Tooth Preservation
With modern techniques and individual treatment plans, we do everything we can to preserve your natural teeth in the long term.
Root Canal Treatment
Last minute rescue
Root canal treatment may be necessary if a tooth is deeply affected by decay or if the pulp is inflamed. The goal is to preserve the tooth. The treatment is almost painless and can be performed under local anesthesia. In the case of complaints, root canal treatment is often the last minute salvation.
Root canal treatment is often a necessary procedure after severe caries and is intended to enable tooth preservation. If caries is allowed to spread undisturbed in the tooth for too long, sooner or later it will find its way inside the tooth. The bacteria invading there cause the small blood vessels, the so-called pulp, to become inflamed and swollen. As a result, the tissue swells and irritates the tooth nerve, which usually causes considerable pain.
The resulting inflammation can spread from here to the jaw within a few hours or days. The result is the famous "fat cheek" and further pain. To prevent this from happening or to prevent the inflammation from spreading even further and spreading to neighboring teeth, you should visit the dentist as soon as possible and have the problem corrected.
When is root canal treatment necessary?
Root canal treatment is necessary if the tooth is inflamed to the core (pulpitis). In addition to this most common reason, such treatment can also be caused by a tooth fracture, the application of dentures, an incomplete old root canal filling or even a further circumscribed inflammation of the root tip. Each tooth root has one or more root canals in which the pulp is located, a "living" tissue crisscrossed with blood and lymphatic vessels as well as nerves. The root canals are open at their ends, as a connection to the body that is beneficial to the metabolism. If this tissue is attacked by bacteria or germs, root canal treatment is usually the only way to preserve the teeth.
Root canal treatment is also considered for tooth fractures or infected fillings, crowns, or inlays if bacteria have invaded the pulp. Even dead, dead teeth can often be saved with root canal treatment. In some cases, antibiotic treatment of acute inflammation is required before root canal treatment can be performed.
It is important to consult a dentist if there are signs such as pulsating or throbbing pain in the jaw or head area, as well as pain when using one or more teeth, to avoid further spread of the infection and possible health risks.
Procedure of a root canal treatment
A root canal treatment is a multi-step process that aims to remove the infected pulp with its vessels and nerves and to rid the tooth of bacteria. The process of root canal treatment is divided into several steps:
- X-ray: Before the treatment, the dentist takes an X-ray to assess the number of roots, the progress of inflammation, and the need for root canal treatment.
- Anesthesia: To avoid pain during the treatment, the tooth is anesthetized locally. In rare cases, when the tooth is already dead, the treatment can be performed without anesthesia.
- Rubber dam: The dentist isolates the tooth from the oral cavity using a latex or silicone blanket (rubber dam) to prevent saliva and bacteria from entering the tooth or from swallowing instruments and disinfectants.
- Access to the inside of the tooth: The dentist drills a hole in the chewing surface of the tooth to gain access to the inside of the tooth and root canals.
- Measurement of the root canal: With the help of measuring needles or electric measuring probes, the length of the root canals is determined to ensure optimal filling.
- Preparation of the root canal: The dentist uses special instruments to widen the fine structures of the root canals and clean them of inflamed tissue and bacteria.
- Disinfection: During and after cleaning, the root canals are disinfected with various irrigation fluids to kill germs and contain the infection.
- Root canal filling: The cleaned and disinfected cavity is sealed with a special filling material. The access in the chewing surface is closed with a dense and stable plastic filling to prevent bacteria from entering. If necessary, a root post is inserted for stabilization.
- Crown: As a final step, a crown is usually placed on the root canal treated tooth to ensure its stability and tightness.
The duration of a root canal treatment can vary, depending on the extent of the inflammation, the number and nature of the roots, and the location of the affected tooth. As a rule, there should be no pain during treatment, as the affected area is locally anesthetized. Pain may occur after treatment, but it can usually be relieved well with painkillers.
Is root canal treatment painful?
Most patients are familiar with root canal treatment as a treatment method that can cause severe pain. Thanks to modern technology, root canal treatment is no longer painful.
Usually, the area is anesthetized by local anesthesia, which means you don't have to suffer from pain.
In very rare cases, the infected tissue can prevent the effect of the anesthesia. In such cases, your dentist may prescribe an antibiotic first and perform the root canal treatment afterwards.
What are the chances of success of a root canal treatment?
Scientific studies have shown that the chances of success with a professional root canal treatment with a high-quality root canal filling are over 90 percent. In the case of treatment by a specialist, the preservation of the treating tooth is therefore very likely.
However, complications and side effects can occur with any treatment. Here are some possible consequences and complications of root canal treatment:
- Pain and discomfort: Sometimes pain and discomfort occur in the affected tooth during or after root canal treatment. However, these symptoms usually subside on their own after some time.
- Inadequate cleaning of root canals: In the case of curved or highly branched root canals, it can be difficult to remove all inflamed tissue and clean the canal system adequately. If bacteria remain and cause inflammation, a new root canal revision or even an apical resection is required.
- Broken instruments: During root canal treatment, instruments can break off, especially if the tooth roots are very narrow or very curved. In such cases, special instruments or surgery must be used to remove the broken part.
- Drilling of the tooth wall: If the technique is incorrect or the instruments are too large and rigid, the dentist can drill through the side of the tooth wall.
- Root canal overfilling: If the filling in the root canal is too long, it can irritate the maxillary sinus in the upper jaw and the mandibular nerves in the lower jaw. Minor overcrowdings are often eliminated by the body itself, while surgical removal is recommended for larger ones.
Apart from the possible complications mentioned, the fear of root canal treatment should be reduced by knowing that the procedure is almost painless through the use of modern local anesthetics. Mild pain that occurs after the anesthetics wear off can be treated with painkillers and should go away within a few days.
Root canal treatment or tooth extraction?
Whether you should opt for root canal treatment or tooth extraction and subsequent treatment with dental implants depends on the individual initial situation. The anatomical nature of the jaw, the accessibility to the root canals and any root canal treatments that have already been done or failed are decisive factors in the decision.
In case of previous root canal treatment and persistent symptoms, conventional root tip resection or microsurgical root tip resection may be considered to save the tooth.
We are advocates of treating a natural tooth that is worth preserving and avoiding complex and expensive treatments such as bridges or implants. In our practice, we will advise you in the best possible way and find the best option for you.
What is the difference between root canal treatment and apical resection?
Root canal treatment and root tip resection (WSR) are two different methods of treating problems related to inflamed or infected tooth roots. Both procedures have advantages and disadvantages, and often the choice of method depends on the severity and location of the inflammation, as well as the individual circumstances of the patient.
Root canal treatment: A root canal treatment is the less invasive and standard treatment for problems with the tooth root. It fixes the problems in the inflamed root canals from the inside out. An access to the root tip is drilled through the tooth crown and the inflamed tissue in the root canal is removed. Then the tooth canal is refilled with a special filling compound. The aim of root canal treatment is to preserve the tooth and eliminate the inflammation.
Root tip resection (WSR): An apex resection is a surgical procedure and is often considered as a last resort to preserve a tooth with an infected root tip. It involves opening the gums, underlying tissue, and jawbone to access the root tip. The inflamed root tip is then cut off and the root canal is closed bacteria-tight. An ESC is performed when a classic root canal treatment has not been able to soothe the inflamed tooth. In our practice, we offer conventional root tip resection and microsurgical root tip resection.
Pros and cons: One advantage of root canal treatment is that it is less invasive than ESC and causes less pain and complications. However, one downside is that it can sometimes be difficult to completely remove all bacteria from the root canal, which can lead to re-inflammation.
One advantage of WSR is that the affected tissue can be removed quickly and effectively, reducing the likelihood of re-inflammation. One disadvantage is that the surgical procedure also affects the jawbone, which means that the healing process can take longer and be more complicated.
In some cases, both treatments are performed at the same time or blended into each other in order to achieve the best possible treatment outcome. However, the choice of treatment method should always be individually tailored to the patient and taken into account with the fears and problems of the respective affected person in the context of the treatment.
Can an apical resection be performed on a tooth that has undergone root canal treatment?
Both root canal treatment and root tip resection can be performed on the same tooth to achieve the best possible treatment result.
The main difference between these two procedures is that root canal treatment is performed from the inside out to correct problems in the inflamed root canals. In contrast, root tip resection is a surgical procedure in which the gums and jawbone are opened to access and shorten the root tip in order to remove the inflamed part of the jaw.
Root tip resection may be necessary if an initial root canal treatment has not been successful or if there are difficulties in reaching certain areas of the tooth root due to skin problems such as curved roots or a widely branched canal system.
It is important to note that the decision for or against re-root canal treatment or apical resection is based on a thorough examination of the affected teeth and a careful consideration of the potential benefits and risks of these procedures. This decision should be made together with your dentist, who will inform you about the most appropriate treatment options for your individual situation.
Root canal treatment in competent hands
Our team, led by Dr. Nina van Sprundel, specializes in root canal treatment. In our practice, we use state-of-the-art technology to provide our patients with a gentle and pleasant treatment.
Our goal is to preserve your natural teeth and ensure a high quality of life. Through regular training and the use of innovative technologies, we are always up to date with the latest developments in dentistry and can thus offer you successful treatment at the highest level.
Thanks to our many years of experience and expertise, we can guarantee you optimal treatment. We take time for your individual needs and are always available to advise you.
Visit us in our practice and let our empathetic and competent team convince you. We look forward to seeing you!