Root Canal Treatment: What You Need to Know About Endodontics?

Dr. Irina Yerofeeva, a dentist at Kandinsky Clinic in Dubai, explains the indications for endodontic treatment - the procedure of filling root canals in cases of pulpitis and complicated cavities.

Types of Endodontic Treatment

Each tooth contains canals that house blood vessels and nerves. Endodontic treatment falls into two categories: primary and secondary. Primary treatment involves treating canals that haven't been previously treated, while secondary treatment involves removing old fillings and retreating previously treated canals.

Understanding Pulpitis vs. Cavity

Primary treatment becomes necessary when inflammation reaches the pulp (soft tissue under the enamel and dentin) - a condition called pulpitis. It can be either symptomatic or asymptomatic.

Symptomatic pulpitis causes prolonged pain that can be difficult to locate. Teeth become sensitive to temperature changes, with pain persisting longer than with deep cavities. Often, patients struggle to pinpoint the exact location of the pain.

Sometimes, what appears to be a cavity turns out to be pulpitis during treatment. This discovery may occur during the procedure itself, as advance diagnosis isn't always possible without diagnostic imaging, CT scans, and symptom evaluation.

While dentists strive to keep the tooth vital whenever possible, there are cases where nerve removal becomes necessary.

Pulpitis Treatment Process

Nerve removal is performed under anesthesia: the dentist opens the tooth cavity, removes the pulp, and cleans the canals to prepare them for filling. Some canals can be extremely narrow, especially in older patients, requiring instruments as thin as a human hair for treatment.

These narrow canals may be impossible to flush out initially, necessitating widening and shaping into a cone for proper treatment. The procedure always requires optical equipment, and sometimes a microscope.

Treatment Duration

A single, easily accessible canal can be cleaned in about 30 minutes. More canals mean longer treatment times. The upper sixth tooth, typically having 4 or more canals, often requires two 1-2 hour sessions.

Canal anatomy varies greatly, sometimes featuring unexpected branches or additional canals. More complex cases require more time.

While canals can be filled during the same visit, it's preferable to first use a special antibacterial paste. Patients wear this for 2 weeks before returning for permanent polymer filling.

Quality restoration is essential for successful endodontic treatment. Never leave treatment incomplete or settle for temporary fillings, as this will inevitably lead to complications.

Other Applications of Endodontic Treatment

Periodontitis is another condition requiring endodontic treatment. Unlike pulpitis, inflammation extends beyond the root system into surrounding bone and ligament tissue.

Patients experience a sensation of an "enlarged" tooth and pain when closing their mouth. Periodontitis can develop in both previously untreated teeth with pulp decay and in teeth with treated canals following unsuccessful primary endodontic treatment.

Retreating root canals typically requires more time than primary endodontic treatment.