Root therapy - endodontics
Nearly pain-free and successful treatment of root inflammation (pulpitis) by dentist Dr. Paulsen in Bad Honnef near Bonn
Preserving and restoring the tooth despite root inflammation
Frequently, only minor pain is experienced at the beginning of root inflammation and the affected tooth is suddenly sensitive to pressure or cold and hot food. If these initial signs are ignored, the root inflammation can develop into a very painful condition. If the root (including the nerve) has become inflamed or possibly even necrotic, dental intervention is necessary as soon as possible. The dentist can pull the inflamed tooth (but then it is lost for good) or try to preserve it with root therapy.
The goal of every root canal therapy is to remove the inflamed pulp as well as tissue residue and bacteria from the interior of the tooth, in order to subsequently close off the cleaned root canal and prevent bacteria from entering, thereby preserving the natural tooth.
Modern, successful and pain-free root canal treatment includes a number of innovative techniques such as mechanical preparation, electronic length measurement of the root canal, laser treatment and ultrasonic lavage, which are used in our practice as standard procedure.
Causes for root inflammation
Most of the time, the cause for the inflammation of the tooth, or more precisely the pulp, is deep-reaching decay. Bacteria infiltrate the dentine from the outside and damage the pulp. The result: an inflammation of the nerve (pulpitis), which can lead to nectrotization of the pulp, and in the end can also infiltrate the surrounding bone and create much damage to the bony substance.
Process of endodontic therapy - root therapy - root filling
In principle, we do not treat a patient who is in great pain; therefore, we initially administer special pain medication and wait until the inflammation has subsided. For this reason, root therapy can frequently span several appointments due to the involvement of the procedure.
As soon as it is possible, we complete the root therapy. Initially, all pulp must be completely removed and the root canal must be freed of bacteria.
Under local anesthesia or on request also general anesthesia all pulp is removed. In doing so, it is particularly important that all affected root canals are detected, so that the root canal system can be completely freed and cleaned of the dead tissue all the way down to the tip of the root. To safely kill all germs, we utilize the dental laser, among other things. The laser light reaches even the smallest side canals that cannot be reached by a conventional rinsing solution. Furthermore, we utilize other advanced instrument technology such as mechanical preparation and electronic length measurement in order treat the root inflammation as successfully as possible.
After removing the pulp we prepare the root canals for the root filling. To accomplish this, we rinse the root canals with a disinfecting solution so that any existing bacteria are killed and the tooth remains free of inflammation.
We then fill the root canal with a tissue-conserving filling. It seals off the cleaned root canals so that no new, damaging bacteria can enter. This is also important for the access cavity - the so-called "drill hole" to the root canal system. Based on the extent of the damage, this "drill hole" can be covered with a ready-made endoceramic inlay, a composite filling or onlay. In many cases, however, teeth that have been treated with root canals must be protected by a crown in the future in order to be preserved! To check the treatment result, we take a digital x-ray in the end (monitoring image)
For particularly complicated endodontic cases we collaborate with an experienced dentist specializing in endodontics.
When root therapy was unsuccessful:
Despite correctly performed root canal therapy, further inflammations of the tip of the root may occur. With a surgical intervention, the inflamed tissue can be removed and the tip of the root can be capped (apicoectomy). In many cases, this can preserve the tooth. If the apicoectomy fails, however, the dentist has no other choice: He must extract the tooth.
As caries bacteria are the predominant triggers for inflammations of the pulp, you can prevent painful root inflammations with good at-home oral hygiene, regular check-ups and professional teeth cleaning (PTC) by your dentist.
Do you have questions? Please contact us - we will gladly advise you.
Telephone: +49 (0)2224 / 911033 or Email
Your dental practice team in Bad Honnef near Bonn