It is that branch of dentistry which deals with the diseases related to tooth pulp. The pulp is right in the center of tooth and the canal within the root of the tooth. The pulp is made of connecting tissues, blood vessels and nerves.
The tooth gets its nourishment from the pulp and as the tooth matures it becomes hard to remove the pulp without completely removing the tooth. Removal of this pulp is known as endodontic treatment and commonly called as root canal treatment or therapy.
Who is the Right Candidate for Endodontic Treatment?
One would need an endodontic treatment because of two reasons, the first one could be an infection that is mainly because of untreated cavity that can reach to the pulp and damage it. Before reaching the root canal it already damages the dentin and the enamel; the inflammation around the area affects the blood supply and stops the pulp from healing.
The second reason could be a fracture or a trauma that can totally damage the pulp. At times an inflamed pulp can heal automatically, the dentist perform a root canal treatment only after verifying all this. Increased inflammation can become painful and lead to infection that can even damage the bone around the tooth. The aim of endodontic treatment is to remove the infected pulp and filling the empty space with “gutta percha”.
Signs and Symptoms of Pulp Infection
It is important to know the signs of pulp infection so that you can find an endodontist for yourself as early as possible. The first sign to it is any kind of pain or swelling which can change to infection if not treated timely. You can need an endodontic treatment if you suffer from any of these:
1. It pains when you bite, touch it or push it
2. Sensitivity towards hot and cold
3. Discolored even if it doesn’t hurt
4. Noticeable swelling
5. Broken tooth
Thorough Examination before the Treatment
The dentist with take your through some examinations to make sure that you are the right candidate for this treatment. Hot and cold substances will be placed near your tooth to judge sensitivity and the tissues are examined by gentle tapping. X-ray of the surrounding bone of the tooth will be taken and in case of a damage it will appear in the for of ligament widening or it could be a dark spot somewhere near the root. Any of these could lead to a root canal treatment.
For further clarification the dentist might make use of an electric pulp tester. It is a small hand-held device that triggers an electric current to the root of the tooth. This will further help the endodontist to specify whether the pulp is dead or alive. This tester cannot be used on patients with cardiac pacemaker or with any other form of electronic device.
The Endodontic Treatment Procedure
The treatment produce varies from person to person and it is carefully designed after thorough clinical examination, reviewing of x-rays, and complete diagnosis. Endodontic treatment or root canal treatment can extend up to three appointments depending upon the current state of infection, age group and oral health. Local anesthesia is made use of for the patient’s comfort, the tooth with damaged root and surrounding area is made numb. Latex sheet is used around the treated tooth to prevent bacteria to enter the tooth.
Removing of Pulp
Operating microscope is used to make a small opening at the top of the tooth that allows the endodontist to carefully remove the pulp by making use of specially designed appliances and instruments. After this procedure the root canal is disinfected, thoroughly cleaned and reshaped.
The next step involves the filling of empty space in the root canals with biocompatible material. Orthodontics make use of tiny cones made of rubber-like material “gutta-percha”. This is done to make sure that the gap is completely sealed and there are no further changes of infection.
The access opening is covered with a temporary filling. As soon as the tooth is treated, the endodontist will give you an appointment for removing the temporary filling and placing a crown over it.
Any kind of infection in the roots of the tooth, the pulp, a crack, an accident, or leaking filling can be a common reason for the discoloration of the tooth. One the patient is done with the endodontic treatment on tooth in the front, its color is improved with an internal bleaching or a whitening agent.
Whitening is done generally when the tooth takes its natural position and it might take several sitting depending upon the effect of discoloration. If the tooth has lost its natural structure then porcelain crown is made use of and in that case there is no need of whitening agent.
It is a minor surgery that takes care of removing inflamed and infected tissues from the base of tooth which is known as apex. This is done if the infection doesn’t go completely even after the endodontic therapy or when it becomes difficult to seal the tip of the root with a normal filling.
Local anesthetic is administered to the gum and the tooth, the bone is accessed through an incision and infected tissue is carefully removed along with small amount of nearby bone. The area is disinfected again and cleaned, before stitching the incision a small amount of filling is used to seal the ends. Within 5-7 days the stitches are removed and the bone at the tip grows on its own.
Tooth Restoration after Endodontic Treatment
The perfect restoration option following an endodontic treatment is making use of porcelain crown especially when the tooth looses its natural structure completely. Crown is used as a replacement of missing tooth gives a support to rest of the teeth minimizing future cracks. In case of minimal loss, a conventional filling can solve the purpose of providing the tooth its natural functionality and appearance.
Role of Prosthodontist
The root canal treatment is performed by the endodontist and then the patient is sent to prosthodontist who takes care of for tooth restoration. They are the dental specialists who replace damaged teeth with bridges, crowns, implants and dentures. The choice of tooth restoration entirely depends upon the strength of tooth left and the back tooth are specially crowned as they are widely used in chewing that puts a lot of pressure on them.