Root canal filling

Tooth pain can have multiple causes, two of which are pulp infection and root caries, which affect the root of the tooth. Root canal treatment is the simplest way to address such conditions and save the natural tooth from extraction.

Root canal treatment is a stage of endodontic therapy performed to save a tooth affected by deep decay or severe root infection.

Thanks to advancements in dentistry, root canal treatment is now a painless solution, so there is no need to worry when a dentist or endodontic specialist recommends it. According to an article published in the European Journal of Dentistry, root canal treatment is a predictable and effective procedure, with a success rate of 86% to 98%.

To better understand what a root canal treatment actually entails, it's important to know more about the anatomy of a tooth. Inside the tooth, beneath the enamel (the hardest tissue in the body) and dentin, lies a soft tissue known as the dental pulp, commonly referred to as the nerve. The pulp consists of nerves, blood vessels, and connective tissue. It is extremely important during a tooth's growth. However, once a tooth is fully mature, it can survive without the pulp because it continues to be nourished by the surrounding tissues.

When the dental pulp is infected by bacteria that penetrate into the pulp chamber, endodontic treatment is necessary to keep the tooth in the arch and to maintain good oral health.

Essentially, the procedure involves cleaning the canals inside the tooth's root and devitalizing it by removing the connective tissue and infected pulp.

A root canal filling should ideally be performed by an endodontic specialist, as their experience ensures the success of the root canal treatment. Generally, endodontic treatment involves 1-2 visits to the dental office, unless additional complications arise.

There are several techniques used for root canal filling, but most often, the endodontist will use a combination of these methods. At DENT ESTET clinics, root canal treatments are performed using an endodontic microscope, which ensures a success rate of over 90%. The endodontic microscope allows for the complete removal of affected tissue and precise cleaning of the canals.

It is important to know that, at the end of the endodontic treatment, a dental X-ray must be performed to verify that the root canal filling has been properly done, ensuring that the root canal and pulp chamber have been cleaned of infection and hermetically sealed with the materials used in root canal fillings.

Root canal filling materials can be divided into three categories:

• Gutta-percha cones;
• Canal sealers;
• Combinations of the two.

Gutta-percha is a plastic and insulating substance used to fill a tooth after root canal treatment.

During the root canal filling procedure, the damaged area of the tooth, specifically the pulp, is removed, and the tooth’s canals are cleaned and disinfected before being filled and sealed. Gutta-percha is a thermoplastic filling material that is heated and compressed into the tooth’s canal, then sealed with adhesive cement.

Other types of root canal filling materials include apical sealers, cements, or other active materials used to fill any remaining gaps after the gutta-percha has been placed. For complete hermetic sealing of the root canal, the endodontist will use root canal files made of stainless steel.

Root canal treatment is necessary when bacteria from the oral cavity invade the dental pulp. This usually happens when a cavity is left untreated for an extended period. Additionally, the tooth's nerve can be affected if it becomes damaged or if cracks occur due to dental trauma.

Symptoms of a Dental Infection

Some of the most common signs that an infection has spread inside the tooth include:

• Severe tooth pain during chewing or biting;
• Sensitivity to hot or cold foods that persists afterward;
• A feeling of the tooth "throbbing";
• Changes in the tooth's color;
• Swollen and sensitive gums;
• Pus around the infected tooth;
• Swelling of the face or neck;
• A weakened tooth (pus from the infected pulp can soften the bone supporting the tooth).

Here are the main steps in performing a root canal filling:

1. Anesthesia - Local anesthesia is administered to ensure the patient's comfort during the procedure and to alleviate pain after the root canal filling.
2. Isolation of the Work Area - Before starting the root canal treatment, the tooth is isolated using a special device called a rubber dam to keep it dry during the procedure.
3. Access Opening - The endodontist will create an access opening to the pulp chamber and root canals using a dental drill.
4. Removal of the Pulp - The dentist will perform a pulpectomy, which involves removing the dental nerve while leaving the rest of the tooth intact.
5. Canal Disinfection - The pulp chamber and root canals are cleaned, disinfected, dried, and reshaped to prepare them for filling with the root canal material.
6. Filling the Root Canals - The dentist will fill the disinfected canals with gutta-percha or other materials used in endodontic treatment.
7. Sealing the Tooth - After filling the canals, a temporary filling is applied to seal the tooth and prevent reinfection.
8. Final Restoration of the Tooth - In some cases, after a root canal filling, the tooth may need a dental crown to protect it and restore its functionality.

Post-treatment care for a root canal should be divided into three stages: immediately after the procedure, in the following days, and in the long term.

Immediately after a root canal filling, the patient may experience numbness in the mouth for a few hours. Therefore, it's important to avoid consuming foods that need to be chewed or very hot or cold drinks.

In the following days, continue to eat softer foods, chew on the side of the mouth where the procedure was not performed, and brush the tooth gently. Although minimal, any pain after the root canal treatment should subside within a few days.

It is crucial not to neglect regular visits to the dentist. With proper care, the health of teeth treated with a root canal filling can be maintained over the long term.

The main goal of a root canal filling is to save the tooth. However, sometimes the tooth may be too damaged or the enamel too fragile to withstand the root canal treatment. These factors can eventually lead to the loss of the tooth.

If the procedure is not performed correctly, there is a risk of the infection reoccurring at the root of the tooth. Additionally, when the situation requires it, it is important to have a final restoration of the tooth, using a dental crown, to prevent bacteria from entering and reinfecting it.

Following a root canal treatment, there is also a risk of discoloration of the treated tooth. This occurs because the dental pulp has been removed to stop the spread of the infection. However, this happens in a very small percentage of cases.

Maintaining proper oral hygiene is extremely important after a patient has undergone a root canal filling. Teeth should be brushed twice a day, in the morning and at night, for two minutes, and auxiliary cleaning tools such as dental floss and an antiseptic mouthwash should be used.

If you're wondering how much a root canal filling costs, you should know that the price varies depending on the complexity of each case, the type of treatment, or the type of materials used.

The patient's recovery time after a root canal treatment typically lasts less than a week, and any minimal discomfort experienced can be managed with anti-inflammatory medications.

References:

• https://www.colgate.com/en-us/oral-health/root-canals/the-truth-about-root-canal-dangers
• https://www.aae.org/patients/root-canal-treatment/what-is-a-root-canal/
• https://www.healthdirect.gov.au/root-canal-treatment
• https://my.clevelandclinic.org/health/treatments/21759-root-canal
• https://www.mayoclinic.org/diseases-conditions/tooth-abscess/multimedia/root-canal/sls-20076717
• https://www.aae.org/patients/root-canal-treatment/what-is-a-root-canal/