What is endodontic treatment (root canal)?

Beneath the outer enamel, which is composed of enamel, and inside the dentin is a cavity of soft tissue called the dental pulp, also known as the nerve. The dental pulp includes the tooth’s nerves, veins, arteries and lymphatic vessels, with the purpose of keeping the pulp (nerve) alive and providing the main source of ‘life’ to the tooth. When the nerve is infected the treatment is root canal and after the root canal, the periodontal tissue keeps providing the tooth with life.

Root canals, which are small and thin tubes, because they start branching from the top of the dental pulp and reach the tip of the root. Inside these tubes pass the microvessels and the nerve. Each tooth usually has from one to usually four root canals. In rare cases, five or even six root canals have been detected.

Why do I feel pain?

When the nerve becomes infected, due to some deep cavity which may be due to caries, cracking or breaking the tooth may provoke pain. Infected or dead dental pulp increases blood flow and cell activity so the tooth cannot relieve the pressure inside it on its own. You usually feel pain in the tooth when chewing, as well as when it comes into contact with hot or cold foods and drinks, or even without any obvious stimulus.

Why do I need root canal?

It is important to know that our body cannot deal with tooth and jaw infections on its own. Without proper treatment, infections cannot heal, the bone structure around the tooth is destroyed, and if the infection is not diagnosed in time, the tooth is at risk of extraction. In cases where the pain worsens, immediate dental care like root canal is required. Untreated infection can lead to serious consequences, including the need to extract the tooth.

If an infected tooth, that causes pain or not, remains untreated, the rooth canal as a solution is less probable and the extraction is more probable.

This can lead to distortion of the surrounding teeth, affecting chewing and the way the mouth closes. In addition, it can cause problems in the temporomandibular joint, causing pain in the muscles that contribute to chewing, as well as in the joint itself during chewing or even when not chewing.

When a tooth is removed from the oral cavity, the remaining teeth are ‘forced’ to receive more forces to cover the absence of the extracted teeth. In the long term the remaining teeth suffer more and are at risk of breaking, decaying or moving faster because they tend to move towards the neighboring teeth to close the gaps.

Although extraction is an inexpensive solution, the resulting gap requires the placement of an implant or bridge, which have a higher cost than denervation. Therefore, preserving your own teeth with treatment is always preferable. Nothing can replace the natural tooth, both functionally and aesthetically, because a healthy dental root without mobility is actually a natural implant.

How is a root canal treatment done?

The root canal is a procedure applied to remove the damaged or dead pulp of the root canal of a tooth. This is achieved by cleaning out the pulp and any roots that are infected with microbes, followed by closing the root canals. The root canal is filled with gutta-percha, a rubber-like elastic material, to prevent infection from reoccurring in the tooth. The tooth is then permanently sealed, or if a large part of it is missing, a fiberglass or carbon fiber shaft is placed, which mimics the bioelasticity of dentin, i.e. the area where the shaft is placed. Depending on the amount of healthy tooth left after the removal of the caries, it is decided to seal the tooth with a modern restoration method or with a ceramic crown to keep the tooth in the mouth for the longest period of time, improving the aesthetics of the tooth at the same time.

Endodontic treatment is performed by a dentist using a microscope. If the dentist judges that the difficulty of the tooth requires an endodontist then he refers and usually it is completed in one session, depending on the difficulty and the extent of the inflammation. Endodontic treatment is considered painless as local anesthesia is used to numb the area.

The Association of Hellenic Endodontists and the European Society of Endodontology present in a simplified way the possibilities of modern Endodontics for maintaining the vitality of the pulp with living pulp treatments. We hope this video will become a useful tool in communicating with our patients.

What happens after endodontic treatment?

Inflammation of the tissues may cause some discomfort when closing the mouth or minor pain for a few days, which can be relieved with simple pain relievers. It is important to monitor tissue healing, especially in cases of extensive bone damage, through repeat examinations. Simple over-the-counter pain relievers are usually enough to provide relief.

Always remember that if you were experiencing tooth pain prior to treatment, it may take some time for them to heal and return to their normal state.

When should I restore my tooth?

During the first period after the treatment, please avoid biting and eating with the treated teeth until the tooth sealing is completed.
Once denervation is complete, a temporary seal is placed. During this period, the tooth continues to receive nutrients from the neighboring tissues, but it is necessary to restore it permanently. The choice of the type of restoration depends on the location and condition of the tooth. It is equally important that the permanent restoration of the tooth is carried out as soon as possible, as the tooth is at risk of fracture or infection.

What is the expected lifespan of my tooth after the root canal treatment?

When an endodontic treatment is performed in the correct scientific manner, the treated tooth can be preserved for your entire life. However, proper care is required, just like the rest of your teeth. This includes daily brushing, flossing, and regular visits to the dentist every six months for cleaning and check-ups.

Regular visits to the dentist are especially important, as a check-up can prevent problems before they develop. For example, a small cavity can be easily treated with a simple filling, while a larger cavity that has been treated endodontically may require extra attention, or even progress to the need for extraction, especially if it has spread deep below the gums.

Antibiotics in Endodontics and the dangers of their misuse

The Hellenic Endodontist Association in collaboration with the European Society of Endodontology translated and shared the following video. It presents the indications for the administration of antibiotics in Endodontics and the dangers of their misuse. We hope this video will become a useful tool in communicating with our patients.