a tooth has, the longer the root canal treatment takes. A molar tooth with up to three roots is more complex to treat than an incisor, which often only has one root. • The nature of the roots: roots with a kink are harder for dentists to get into with their instruments than with straight roots - you have to plan more time. • The localization of the diseased tooth:

After the root canal treatment

After the root canal treatment, you should take it easy and rest. The body need time to break down the anesthetics and to recover from the procedure.

After a root canal treatment, you should avoid the following activities:

  • Intensive exercise: wait a while before you return to exercise after the root canal treatment.
  • Avoid alcohol, nicotine and coffee for at least 24 hours; the ingredients slow down wound healing.
  • Do not eat again until the anesthesia has worn off and the numbness has gone. Otherwise you may injure yourself chewing or burn yourself while consuming hot food and drinks. Depending on the duration of the treatment and the amount of anesthetic, the anesthesia lasts four to six hours.

Root canal treatment - pain tips for afterwards!

  • You can treat pain with pain relievers. A frequently used active ingredient is ibuprofen, which has both analgesic and anti-inflammatory effects.
  • Also, make sures you have good oral hygiene . Brush your teeth, but not too hard and only carefully in the immediate vicinity of the tooth being treated. Mouthwashes are also helpful.

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