What Is Endodontics?

Endodontics or root canal treatment is a dental procedure that is performed when the decay advances far enough that it cannot be treated with filling or filling, as it is too close to the pulp or the dental nerve.

When caries is very deep, it causes necrosis of the piece or inflammation of the nerve, called pulpitis. Other reasons for performing this treatment are, for example, dental trauma, fractures, abrasion or erosion of teeth, or pathologies such as bruxism.

The dental pulp, although erroneously, is called the tooth nerve. It is in its innermost part, providing vascularization and innervation to the piece. When it starts to be affected for any reason, it produces occasional or continuous pain.

It usually starts to manifest with discomfort when biting and sensitivity to cold or heat, called “reversible pulpitis”. Now, when the pain is continuous, prolonged or increases at night, it is known as “irreversible pulpitis”.

Methods before endodontics

Before performing endodontics, or root canal treatment, we should always try to save the tooth piece with less aggressive methods that include:

• Pulp protection : this is a treatment carried out with something similar to a temporary filling that allows us to conservatively recover the piece, correcting the still reversible pulp damage.
• Pulp coating : is a way to isolate the exposed pulp by cleaning the caries under the filling, using a layer of a medicine.
• Pulpotomy : is a treatment that consists of partially eliminating the pulp, later covering the remaining pulp with medicinal substances.

How is a root canal treatment performed?

Endodontics is a procedure in which the entire tooth nerve is removed from the affected tooth. For its realization, local anesthesia is used. Nerve tissue is removed from the root canals using dental files.

Dental files can be either manual, with rotating movements by hand, or rotating, together with an endodontic motor that rotates the files at low speeds.

The next steps for endodontics are:

• Local anesthesia of the part to be treated.
• Opening the piece until reaching the pulp.
• Removal of the nerve from the canals and their disinfection.
• Filling the channels with plastic material.
• Control through radiography to verify that the treatment was successful.
• Part reconstruction.

Is there endodontics in children?

In children, before performing root canal treatment, pulpotomy is always attempted. If this is not possible, a treatment called “pulpectomy” is performed, which is equivalent to endodontics, but on primary or milk teeth.

The pulpectomy is also complete removal of the pulp, followed by disinfection, instrumentation and filling of the root canal.

The difference is that in baby teeth it is not possible to remove all the pulp from the canal, leaving approximately 4 mm at the end of it.

In this way, we avoid possible damage to the permanent tooth germ that is forming above the baby tooth.

Disadvantages of this procedure

As with all types of medical treatments, there are side effects or sequelae on the tooth piece, among them we find, for example:

• Frailty and increased risk of fracture.
• A certain change in shade and translucency of the tooth.
• Occasionally, a small radiolucent scar, which resembles permanent inflammation at the tip of the tooth root

What can happen after endodontics?

After a root canal the pain should go away as we have removed the nerve from the tooth. However, it is very common to continue with some discomfort because the treated area can become inflamed by the procedure. This can take approximately two or three days after completion.

However, there are some cases where endodontics does not work, whether due to a failure in the procedure, the anatomy of each tooth, infections, etc. If so, the treatment must be repeated.

In endodontic retreatment, the filling is removed from the endodontic cavity, cleaned again, disinfected and then refilled to seal the canal. This way we avoid the extraction of the part.