When it is said...

Endodontics

The word “endodontics” is of Greek origin: “endo” means “inside” and “odons” means “tooth”. Endodontics therefore literally means “work on the inside of the tooth”. It is a branch of dentistry specialising in the diagnosis, prevention and treatment of the inner part of the tooth, known as the dental pulp and root canals. This treatment is often referred to as root canal treatment and is performed when the dental pulp has been damaged or infected, which can cause severe pain and inflammation.

During treatment, a dentist or endodontist removes the diseased tissue, cleans the root canals and then fills them with a special material to prevent further infection.

The Goals Are:

  • saving the tooth

  • eliminating the infection

  • relieving pain

  • preventing the spread of infection

This procedure is often necessary for teeth with deep decay, infection, inflammation of the surrounding tissues or traumatic injuries. Preserving the natural tooth helps prevent the neighbouring teeth from shifting and maintains the aesthetic appearance and function of the mouth.

Thanks to modern endodontic treatment techniques, it is now possible to save teeth that were previously considered untreatable and would have had to be extracted.

Dental Pulp

The dental pulp, also known simply as the pulp, is soft tissue located inside the tooth. It contains blood vessels, nerves and connective tissue. Unfortunately, the dental pulp in adults has very limited capacity for regeneration and healing. When it becomes severely affected, it usually dies. Infection can occur as a result of deep tooth decay or dental trauma. This can lead to pain, inflammation and loss of the pulp, potentially causing problems not only for the tooth itself but also for the surrounding tissues. Endodontic treatment is then necessary.

The proper function and health of the dental pulp are important for maintaining the tooth and its vitality. Preventing diseases of the dental pulp is the first step towards minimising the risk of tooth decay and infection. This includes regular and effective oral hygiene and regular visits to the dentist.

The Endodontic Treatment Procedure

When inflammation develops in the dental pulp or surrounding tissues, endodontic treatment is always performed under local anaesthesia.

The procedure usually involves the following steps:

  • Diagnosis and treatment planning: The dentist or endodontist performs a thorough examination, including an X-ray, identifies the affected tooth and assesses any inflammation of the pulp. The treatment is then planned based on the findings.

  • Anaesthesia: Before treatment begins, the area around the affected tooth is numbed so that the patient does not experience pain.

  • Isolation of the treatment area: The dentist creates a clean and dry working field. A rubber dam is used to isolate the tooth from the surrounding environment and prevent contamination during treatment. It also protects the patient from inhaling or swallowing instruments, chemicals, filling material or tooth debris.

  • Access to the root canals: The dentist creates an opening in the tooth to gain access to the root canals.

  • Cleaning and shaping of the root canals: Instruments and chemical solutions are used to clean and enlarge the root canals and remove the diseased pulp. The canals are then hermetically sealed and filled with a special material to prevent further infection.

  • Restoration of the tooth: After the root canals have been sealed, the tooth is often additionally protected with a filling or crown so that it can be fully restored to function.

  • Follow-up: A follow-up examination and X-ray are performed after treatment to assess its success and determine whether any further treatment is required.

Today, modern technologies and treatment techniques offer significant advantages, making the work of endodontists easier, improving access to the root canals and saving time. The success of the procedure depends on thorough removal of the infection from the pulp chamber, careful cleaning and shaping of the root canals, followed by precise and airtight filling.

After the root canals have been cleaned and disinfected, they are filled with gutta-percha, a thermoplastic material derived from trees of the genus Palaquium. Gutta-percha is widely used because of its flexibility, chemical inertness and biocompatibility.

Endodontic treatment usually cannot be completed in a single appointment due to the need to place a disinfecting and therapeutic dressing (calcium hydroxide) inside the root canal. This dressing is important for eliminating any remaining microorganisms, their toxins and necrotic tissue after the canal has been cleaned and irrigated. It also supports remineralisation. For effective disinfection, calcium hydroxide should remain in the canal for at least 7–10 days. In cases of a severely infected root canal, the dentist may need to repeat the procedure.

In cases of chronic periodontitis with radiographic findings and apical resorption, calcium hydroxide is used to help stop the resorptive process and support remineralisation of the bone around the root. This treatment requires a longer period, with calcium hydroxide left in the canal for approximately 2–3 months.

Endodontic treatment performed to a high professional standard is both time-consuming and financially demanding. It requires patience from both the patient and the dentist. Ultimately, the patient must decide how much they are willing to invest in saving their natural tooth.

When it is said...