Endodontics is a major branch of dentistry that deals with the diagnosis and treatment of problems related to the pulp (the living tissue containing nerves and blood vessels) and the surrounding dental structures.
Endodontics, also known as root canal treatment, is performed when a tooth becomes infected or suffers significant decay. It eliminates most issues that would otherwise require tooth extraction and helps preserve the tooth. As one of the most critical treatments in dentistry, endodontic procedures are performed in a relatively straightforward manner.
What Treatments Does Endodontics Include?
- Root canal treatment
- Endodontic surgical procedures
- Prevention of pulp diseases and vital pulp therapy
- Differential diagnosis and treatment of oral and facial pain originating from pulp and periapical tissues
- Retreatment of failed root canal treatments
- Whitening of endodontically treated teeth
- Treatment of teeth that have suffered dental trauma
- Endodontic treatments that support prosthetic, periodontal, and orthodontic procedures
- Placement of posts within the root canal space to support coronal restorations
Bacteria Threaten Our Teeth!
Bacteria combine with many of the foods we consume to produce acids in our mouths. If we neglect oral hygiene, these acids damage the enamel and cause cavities. When cavities in the enamel remain untreated, they progress to the underlying dentin layer. Although the dentin layer signals us through pain, if the decay continues untreated, microorganisms move toward the pulp. At this stage, the pulp responds with pain to protect itself. However, if treatment is still not sought, microorganisms destroy the nerves and blood vessels within the pulp, leading to infection.
Another way the pulp can become infected is through trauma. A blow to the tooth may sever the nerves and blood vessels that enter the root tip, causing the tooth to lose its vitality. If microorganisms enter the pulp in any way, an infection develops. Additionally, long-term periodontal disease (affecting the gums and surrounding tissues) can also lead to pulp infection.
Oral Hygiene Must Be Maintained!
The most common cause of tooth pain is inadequate oral hygiene. If oral and dental health is neglected, cavities begin to form, first affecting the tooth itself and then spreading to neighboring teeth. The reason cavities cause pain is the damage to the outermost layer of the tooth, the enamel. Since enamel does not contain nerve endings, decay may start and progress unnoticed.
Poor hygiene and excessive consumption of sugary and starchy foods weaken the enamel over time. The microorganisms responsible for cavities penetrate deeper layers, eventually causing unbearable pain. Pain may manifest in different ways, including:
- Sensitivity to hot and cold temperatures
- Pain during chewing due to pressure
- Increasing pain caused by cavities
- Spontaneous and persistent pain
What is Root Canal Treatment?
Root canal treatment is a procedure performed when the nerve inside the tooth (pulp) is irreversibly damaged or dead due to decay or trauma. After the treatment, the affected tooth remains in the mouth, serving as a functional unit. Even though the tooth itself is non-vital, it still helps with chewing and prevents bone loss in the jaw by keeping the surrounding bone active.
What is Laser-Assisted Root Canal Treatment?
Laser technology produces a concentrated beam of energy that moves in a linear direction. In dentistry, this energy is used to vaporize water molecules in tissues, thereby breaking down the tissue. With laser-assisted procedures, surgeries can be performed without bleeding. Minor interventions may not even require anesthesia. Additionally, laser treatment helps save time during both the procedure and the healing period.
What is the Treatment Process?
- Taking radiographs to identify the problematic tooth.
- If the tooth is vital, applying local anesthesia to eliminate sensitivity in the tooth and surrounding tissues.
- Removing decay from the enamel and dentin layers and creating an opening to access the pulp.
- Isolating the tooth using a rubber dam.
- Determining the working length with electronic devices and confirming it with radiography.
- Using rotary instruments to remove infected dentin layers and microorganisms within the root canal.
- Disinfecting the root canal with various antiseptic solutions while using rotary instruments.
- If the tooth is non-vital at the start of the procedure, placing an antiseptic agent inside the canal and waiting for a certain period before filling the root canals in the next session.
What is the Success Rate?
Root canal treatment aims to eliminate the infection and prevent reinfection by sealing off the tooth from surrounding tissues. If any damage has occurred to these tissues, the goal is also to aid in their healing. The procedure is performed under local anesthesia, ensuring that the patient does not feel pain. After treatment, especially in vital teeth, mild discomfort or pressure pain for a few days is normal. With proper care, this discomfort resolves quickly. Today, when performed using correct techniques, root canal treatment has a success rate of up to 90%.
Dr. Dt. Esra Duran
Endodontics Specialist
