All About Endodontics in Dentistry

Do you know about endodontics in dentistry is? This is a procedure that's decisive in the treatment of cavities in their advanced stage. Read this article to find out more about it!
All About Endodontics in Dentistry

Last update: 18 November, 2020

Have you ever heard about endodontics in dentistry? What about a root canal?

Endodontics, or a roots canal, is a dental treatment used when damage from cavities is advanced and dentists can no longer just dig it out and put a filling on it. This is mainly because it’s too close to the pulp or dental nerve. As soon as cavities become very deep, they lead to necrosis of the dental piece and inflammation of the nerve. This is known as pulpitis.

The dental pulp is the nerve of the tooth. It lives in its innermost part, providing vascularization and innervation to a dental piece. When it becomes affected for any reason, it produces occasional or continuous pain. Normally it begins to manifest with discomfort when biting and sensitivity to cold or heat. This is referred to as “reversible pulpitis.” However, when the pain is continuous, prolonged or increases at night, then we know it’s “irreversible pulpitis.”

Other reasons for carrying out this treatment may include dental trauma, fractures, abrasion or tooth erosion, or conditions such as bruxism.

Methods used in endodontics

Before performing a root canal, dentists should always try to save the piece with less aggressive methods such as:

  • Pulp protection: This is a treatment done using something similar to a provisional filling. It allows them to recover the piece conservatively while treating the pulp damage that’s still reversible.
  • A pulp coating: This is a way to isolate the exposed pulp due to the cleaning of a cavity under the filling. Dentists use a layer of medicated insulation.
  • Pulpotomy: This treatment is about partially eliminating the superficial part of the pulp, subsequently covering the exposed parts with medicinal substances.

The root canal procedure

A dentist looking inside a woman's mouth.
Endodontics is a procedure in which a dental surgeon removes the entire dental nerve from the affected part. They use local anesthesia for it.

This is the total removal of the dental nerve from the affected location. Dentists perform it under local anesthesia, removing nerves from the root canals with dental files. The dental files might be either manual. They work by doing rotary moves with the hand, or in the form of an endodontic motor that rotates at low revolutions.

The steps they follow are:

  • Local anesthesia of the piece to treat.
  • Opening of the piece until it reaches the pulp.
  • Removal of the nerve from the ducts and disinfecting them.
  • Filling the ducts with a resin or plastic.
  • A control x-ray to verify that the treatment was indeed successful.
  • Reconstruction of the dental piece.

Endodontics and dentistry in children

Dentists will always try to do a pulpotomy before performing a root canal. If it isn’t possible, then they try a treatment called “pulpectomy.” It’s the equivalent of endodontics but in deciduous or baby teeth.

A pulpectomy is also a complete removal of the pulp, followed by disinfection, instrumentation, and filling of the root canal.

The difference is that it isn’t possible to eliminate all the pulp of the duct in the baby teeth, leaving approximately 4mm at the end of it. This way, the dentist prevents possible damage to the permanent tooth that’s forming under the baby tooth.

Endodontics in dentistry: Side effects

As in all types of medical treatments, there are side effects or sequelae on the dental piece, among them:

  • Fragility and greater risk of fracture.
  • A certain change in the hue and translucency of the tooth.
  • Occasionally, a small radiolucent scar, which resembles permanent inflammation at the tip of the root.

After endodontics

A woman with a toothache.
It’s normal for pain to go away after undergoing endodontics. However, sometimes the discomfort could go on for a few days.

After a root canal, the pain should disappear since the tooth nerve is gone. However, it’s very common for the discomfort to continue until the treatment settles, approximately two or three days after surgery.

However, there are some cases in which endodontics is not a definitive treatment. This may be either due to a failure in performing the procedure, human errors, the specific anatomy of each tooth, infections, etc. If so, the most effective treatment is to redo it. In re-dentistry, dentists remove the filling of the ducts, clean them again, disinfect them and re-seal them afterward. This way, they can avoid having to extract the dental piece.

In conclusion, this treatment can allow you to keep a tooth in your mouth even when it’s very damaged. It’s very effective!

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  • Abbott PV. Endodontics – Current and future. J Conserv Dent. 2012;15(3):202–205. doi:10.4103/0972-0707.97935
  • Tabassum S, Khan FR. Failure of endodontic treatment: The usual suspects. Eur J Dent. 2016;10(1):144–147. doi:10.4103/1305-7456.175682
  • Kishen A, Peters OA, Zehnder M, Diogenes AR, Nair MK. Advances in endodontics: Potential applications in clinical practice. J Conserv Dent. 2016;19(3):199–206. doi:10.4103/0972-0707.181925