Endodontics

Endodontics is the subfield of dentistry dealing with dental nerves. Related types of treatment are commonly known as root canal treatment.
treatments / Endodontics

In the past, this was often seen as a quick pain relief treatment involving the removal of the dental nerve. However, over the past 30 years, this has become specialised dentistry, for which our dental specialists have followed an additional three-year post-graduate master's degree. After all, the root canal is a complex part of the tooth, and it can no longer be regarded as a simple canal that leads to a root.

In the tooth's centre is a nerve chamber where both blood vessels and nerves enter through the root. These ensure blood flow to the tooth and enable experiencing hot and cold sensations. This complex structure can become inflamed, causing swelling, which in turn causes pain sensation from stimuli such as cold or heat. At first, this is mild, but sometimes it can get progressively worse to the extent where even pain relief no longer helps. A dental nerve can become irritated and then inflamed for the following reasons:

  • Tooth decay (caries) deep down in the tooth. 
  • A crack from clamping, grinding or an old filling. 
  • A new, deep filling close to the nerve. 
  • Irritation from heat when grinding for a crown or bridge. 
  • Resorption due to stress on the teeth. 
  • Trauma or fracture of the tooth exposing the nerve.

When this irritation results from bacteria entering the nerve chamber through cavities in the tooth, complete disinfection of this dental nerve is necessary to avoid problems in the future. After all, experience proves that many repeated root canal treatments result from previous root canal treatments where not all bacteria were removed or where the nervous system was insufficiently cleaned.

These treatments at MOND are specifically carried out as follows: 

  • A diagnosis is made based on examination and radiography. Complex problems may require 3D imaging. 
  • The treatment is scheduled or started, after which you are informed of the cost. 
  • The treatment itself takes 1 to 2 hours (a molar sometimes has 4 nerve channels, an incisor often only 1) 
  • The dentist will always apply a good, local anaesthetic so that the treatment is painless 
  • Afterwards, the tooth is opened via a small opening through the chewing surface or crown or bridge (if it can be preserved) 
  • Once access to the nerve canal has been found, all affected nerve tissue is removed with very fine sterile instruments adapted to the complex anatomy of these canals ( curved or very fine canals) without causing additional damage.  
  • As this work is so delicate, the specialist uses a microscope to inspect everything down to the root canal. 
  • During these treatments, the canals are extensively rinsed and disinfected with antibacterial rinsing agents to achieve maximum disinfection. 
  • The sterile root canal system is then completely filled with a liquid rubber paste according to the tooth's anatomy. 
  • Finally, the access to the canal is closed with a permanent or temporary filling depending on the necessary follow-up treatment (crown or filling) or the time available. 
  • These treatments are always done using a dental dam to avoid saliva contamination containing bacteria and also to protect yourself from the often sharp instruments used (rotary files and drills).

In some cases, inflammation of the nerve has already spread to the jawbone, and treatment has to be done in several steps to control the inflammation first before filling the tooth completely. 

When even a root canal retreatment proves unsuccessful due to broken instruments, persistent bacteria or a complex root canal anatomy, additional surgery may be required. With this treatment, a small opening is made through the gums to the root tip to remove the subsequent visible root tip and related inflammation. This is done under local anaesthetic and sterile conditions. 

The current materials and techniques ensure that a denervated tooth does not become discoloured after the treatment. Conversely, a grey tooth caused by an old nerve problem can be lightened again by a correct root canal treatment combined with bleaching the nerve chamber. 

Since our dental specialists have undergone additional training and use expensive, special materials such as rotary NiTi files and microscopy, this treatment is unconventional. Therefore, the fee supplement will be much higher on top of the standard cover. Additional insurance in the form of a dental plan can often cover these extra costs.

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