Drs. Buchholz and colleagues
Oral Surgery Specialists
Areas of expertise: endodontics
out-patient surgery

What is endodontics?
Endodontics involves the treatment of the tooth pulp and also is referred to as root canal treatment. The objective is to conserve severely diseased and deeply compromised teeth using state of the art methods.

Below we have compiled a number of FAQ regarding endodontic treatment for your reference.


What are the indications for root canal treatment?

Healthy teeth are made up of a crown and one or more roots. The crown and root(s) are filled with tooth pulp (or pulpa or nerve) that consists of connective tissue, blood vessels and nerve fibers.

If the exterior of the tooth is damaged, for example, by deep caries or a defective filling, bacteria can invade the pulp and cause painful inflammation that destroys the tissue. If the bacteria penetrate the pulp even deeper, the jaw bone in the area of the root tip can become infected. The body’s natural defenses react to the invasion of bacteria by creating a suppurative focus at the root tip that can be painful and affect diverse parts of the body if the bacteria and their metabolic products disseminate via the bloodstream.
The only way to combat such an infection and conserve the diseased tooth permanently is endodontic treatment.

What is the goal of root canal treatment?
Root canal treatment is performed to remove the diseased tissue from the root canal system, kill the bacteria and cleanse the root canal system. After this process, a tight filling ensures that bacteria no longer can penetrate the area.
No two teeth are the same. A tooth’s root canal system can be extremely complex because most canals are not round but have irregular shapes and are bent. In addition to the main canals there are many small side canals as well as ducts, convexities and other obstacles. Traditional methods typically clean and fill only parts of the canal system; the other parts of the fine network of roots cannot be freed from bacteria completely without the aid of a surgical microscope. This results in new inflammation foci. However, this outcome can be avoided when treatment is provided by an experienced specialist.
Root canal treatment requires time, experience and know-how. Only a specialist fully familiar with state of the art techniques and methods who undergoes continuous training can guarantee the long-term success of such treatment.

What does root canal treatment include?
1. Clinical examination and diagnostic X-rays
The affected tooth and the mechanism that supports it are examined thoroughly to allow an accurate diagnosis of pulp disease. X-rays provide the dentist with information about the length and curvature of the root canals and the extent of the inflammation at the root tip.
2. Eliminating the pain
In modern endodontics, root canal treatment is seldom painful, even in the presence of acute inflammations. Local anesthesia ensures that the patient is pain-free quickly.
3. Isolating the tooth using a cofferdam
The purpose of the treatment is to free the root canal system from bacteria. To prevent new bacteria, for example, from the saliva from penetrating the tooth, the tooth must be isolated by means of a latex cloth referred to as cofferdam. This process does not cause any pain. It enables the dentist to work without the risk of infection and protects the patient against swallowing liquids used during the treatment.
4. Accessing the root canal system
After the caries has been removed, the dentist creates a cavity to access the root canals through the crown. Due to severe calcification, root canals often are difficult to detect. In other cases, they branch out at the very bottom of the tooth. The dentist uses a microscope to map the tooth structure by enlarging and illuminating the canal system. The entrances of the canals are carefully detected with fine, flexible instruments. The length of the root canals is determined with X-rays and/or an electronic measuring device.

5. Preparing and cleansing the root canal system
Since most root canals are bent to some extent, the use of highly flexible instruments for preparation and mechanical cleansing is essential. These instruments can be operated manually or mechanically. In addition, the root canal is rinsed with diverse chemical solutions to remove any residual tissue and kill remaining bacteria.

6. Inserting medication
If required, after preparation and cleansing the dentist will insert medication into the tooth to kill the bacteria in a more targeted manner.
7. Filling the root canal
Once the entire root canal system has been prepared and fully cleansed, it is filled tightly and three-dimensionally to prevent bacteria from penetrating. To fill all the cavities in the entire system tightly, the dentist employs state of the art techniques using heated plastifiable materials. The results of the root canal procedures are examined using repeated X-rays to ensure that the healing of inflammation at the root tip is complete.

8. Closing the access cavity and restorative treatment
Since the treatment results in significant loss of the hard tooth substance, the tooth is stabilized with an adhesive filling (using a hard tooth substance) which also serves to seal the filled root canal system optimally. Since hard tooth substance is often impaired, teeth with treated root canals are prone to fractures and, therefore, should be protected with a crown or partial crown to restore their stability, functioning and aesthetics.
9. How long do teeth last after root canal treatment?
If the root canal treatment was successful and included correct restorative treatment and a healthy tooth-supporting mechanism, with good care and regular check-ups teeth with treated root canals can last a lifetime.
10. How much does root canal treatment cost?
The cost depends on the level of difficulty and the duration of the treatment. Therefore, the cost is based on the time spent in accordance with the scale of fees for dentists. As a rule, a cost plan is prepared prior to every endodontic treatment so that the cost to the patient is absolutely transparent and the percentage reimbursed by health insurance can be clarified in advance.

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