Root canal treatment

Root canal treatment becomes necessary when the tooth goes so ill that the inflammation extends to its pulp and can no longer be treated with medication in the long term.

Root canal treatment is one way to preserve the tooth. Otherwise, the tooth would have to be extracted or, for example, replaced with an implant. Root-treated teeth can survive for decades after the nerve and blood vessels have been removed through an aseptic sealing of the root canal (root filling).

However, the success of the root canal depends heavily on the quality of the treatment and also on the condition of the tooth pulp. In the case of teeth that have already undergone root canal treatment and are causing further problems, we can try to remove the “old” root canal filling and replace it with a new one (root canal revision). This re-treatment can be worthwhile for saving the tooth.

Each tooth has a pulp containing a network of nerves, blood vessels and connective tissue, commonly referred to as “the nerve”. The pulp has a sensory function that measures changes in temperature, supplies the hard tissue with minerals and also serves to ward off external stimuli such as bacteria. Because of various stimuli, such as tooth decay, the tooth nerve can become painfully inflamed.

The inflammation can even spread to the tissues and bones surrounding the tooth, causing pain when biting. A possible treatment in these very unpleasant cases is the removal of the tooth nerve, as part of a root canal treatment.

This makes it possible to preserve the dead tooth. From a biological point of view, it is not a wise thing to leave a dead tooth in the body. The immune system will perceive the dead tooth as a foreign body and will develop a defense reaction (a chronic inflammation). This can have a negative impact on the corresponding organ system.

Under local anesthesia, the pulp chamber is accessed from above and the nerve tissue is removed from the inside of the tooth. The tooth pulp contains large nerve branches of various shapes and sizes.

The particular difficulty that arises with this type of treatment is to thoroughly clean and disinfect these complicated canals and to seal them with a special filling (root canal filling), after they have been shaped to allow the filling.

These minuscule canals cannot be safely accessed and treated without special instruments, such as high magnification and the use of the latest technologies. Because of its complexity, the treatment may require several sessions and take longer in more complicated cases.

In some cases, the treated tooth becomes discolored, because of the iron or other metabolic products present in the blood. However, severe discoloration can usually be avoided by treating and cleaning the tooth appropriately and thoroughly. If, however, the tooth becomes discolored, it can be whitened again.

It is imperative that the tooth undergo a stabilizing restoration as soon as possible, in the case of posterior teeth, by means of a crown or partial crown. This is the only way to avoid a reoccurring infection and to compensate for tooth breakage, caused by the weakening of its substance.