Endodontics / Root canal treatment

Root canal treatment – a rescue measure for teeth under serious threat

We require root canal treatment – more commonly known as root canal therapy – when a tooth’s pulp becomes inflamed. Pulp is the soft tissue inside a tooth, surrounded by hard substance. Since it contains nerve fibres, among other things, it is often referred to as the ‘dental nerve’. The so-called ‘pulp cavity’ extends to the tip of the tooth root.

Inflammation of the pulp can occur when the hard substance surrounding it, i.e. enamel and dentin, has become permeable due to extensive internal damage. There are variety of possible causes: a fracture, caries, and also fillings or crowns that do not (or no longer) seal. Bacteria from the oral cavity can then penetrate into the pulp and make root canal treatment necessary.

Not infrequently, pulp inflammation progresses painlessly for years. It is only visible on x-rays – not externally. X-rays capture the erosion of bone tissue surrounding the affected pulp. If this is not counteracted with root canal treatment, the erosion of the bone continues. Generally, however, pulp inflammation makes itself felt through pain, the intensity of which is notorious. This is why root canal treatment is among the most urgent of dental emergencies.

What happens during root canal treatment?

The aim of root canal treatment is to remove the bacteria-infested tissue in its entirety from the root canal system. Only then is there a good chance of preserving the tooth. Unlike in the past, when root canal treatment was synonymous with a dental ordeal, treatment today is much more precise and painless. This is enabled by minimally invasive surgical methods and precise measuring techniques, which we also use in our practice. According to the German Society for Tooth Preservation, the success rate for standard root canal treatment is around 95 percent; even in more complicated cases, the treatment goal is achieved in around 80 percent of cases.

If the bacteria have entered the tooth’s interior through leaking dentures, the filling, crown or inlay should first be replaced. Otherwise, the germs could find their way to the pulp again during or after treatment. This step is called pre-endodontic build-up (endodontics is the technical term for root canal treatment). Before the actual procedure, the affected tooth is then isolated from the oral cavity with a latex or silicone cloth (rubber dam). This ensures a germ-free treatment environment. An entry point to the pulp is then created through the tooth, through which instruments drawn from the latest technology are used to remove affected tissue and to clean the root canals. Various liquid disinfectants are used in the process.

After disinfection, the cavity is filled with a body-compatible material and then sealed. The occlusal surface is also hermetically sealed with a composite filling. In addition, anchoring a root post to stabilise the filling may be appropriate if extensive tissue has been lost due to inflammation.

Studies have shown that it makes no difference to the success of the treatment if root canal therapy is performed during one session at the practice, or several. Due to the greater concentration of stress in one session, there tends to be more pain with this option; but with the appropriate medication, it can be kept well in check.

If you have any questions about root canal treatment, we will be happy to answer them. And if you have an acute need for this treatment, please contact us for a prompt appointment.