Endodontics is the science of root canal treatments. The most feared treatment among dental treatment procedures is usually root canal treatment. However, today, thanks to the developing technology, root canal treatment is performed painlessly with local anesthesia in a single session in live teeth and in two sessions in teeth that have lost vitality.
Dental Anatomy
The part of the tooth that is visible in the mouth is called the crown, and the part that is not visible in the mouth and remains in the bone is called the root. Our teeth are made up of several layers. The outer part of the crown that is seen in our mouth is called enamel. Enamel is one of the hardest tissues in our body. The cementum layer covers the root of our teeth under the gingiva and is surrounded by bone. There is also the dentin layer under the enamel and cement layers. Dentin is the largest layer of the tooth and, unlike the enamel layer, contains nerve endings. With this feature, it plays a role in the pain mechanism.
Under the dentin layer is the pulp of the tooth. This part contains the vessels and nerves of the tooth. The pulp plays an important role during the eruption and development of the tooth. It also conveys the mechanism of pain and the problems our teeth face after eruption.
How Is the Pulp Inflamed?
Every person has bacteria in their oral cavity. They do not harm unless undesirable situations occur. Bacteria combine with many of the foods we ingest, causing acid in our mouths. If we cannot remove these acids from our mouth, these substances damage the tooth enamel and cause decay in the enamel layer. If the bruises on the enamel are not treated, they pass into the dentin layer under the enamel layer. Although the dentin layer warns us with pain, if the caries is not treated again, this time the microorganisms move towards the pulp. Meanwhile, the pulp activates various ways to protect itself. One of these ways is to warn us with pain. However, if we do not treat our teeth, after a while, microorganisms cause inflammation by destroying the vessels and nerves in the pulp.
Another way of inflammation in the pulp is trauma. A blow to the tooth can cause the veins and nerves entering the root of the tooth to break off from the root tip, causing the tooth to lose its vitality. In this case, the addition of microorganisms in any way causes inflammation of the pulp.
Another way that the pulp can become infected is the presence of long-term periodontal (gingival and surrounding) disease around the tooth.
How to tell if a tooth is infected?
Increased pain and sensitivity to cold and hot foods and beverages in the tooth, pain while eating, are the harbingers of the onset of inflammation. Again, excessive color changes in the teeth can be perceived as a sign of inflammation. Apart from these, in untreated teeth where the decay reaches the pulp, the infection reaches the jawbone from the root tip and may cause small or large swellings on the face. In this case, it is appropriate to use antibiotics in addition to the procedures performed by the dentist in the fight against infection. The general belief is that the tooth that creates a swollen face should be extracted after the swelling. However, this is a very old idea. Even teeth that cause such large infections can be kept in the mouth with root canal treatment and this tooth can also serve you for years like a healthy tooth.
Root canal treatment stages
Identification of the problematic tooth by taking radiography.
If the tooth is alive, local anesthesia is applied to relieve the sensitivity in the teeth and surrounding tissues.
Cleaning the caries in the enamel and dentin layers of the tooth and creating a space to reach the pulp.
To isolate the tooth by wearing a rubber cover.
Determination of working length using electronic instruments and confirmation by radiography.
Destruction and removal of infected dentin layers and microorganisms in the root canal using rotary instrument systems and various canal disinfectants.
If the tooth is not alive when starting the root canal treatment, waiting for a certain time with the canal antiseptic to be placed in the canal and filling the root blood at the next meeting.
After root canal treatment, the tooth is cut from the surrounding tissues, the infection does not occur again, and if there is any damage to the surrounding tissues of the tooth, it is aimed to be repaired.
After the root canal treatment, especially after the treatment of live teeth, there may be pain in the tooth that can be folded for a few days or pain when the tooth is pressed. It is a normal pain that occurs after root canal treatment. It disappears in a short time with a little protection of the tooth with root canal treatment. Today, the success rate in root canal treatments, where the right treatment method is applied, reaches 90%.