Endodontics is a field of dentistry that deals with the treatment of teeth. It is applied when irreversible damage has occurred to a nerve, i.e. there is inflammation of a nerve. The causes of nerve damage can be varied, and some of these are: deep caries or tooth trauma from e.g. a blow or inappropriate force etc. When irreversible damage has occurred to a nerve (or pulp), then the only way to save that tooth is an endodontic procedure.

Goal?

The goal is to clean and seal the space where the nerve is located. Pulp chamber with root canals create a complicated area inside the tooth where the nerve is located. After the nerve has died for some reason, these spaces are left with infected decaying parts of nerve and bacteria. This can be followed by inflammation spreading from the tooth to the area around the tooth, and can be followed by a granuloma, abscess or a cyst.

In these instances it is necessary to open the tooth and clean the entire area. Cleaning is performed sing manual and machine needles, and rinsing with various irrigants.

The anatomy of the interior of a tooth is extremely complex, and it is fair to say that cleaning such a space is a highly challenging procedure. This is a procedure that take place in the dark and relies on a knowledge of tooth morphology and the experience of the dentist to navigate such a procedure.

Once the space inside the pulp chamber has been thoroughly cleaned, it is filled with sticks specifically designed for this purpose and then filled with a special filling paste. This filling should be solid, homogenous and non-porous, the area should be sealed to prevent the passage of bacteria and further inflammation.

The tooth is then sealed with a dental filling during the same visit.

This entire procedure can be completed in a single, slightly longer visit, or over a couple of sessions. Longer treatment is only required for more complicated cases that involve large periapical inflammation, the extraction of previously broken instruments or calcified or perforated roots.

Once the procedure has taken place, a small and very precise RVG scan of the teeth should be carried out to confirm whether the procedure has been successful. If this procedure involves a severe inflammation, check-ups should take place after 2 and 6 months to confirm successful healing inside the bone. We should however be able to see after a few days whether the procedure has reduced the inflammation and the teeth can be used to chew.

What can you expect after treatment?

In most instances there is sensitivity and mild pain (much less than the pain caused by nerve inflammation) which should subside on its own after a few days. This is completely normal and is no cause for concern. In a few cases the tooth shows no symptoms at all.

What about the tooth after treatment?

The dead tooth will be dehydrated, weakened and susceptible to cracking. It often happens that a treated dead tooth darkens, which can cause problems for the front of the jaw. This can be treated with internal whitening or insertion of a crown.

In any case it is better to place a crown on the repaired tooth to protect it from further fractures.

What if you already have a poorly treated tooth?

Such a tooth does not necessarily need to be extracted, instead we can opt for retreatment or replacement of the old filling. This procedure removes the old filling, cleans and shapes the canal, and then fills the cavity. This procedure is somewhat longer and more difficult than the initial treatment, but if this is completed effectively, we can maintain the tooth for many years.

‘From Root to Crown’ Concept

This concept refers to the entire treatment of a non-vital tooth. Following endodontic therapy, the success of which is confirmed with X-ray imaging, the tooth should in any instances be provided with dental extension, i.e. a crown, should be inserted. In this way reinfection and cracking of the repaired tooth can be prevented.

At the Lumed Dental Practice we have invested a great deal in high-quality endodontics (dental treatment) which we perform using mechanical techniques and mandatory ultrasonic irrigation. We use the latest technologies and material and X-ray check is mandatory.

This area of dental medicine is rather ‘invisible’ and unclear because patients are not adequately informed about the issues that face this branch of dental medicine. For this reason, we are more than happy to talk to our patients and help clarify endodontics as one of the most complex, but ‘invisible’ branches of dentistry.