Referred to as root canal treatment in other countries, endodontics is a dental treatment aimed at removing vascular and nerve tissue from inside the tooth. This treatment is erroneously referred to as “killing the nerve”. It is performed when such tissue presents an irreversible inflammation or a degenerative infectious process.
This vascular and nerve tissue is called dental pulp. The pulp is located inside the crown and roots of the teeth, in the so-called root canals, which are a closed space. Therefore its involvement by an inflammatory or infectious process increases the volume of the same manifesting with a sign of pain, or expands into the bone producing a bone and mucosal involvement (phlegmon).
Objectives of endodontics
- The first objective of endodontics is to eliminate the pain present.
- Secondly, to disinfect and permeabilize the canal.
- And thirdly, to preserve the tooth.
How is endodontics performed?
To perform the endodontic treatment, an opening is made in the crown of the tooth (after infiltration of local anesthesia) that allows us to reach the entrance of the pulp chamber (where the most superficial part of the pulp is located). From here we proceed to remove the pulp tissue mechanically with a rotating instrumentation. This instrumentation is cleaning and shaping a wider space inside the root canals, since, once the instrumentation process is completed, we must perform a sealing of the root canal to its apex (final part of the root) thus achieving a three-dimensional closure.
When is it not advisable to perform an endodontic treatment?
Endodontics is contraindicated in all those cases in which it is not feasible to reconstruct the tooth, either by:
- presenting a vertical fracture
- having little bone support
- having an unfavorable crown-root ratio
- if the root canals are calcified and do not allow instrumentation.
Tips for recovery after endodontic treatment
After endodontic treatment, chewing with that tooth should be avoided, especially if it does not yet have the definitive restoration. On many occasions a full crown covering will be needed to avoid fracture, since the tooth becomes more dehydrated.
Generally pharmacological treatment is prescribed to alleviate the postoperative pain that usually appears after the treatment and lasts 48-72 hours. We also indicate dietary guidelines, such as eating foods of a more or less soft consistency.
It is advisable to perform periodic controls of the endodontic piece every 6 months, initially, especially if an infectious process had been generated at bone level. In this case it will be verified radiographically if the bone lesion is reduced.