What is root canal treatment? When and when not to have root canal treatment?

What is dental pulp?What is dental pulp treatment? Degrees of dental pulp disease

The dental pulp is a specialized connective tissue consisting of blood vessels and nerves, located in the pulp cavity and surrounded by the hard tissue of the tooth (including enamel and dentin). The dental pulp enters from the apex of the root.

Pulpitis  is caused by bacteria that break down the tooth structure and invade the pulp, causing the pulp to swell and become painful.

Root canal treatment is the process of removing all of the tooth’s pulp (both the pulp chamber and the root canal). After removing all of the pulp tissue, the dentist will clean, shape, and seal the root canal system.

Levels of pulp disease:

Level 1: Reversible pulpitis
Reversible pulpitis is the mildest form of pulp disease caused by tooth decay that is not detected and treated promptly.

Level 2 : Irreversible pulpitis
Irreversible pulpitis is divided into two forms: painless or painful. In the painful form of irreversible pulpitis, the patient may experience typical pulp pain such as:

• Natural toothache;
• Hemifacial pain and ipsilateral migraine;
• Pain in the area, cannot determine the exact location of the painful tooth;
• The pain may last for just a few minutes or it may last for hours;
• The pain worsens when changing position or with hot/cold stimulation.

For the painless form of irreversible pulpitis, it can be detected through clinical examination, seeing the exposed pulp tooth with yellow spots, dark red mass or cavities.
Level 3 : Acute pulpitis
Typical symptoms of acute pulpitis include:

• Spontaneous pain often occurs at night and may be prolonged;
• When food falls into the cavity or a sudden change in temperature triggers the pain;
• Constant dull pain or sharp pain that comes and goes.

Patients can return to their normal activities when the pain ends. However, if acute pulpitis develops pus, the pain will become more severe and intense:

• Feeling like there is a drum beating in the ear;
• Pulsating tooth pain;
• The painful tooth is higher than normal and slightly loose.

Level 4 : Chronic pulpitis
This form of the disease is common in young people. Chronic pulpitis is caused by continuous, mild irritation and affects the vascularized pulp tissue.

Level 5 : Pulp necrosis
Pulp necrosis is the most severe level of disease related to the dental pulp. Some cases of tooth necrosis will experience a feeling of prolonged pain.

The accumulation of necrotic pulp in the tooth root will spread to adjacent teeth, leading to inflammation in the surrounding areas, causing serious complications.

Signs of dead tooth pulp?

When the pulp is necrotic, the tooth has almost no pain or sensitivity. This causes many difficulties in the detection and treatment process. However, if you pay attention, you can detect a dead tooth through signs such as:

• Tooth enamel turns gray and dark brown due to lack of continuous nourishment. If the pulp is dead, the discoloration only occurs in one tooth.
• Touching, tapping and tapping on the teeth do not produce any sensation.
• Teeth with dead pulp can cause an unpleasant odor in the mouth, causing pus to leak out of the tooth tip. Bad breath caused by pulp necrosis often persists even after good oral hygiene.
• In cases where the pulp is dead for a long time, the tooth may become loose, reducing the ability to chew and crush food.
• In some cases, a tooth with dead pulp may also be broken into pieces, and when observed on the tooth surface, there may be a large cavity with pink or red tissue inside (progressive pulpitis). This condition is the result of long-term necrosis of the tooth pulp that is not treated promptly.

When should and should not have root canal treatment?

Below are cases where pulp disease should and should not be treated:

Cases requiring root canal treatment

• Acute pulpitis.
• Chronic pulpitis.
• Pulp necrosis.
• Pulp exposure.
• Periapical disease.
   

Cases where root canal treatment is not recommended

• The tooth tissue and root have been extensively destroyed.
• Teeth have severe periodontitis and bone loss.
• Root canal treatment many times without success
• People with osteomyelitis, connective tissue inflammation.

Complications of not treating the root canal promptly

Below are the consequences of not treating tooth pulp promptly:

Sensitivity, prolonged pain
Patients will feel sensitivity, pain when eating sour, hot or cold foods. The pain can last for several hours, several days or several months depending on the stage of pulpitis.

Risk of tooth loss
When pulpitis is in stages 2 and 3, the possibility of tooth loss is very high. Tooth loss affects chewing function and aesthetics…

physical weakness

When suffering from pain due to pulpitis, patients will feel loss of appetite, reduced ability to chew, insomnia… thereby greatly affecting their health.

The pulp does not heal itself.

When the severe pain that lasts for a long time disappears, that is when the entire nerve inside has died. At that time, the infection spreads and spreads throughout the inside, meaning that the inflamed pulp will not heal itself.

Infected adjacent tooth

An infected tooth with pulpitis can cause infection in the adjacent teeth.

Risk of making the disease more serious

Not treating the root canal can cause bacteria in the root canal to move to the tooth root and soft tissue of the gums and jaw, leading to systemic infection and especially leading to the risk of worsening stroke, heart disease, etc.

How to perform root canal treatment

For this form of treatment to be effective, the bacteria in the teeth need to be removed in one of two ways:

• Eliminate bacteria in the dental pulp system (root canal treatment)
• Completely remove decayed teeth

Tooth extraction is rarely recommended by dentists because keeping the natural tooth is best for the patient.

After the bacteria in the tooth are cleaned, the tooth will be filled and the dentist will proceed to fill the tooth or cover it with a porcelain crown.

In the vast majority of cases, the swollen gums around a decayed tooth will heal on their own.

Before performing root canal treatment, the dentist usually gives the patient a local anesthetic. This means that the treatment process will not cause too much pain or discomfort.

This is a form of root canal treatment that has a success rate of over 90 percent. Teeth can maintain stable function for more than 10 years after being treated with this form.

The pulp is the source of life that nourishes the tooth. If the pulp is damaged or dies, the tooth will become weak, brittle and easily broken. Therefore, to ensure chewing function and aesthetics, experts advise you to consider porcelain crowns.

How to perform root canal treatment

For this form of treatment to be effective, the bacteria in the teeth need to be removed in one of two ways:

• Eliminate bacteria in the dental pulp system (root canal treatment)
• Completely remove decayed teeth

Tooth extraction is rarely recommended by dentists because keeping the natural tooth is best for the patient.

After the bacteria in the tooth are cleaned, the tooth will be filled and the dentist will proceed to fill the tooth or cover it with a porcelain crown.

In the vast majority of cases, the swollen gums around a decayed tooth will heal on their own.

Before performing root canal treatment, the dentist usually gives the patient a local anesthetic. This means that the treatment process will not cause too much pain or discomfort.

This is a form of root canal treatment that has a success rate of over 90 percent. Teeth can maintain stable function for more than 10 years after being treated with this form.

The pulp is the source of life that nourishes the tooth. If the pulp is damaged or dies, the tooth will become weak, brittle and easily broken. Therefore, to ensure chewing function and aesthetics, experts advise you to consider porcelain crowns.

Principles during and after root canal treatment

Principles during root canal treatment
When performing root canal treatment, it is necessary to ensure compliance with the principle of “endodontic triad”:

Sterilization : Ensuring sterility is the “barrier” to prevent bacteria from entering and causing cross-infection. When performing root canal treatment, it is necessary to ensure sterilization of instruments, “isolate” teeth from organic and inorganic fragments from the pulp tissue or isolate the root canal from saliva…

Cleaning and shaping the root canal according to mechanical and biological principles includes:

Mechanical principle:

• Create a continuous tapered root canal towards the root of the tooth
• The smallest diameter at the apical foramen has the reference point being the cementum-dentin boundary on the X-ray film.
• Create a smooth, tapered root canal that retains the original shape of the root canal in three dimensions.
• Maintain correct position and size of the apical foramen

Biological principle:

• The effective action of the intramedullary instrument is limited to the root canal system, avoiding damage to the root tissue.
• Avoid pushing elements such as bacteria, necrotic pulp tissue and dentin debris down the root canal.
• Avoid pushing factors such as bacteria, necrotic pulp tissue and dentin debris down the root canal.
• Complete cleaning and shaping of each root canal during each treatment
• Create a pulp cavity large enough to place intrathecal medication, and at the same time drain inflammatory exudate from the apical tissue.

3-dimensional filling of root canal treatment teeth : This helps prevent bacteria from entering, while creating an ideal environment to help restore damage originating from the tooth pulp.

Principles after root canal treatment
After root canal treatment, to keep teeth healthy and avoid complications, the following principles must be followed:

• Eat lightly, should eat soft, easy to digest foods.
• Limit chewing in the area where the root canal has just been filled.
• Use pain relievers and anti-inflammatory drugs as prescribed by your doctor.
• Brush teeth with soft bristle brush, rinse mouth thoroughly with saline solution.
• Get your teeth cleaned and have regular dental checkups to monitor the condition after root canal treatment.

Prestigious, high quality root canal treatment dentistry in Hanoi

At Domin Dental, root canal treatment is our strength. No matter what stage or level of necrosis, our team of highly skilled and experienced doctors will handle it thoroughly. In addition, with modern equipment and international standard treatment procedures, you will feel more comfortable and secure.

Can I go about my normal activities after a root canal?

Normally, after root canal treatment, you can eat and drink normally. However, doctors advise you to eat scientifically, it is best to eat soft, easy-to-swallow cooked foods such as soup, porridge, etc. to help reduce pressure on the teeth so that they heal faster.