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Dentist: when is root canal treatment really necessary?

Dentist: when is root canal treatment really necessary?


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Root canal treatment can be the last chance in case of tooth infection
In most cases, tooth decay is responsible for treating the tooth root. Because if the destructive bacteria have made their way into the interior of the tooth, there is a risk of inflammation of the tooth nerve. So that the nerve does not die or the inflammation spreads to the surrounding tooth structure, a root canal treatment is usually carried out. In an interview with “dpa”, experts explain how this is carried out and what chances of success there are.

Proper dental hygiene protects against tooth decay
Careful dental hygiene is the best protection against tooth decay, periodontitis and other dental diseases. Because if existing dental plaque is removed as completely as possible by regular brushing and the use of dental floss, this helps to keep teeth and gums healthy. On the other hand, if you don't take oral hygiene very seriously, you risk unpleasant consequences. The same applies if you don't go to the dentist regularly and have your teeth checked for changes.

Bacteria can get inside the teeth
If the caries-causing bacteria (plaque) are not removed regularly, they can destroy the tooth structure and thus penetrate into the interior of the tooth. Here they can spread and cause severe damage to the tooth pulp, which fills the inner part of the tooth. The pulp - also known as "dental pulp" or "tooth nerve" - ​​consists of sensitive connective tissue, nerve fibers, blood and lymphatic vessels. It extends from the crown of the tooth to the tip of the root, where the vessels and nerves emerge and open into the jawbone.

Severe pain and increased sensitivity are typical
If bacteria penetrate the pulp, inflammation occurs. "This is noticeable through acute and mostly stinging pain," explains Dietmar Oesterreich, Vice President of the Federal Dental Association in Berlin, to the "dpa". In addition to the severe toothache, the sick tooth can cause hot and cold sensations, discomfort when biting and strong pressure sensitivity. Once the inflammation has progressed, it can spread to the jawbone and the surrounding tissue. An abscess develops that can be recognized from the outside as a facial swelling or “thick cheek”.

Tooth threatens to die
If treatment is not carried out now at the latest, the germs can spread further through the bloodstream in the body. In the worst case, they can even move towards the heart or penetrate the brain and lead to serious illnesses, warns the Federal Dental Association (KZBV). In addition, the dental pulp can die as a result of the inflammation and a “dead tooth” can remain.

Elaborate intervention through curved root canals
However, root canal treatment can prevent such bad consequences and preserve the natural tooth. At the beginning of the procedure, anesthesia is carried out, "then the dentist drills a hole in the tooth and locates the main channels of the individual roots," says dentist Joachim Hoffmann, CEO of the proDente initiative in Cologne. The painfully inflamed or dead tissue in the affected root canal is then removed using tiny instruments. A sometimes complicated matter, because the channels can be strongly curved, emphasizes Hoffmann.

Several treatment steps are often necessary
The cavities are then cleaned and disinfected to free them of any germs, according to the KZBV. The root canals are then filled, whereby several treatment steps may be necessary. If there is a bacterial infection, a medicinal insert is usually first inserted into the root canal. If the root canals are free of bacteria, they can then be sealed with a special mass. After the root canal treatment, the tooth should be provided with a crown or partial crown for better protection.

Regular checks are important
It is important to have a regular check up by the doctor after the procedure. The bone is checked for possible inflammation using X-rays. "Basically, there is no guarantee of success with root canal treatment," emphasizes Hoffmann. Because the dentist cannot take all risk factors such as Affect previous damage to the tooth. Therefore, the patient should be informed in advance about possible possible complications.

"After root canal treatment, an average of more than 90 percent of the treated teeth can still be kept functional in the oral cavity even after ten years," explains Christian Gernhardt in an interview with the news agency. Gernhardt is President of the German Society for Endodontology and Dental Traumatology (DGET) in Leipzig. Alternatively, there is the option of pulling the affected tooth - but this may mean high costs for a denture.

Health insurance companies do not always cover the costs
Whether the cost of root canal treatment is covered by statutory health insurance depends on various factors. If the front teeth as well as small molars have to be treated, the health insurers normally pay the costs. However, the situation is different for large molars: "The statutory health insurance companies usually pay for a root canal treatment when it is foreseeable that the tooth can actually be preserved," said Austria.

Patients should therefore be informed of their costs in writing by their dentist before the procedure. However, these cannot always be calculated exactly. Is e.g. If a root canal is more branched than previously assumed, the treatment can be more complex and may cost several hundred euros per tooth.

Sports injuries or gnashing of teeth can also cause inflammation
In addition to caries, mechanical triggers such as a tooth blow during exercise or gnashing of teeth can cause inflammation of the dental pulp. Other possible causes are crooked wisdom teeth or insufficiently treated periodontitis. In order to avoid time-consuming root canal treatment, one should e.g. use a mouthguard for high-risk martial arts. In general, of course, it is important to pay attention to correct dental hygiene and to have your teeth checked regularly for tooth decay by the dentist. (No)

Author and source information


Video: Guide to Endodontic Root Canal Surgery American Association of Endodontists (June 2022).


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