We use different expressions to indicate the same dental procedure: endodontics, root canal treatment, root treatment, pulp treatment, cameral opening, killing the nerve and pulpectomy (in primary dentition).
The endodontic is a treatment that takes place in the interior of the tooth roots where is located the tooth pulp (popularly known as “nerve”). We access by opening a cavity inside the tooth that passes through the enamel and dentin until we reach the chamber that contains the pulp (pulp chamber). This allows us to visualize the entrance of the ducts in each of the roots. Inside the root there is a canal through which the dental pulp runs.
What is a root canal?
Endodontics is the total removal of the diseased dental pulp and the posterior filling of said space with a filling material that will seal the cavity to create an impenetrable cavity. Endodontics is performed when there is irreversible pulpitis. Although the main indications are tooth breakage or fracture (close to the pulp), deep cavities and pulpitis .
But what is dental pulp? The dental pulp is a connective or filling tissue very rich in vessels and nerves, housed in the innermost space of the tooth or pulp chamber. It is an airtight and rigid space with no possibility of expansion. If there is an inflammatory-infectious process that affects it, it will result in intense pain due to a compromise of that tissue inside a rigid cavity and will very possibly lead to an irreversible injury if it lasts over time.
Steps of a root canal
The procedure requires a high degree of preparation on the part of the professional and several sessions. It is performed in most general dentistry consultations , although there are complicated cases that are referred to experts in this type of treatment (endodontists). A root canal is really one of the most complicated treatments that we find in the consultation. A previous examination of the tooth and an initial X-ray is essential to check the number of rootsthat has that tooth, as well as its shape, its curvature and its length, the root integrity and the state of the apex. All ducts must be treated. For this reason, it is more expensive and laborious to endodontize a molar (with three canals) than an incisor (with only one canal).
- Beginning of endodontics : we begin with a powerful anesthesia to proceed to the opening of the tooth creating a large cavity that allows us to access the interior of the roots and remove the nerve.
- Cleaning the ducts : after leaving the ducts clean, we place a cotton pad impregnated with an antiseptic-anti-inflammatory and leave a provisional filling until the next session a few days later.
- Instrumentation of the canal : this involves the removal of the remains of the pulp and the preparation and widening of the canal for the obturation of the following session.
- Definitive filling and / or crown placement : it is performed by introducing a filling called gutta-percha adjusted to the length of the root that must completely seal the apex of the tooth and occupy the entire canal. It is an inert material and will occupy the space occupied by the diseased dental pulp. Aims to isolate and seal the duct.
Endodontics to treat pulpitis
There are many causes that can lead to pulp disease (pulpitis). They can be classified into three large groups:
- Bacterial (due to superinfection, especially associated with advanced dental caries),
- Inflammatory and chemical (mainly due to deteriorated or poorly sealed filling materials).
The pulpitis is one of the dental emergencies more painful that requires the immediate opening of the tooth to relieve compression symptoms the patient note. It is considered one of the most intense pain. If we approach it before the tissue necrosis, the situation can be reversible, but if it evolves it will lead to irreversible death or pulp necrosis (commonly called nerve death) in which case we must proceed to a restorative endodontic treatment. The warning signsof a possible pulpitis so that you detect them in time are: discomfort in the face of cold or heat, pain when occluding with the antagonist tooth and mild but continuous pain. Your dental pulp is warning you that it is sick!
What you should know…
- Endodontics is the total removal of the diseased dental pulp and the posterior filling of said space with a filling material that will seal the cavity to create an impenetrable cavity.
- The main indications for endodontics are, therefore, fractured teeth (with exposure or proximity to the pulp), deep caries and pulpitis.
- Discomfort from cold or heat, pain when occluding with the antagonist tooth and mild but continuous pain are some signs that should alert us to a possible pulpitis.