Endodontics

When you hear the word Endodontic, the first thing that comes in your mind is the root canal.

Root canal treatment is a dental procedure performed to remove the infected pulp and associated infection from inside a tooth.

Tooth infection is one of the most terrible and painful experiences that a dental patient can have. It occurs when the tooth decay reaches the pulpal tissue.

At this time, cleaning the canals can significantly help to clear the infection from within the tooth. So what exactly is a root canal?

A root canal is a natural cavity present within the tooth at the center. It mainly constitutes the pulpal tissue along with the network of nerves and blood vessels.

The pulp is the only vital tissue present in the tooth which is responsible for providing nourishment and maintains the health of the tooth.

A bad tooth infection doesn’t necessarily mean that the tooth needs to be extracted.

Endodontic therapy is an alternative to save the tooth while removing the infection altogether.

In today’s article, we will read in detail about endodontic therapy and its treatment course.

What does endodontics entail?

Endodontics is a specialized field of dentistry that deals with the biology and pathology of pulpal tissue of the tooth.

The prime focus of this field is on prevention, diagnosis, and treatment of the infected pulp in the tooth. (1)

The commonly endodontic procedure is referred to as root canal treatment. A general dentist is capable of carrying out a root canal procedure successfully.

However, an endodontist is a specialized dentist who deals exclusively with cases concerning tooth infection.

When is an endodontic procedure required?

Endodontic procedures are performed when the pulp in a particular tooth is either injured or infected. Removal of the dead pulp ensures proper preservation of the tooth structure.

Some of the common cases which may require a root canal treatment are – (2)

  • Deep carious cavity extending towards the pulp
  • Untreated cavity associated with a dental abscess
  • Carrying out multiple dental procedures on the same tooth
  • A fractured tooth that involves the pulp
  • Traumatic injury
  • Periodontal infection extending into the pulp through the root canals

Usually, the symptoms may include pain in the tooth, tooth sensitivity, swelling of gums around the infected tooth.

Diagnosis is made based on oral examination and x-ray, which shows a cavity or decay extending into the pulp chamber.

How is the procedure performed?

Usually, root canal treatment is done in two to three sittings. However, root canal treatment can also be completed in a single session.

Following are the steps for endodontic therapy –

  • Numbing the tooth – Local anesthetic injected around the gums and is used to numb the affected tooth. The use of anesthetic helps to relieve the pain and make the procedure comfortable on for the patient.
  • Removing the pulp – the infected pulpal tissue is exposed by accessing the canal opening through the tooth cavity. Specialized dental files and broach are used to remove the infected pulp and clean the root canals of the tooth. (3)
  • Temporary filling – once the pulp is removed and all the canals have been cleaned, topical antibiotics are placed inside the canal to ensure total clearance of the infection over time. The cavity is then filled with a temporary dental material, and the patient is put on follow up until all the infection, pain, and discomfort has subsided.
  • Follow up – follow up appointments, consists of further cleaning of the canal, placement of gutta-percha, which acts as artificial pulpal tissue and permanent filling of the tooth. A crown is placed after the completion of root canal treatment to strengthen the tooth and save the tooth from fracture.

What are the complications of endodontic treatments?

Some of the common complications of root canal treatment may include –

  • Presence of accessory canals. Usually, molars contain a minimum of three canals. However, failure to detect an accessory canal may cause persistence of the infection and continue the process of tooth decay. (4)
  • Insufficient filling of the canals or improper sealing can also lead to re-infection of the tooth.
  • Instrument breakage within the canal is a common occurrence that may not affect the tooth but will make the process of tooth filling difficult.

Endodontists specialize in dealing with such problems and making the treatment painless and straightforward. Always follow the instructions as per the dentist to prevent further infection of the tooth.

How much does an endodontic treatment cost?

Cost of a root canal treatment depends on the severity of the infection, the tooth involved, and the qualification of the dentist.

In general, root canal treatment performed by a general dentist may cost you around $500 to $1000 for anterior teeth and $800- $1500 for molars.

This fee increase by 50% in case of an endodontist. Many dental insurance providers partially cover the charges of endodontic treatments.

Take away message

Endodontic treatments are one of the most common procedures carried out by dentists. Often tooth decays are not attended by the patients and are left untreated.

As caries progresses, it reaches the pulpal tissue and causes a great deal of pain and discomfort to the patient.

At this time, the infected pulp can be saved by performing endodontic treatment.

This procedure includes removal of the infected pulpal tissue from within the tooth followed by cleaning of the root canals.

Topical antibiotics and medications are used to ensure thorough cleaning of the canals and removal of the infection in totality.

The canals are then filled with gutta-percha, an elastic material which blocks the canals and prevents re-infection.

A crown or a dental bridge may be required after the completion of the treatment to prevent tooth fracture and save the integrity of the tooth structure.

Whatever the reason for tooth infection may be, it is always best to save the tooth first instead of getting it extracted. Root canal treatment is a step towards saving the natural tooth.