The part of the tooth that remains above the gumline and is visible inside the mouth is called the crown; the part that is not visible in the mouth and remains within the bone is called the root. Teeth are composed of several layers. These are enamel and dentin, which are from outer to inner layers. Beneath the outer structures of the tooth, enamel and dentin, there is a soft connective tissue called the pulp tissue, which constitutes the living part of the tooth. This is commonly known as the “nerve of the tooth.” During the growth and development of a tooth, the role of the pulp is to nourish it. Once a tooth is fully developed, the pulp tissue’s function is to transmit pain, indicating damage or inflammation in the tooth. Endodontics is the branch of dentistry that deals with problems extending to the dental pulp and provides their treatment.
Root canal treatment is performed to treat inflammations of the pulp that cannot be salvaged. The tooth has tiny and narrow tunnels called root canals that extend from the crown of the tooth to the root tip. The procedure involves removing the pulp from its place. In the past, the only treatment for inflamed pulps was tooth extraction; however, nowadays, root canal treatment allows dentists to preserve teeth in the mouth, enabling them to serve for a long time.
When the nerves inside the canal are damaged and become inflamed, they die because they lack the ability to heal themselves. The death of the pulp (nerve) occurs mostly due to trauma, fracture, or deep decay in a tooth. In both cases, bacteria reach the pulp and cause inflammation. In such situations, chewing, pressure, or stimuli like hot and cold can lead to excessive sensitivity and pain. Additionally, pulp inflammation can lead to pain that cannot be relieved by painkillers and can initiate spontaneously. Taking medications, especially antibiotics, without a dentist’s guidance can only temporarily postpone your pain. Prolonged use of antibiotics makes inflammation more resistant and complicates tooth treatment. To illustrate, think of the procedure like incapacitating enemy soldiers. As soon as your defenses drop, enemies can wake up and attack you again. Antibiotic treatment temporarily immobilizes enemies for a short period, while root canal treatment eliminates them completely. If pulp inflammation is not treated, abscesses, which are “pus-filled pockets,” form due to the accumulation of inflammation at the root ends and in the jawbone. These abscesses at the root end can expand, causing destruction in the surrounding bone tissue. Without removing the infected pulp, pain and swelling will occur. If left untreated for a long time, the tooth might require extraction.
1. After your dentist diagnoses the condition and recommends root canal treatment, the treatment begins. Depending on the tooth’s condition, the treatment may be completed in one or more sessions.
2. Initially, the tooth to be treated is numbed to ensure you don’t feel pain. Then, if there’s decay present, it is removed, and access to the area with the tooth’s nerves is gained by creating an opening through the crown of the tooth.
3. Radiographs (X-rays) are taken to determine the canal’s length, or apex locators can be used. Apex locators cannot be used on patients with pacemakers.
4. The content of the root canals (pulp tissue) is removed, and the canals are cleaned. Using various hand and rotary instruments, the canals are shaped and enlarged.
5. Disinfection of the root canals, eliminating bacteria, is carried out, and the canals are tightly filled with a material compatible with the surrounding tissues.
6. Depending on factors such as the tooth’s root end infection, whether the infection is acute or chronic, and the presence of pain in the patient, the treatment may take 1-3 sessions.
7. In cases of severe infection, the dentist might recommend taking medication orally to reinforce the treatment.
8. After the treatment, mild pain and sensitivity in the tooth might occur, but this is temporary. The best solution is to avoid using the treated side of the mouth for a few days. Sensitivity will likely disappear shortly.
9. A root canal-treated tooth can serve for years, much like a untreated tooth. However, just like any other tooth, root canal-treated teeth can experience decay or fractures and might have gum-related issues. After root canal treatment, maintaining good oral hygiene is essential.
10. Regularly brushing your teeth, using dental floss, and attending regular check-ups with your dentist are necessary.
The success rate of endodontic treatment has increased with advancements in technology and the improvement of dental skills. A well-executed root canal treatment following proper principles has a high success rate, typically around 90% to 95%.
Endodontic success rates have been reported to range between 53% to 94% in various studies. The anatomy of the root canal plays a significant role in the treatment’s success. Cleaning and shaping canals with complex shapes are more challenging.
Endodontic failures may occur due to deficiencies in cleaning, shaping, and sealing the canals, instrument fractures within the canal, missed canals, fractures in the inter-root region, the dislodgment of restorations on root canal-treated teeth, and the recurrence of inflammation in the root canal system. In cases of failure, the usual approach is to renew the root canal treatment while correcting any mistakes. The old root canal filling is removed, the canal is re-shaped and cleaned, and the tooth is re-filled. If this procedure does not work, a surgical intervention called “apical resection” can be performed. This procedure involves accessing the root tip surgically, cleaning the area and its surroundings, and sealing it. If even surgical intervention doesn’t yield results, tooth extraction might be considered.
There is no alternative treatment option to root canal treatment.
When root canal treatment fails or cannot be applied for the second time to teeth where it has been performed before—for instance, when a restoration has been placed over the canal-treated tooth using support from inside the canal, or if a broken instrument is present within the canal—surgical intervention at the root tip can be considered.
In cases of failed repeated root canal treatment or unsuccessful surgical intervention, or teeth with significant substance loss where a filling or crown cannot be placed, extraction should be considered.
The gap after tooth extraction can be treated with a bridge or implant.
However, preserving the natural tooth is always preferred. The absence of one or more teeth can cause neighboring teeth to shift and disrupt the alignment. Moreover, preserving natural teeth does not necessitate expensive and lengthy treatments like implants or bridges.
Root canal treatment should be performed when the pulp is damaged for any reason and becomes inflamed.
The primary reason requiring root canal treatment is when extensive decay reaches the pulp.
Especially in children, falls, injuries, or any trauma to the teeth can lead to pulp damage. In such cases, regular check-ups should be conducted to determine if the tooth is still vital.
Teeth that have lost vitality require root canal treatment. Additionally, in cases of inflammation resulting from improperly executed root canal treatments, the first option is to renew the root canal treatment.
The old root canal filling is removed, inflammation is eliminated, and root canal treatment is redone
. In cases of long-term untreated inflamed teeth, the first step is root canal treatment when swelling and inflammation occur.
How can you tell if you need root canal treatment?
Long-lasting sensitivity to hot and cold, pain when chewing or inability to chew comfortably, spontaneous pain—especially at night, discoloration of the tooth, swelling, pain in the lymph nodes near the affected area, or palpable swelling
Does root canal treatment kill the tooth?
The belief that “root canal treatment kills the tooth” is a misconception from the past. After the live tissue inside the tooth is removed during root canal treatment, the tooth becomes insensitive to heat and cold, but it continues to function with the support of blood vessels and nerves from the surrounding bone and tissues. With proper restoration (filling or crown) after treatment, you can chew comfortably or even use the tooth as an abutment for a prosthesis. According to research, the success rate of root canal treatment is around 98%.
This misconception has persisted for years. Root canal-treated teeth are usually extensively decayed or damaged, requiring meticulous and flawless restoration (filling or porcelain crown) after the root canal treatment. The type of restoration needed varies for each tooth.
Endodontics is the dental specialty that deals with problems extending to the dental pulp and provides their treatment.
Infections developing in the root tip area due to bacterial contamination can lead to bone damage and the formation of cysts in those areas. Clinically, this can lead to pain and swelling in patients, but it can also be diagnosed radiographically without causing any pain. The treatment for such a tooth can involve placing dressings through the root canal or, in cases of non-responsive teeth, surgical intervention involving the removal of the affected area and a resection of one-third of the root (apical resection).
When coming to your first appointment, bringing previously taken X-rays and documents related to
past treatments will provide us with detailed information about your treatment history.
The requested date and time, depending on our doctors’ availability, may vary.
Please wait for us to reach out to you for confirmation.
Özer Dental Clinic, located on Alaiye Street, one of the bustling areas of Alanya, provides dental health services with its team of expert dentists.
Dr. Özer | Hacet Neighborhood, Alaiye Street, B.Uyaroğlu Apartment, Unit: 60/A, 07400 Alanya, Antalya
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