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The White Loft
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ENDODONTICS

Endodontics is a common treatment that allows repairing and saving a tooth. It is a procedure in the inside of the tooth and allows maintaining their natural dentition, the bone, and the gum that surround it, as well as its functionality.
Helping to preserve a natural smile, eating with comfort and with proper care, is something valuable for life. With this technique, we treat the infection, inflammation, and necrosis of the internal tissues of the tooth. It consists of eliminating a part or all of the pulp, depending on the extent of the injury. (La pulpa contiene los nervios y vasos sanguíneos).

The most common causes are untreated deep cavities or trauma. In any of these cases, the tooth can become sensitive to temperature change (cold or heat), as well as chewing. The most common causes are untreated cavities or fractures. In any of these cases, the tooth can become sensitive to temperature change (cold or hot), as well as chewing. The pain may be intermittent or constant and may lead to changes in tooth color. In cases of infection, abscesses or fistulas can appear.
Endodontics is recommended in teeth that require large carvings for the placement of crowns or bridges. It is usually done in one session but depending on the case, up to two sessions may be required.

I have a cavity. Do I need an endodontic procedure?

In the case of deep cavities, it is important to emphasize that two dental procedures can be done.

Cavities can cause nerves to die slowly, causing no pain. They produce an infection, which triggers an inflammatory reaction and destroys the bone surrounding the tooth. In these cases, the symptoms are discomfort when chewing and a slight pain in the tooth. Given these symptoms of infection, the tooth should be treated immediately, because in many cases, if the patient ignores these symptoms of mild pain, then an abscess is formed producing an inflammation in the gum. If it is severe, the patient's face may swell. The other procedure occurs if there is an acute and painful inflammation because the cavity has touched a nerve.

In both cases, the patient must go to the Dental Clinic for an endodontic procedure.  

How is an endodontics intervention performed?

It is a personalized treatment to extract infected or inflamed tissue to reconstruct the tooth effectively.

The endodontist will be examining the tooth and will make an X-ray. Subsequently, local anesthesia will be applied and then a protective film will be mounted on the area to isolate the tooth. In this way, we keep it clean and free of saliva during the procedure.

The endodontic procedure usually consists of four stages:

First, the endodontist cleans all destroyed tissues, eliminating the damaged pulp and infection.

Then, fill the hole with a biocompatible material.

Next, the tooth is sealed.

Finally, this is the most important step for the success of the endodontic treatment. After extracting the pulp, the tooth must be sealed with a composite restoration or with a porcelain crown. Depending on the case, its function is to protect the tooth to ensure its survival for many years.

How many sessions are necessary?

In most cases. Endodontic treatment can be performed in a single session, although in some cases, the patient's clinical situation, the technical difficulty of the case, or other parameters, may require two or more sessions.

How is a tooth reconstructed after endodontics?

After having completed the endodontic treatment, the patient must have another session for the placement of the sheath called incrustation. This incrustation will be made of porcelain and will protect the tooth allowing it to function properly. In cases where the tooth has severe damage, it is necessary to apply a more important reconstructive treatment to return the functionality to the tooth and not compromise its integrity. These situations can be solved with the placement of a post that helps to retain the restoration and with a cusp cover that allows chewing without problems.

The techniques of endodontics and reconstruction of the tooth allow a tooth that has received endodontic treatment to maintain functionality in the chewing and aesthetics of the mouth. In some cases, however, when the infection has affected the root or even the bone, the only solution will be to extract the tooth, so that the damage does not get worse. To avoid these situations, it is necessary to go to the dentist once a year and contact our dental clinic if you notice any dental diseases.

Is the endodontic treatment painful?

The endodontic treatment is usually painless since very effective and long-lasting local anesthesia is used. Once the treatment is finished and the effect of the anesthesia is over, some discomfort may appear for a few days, especially with chewing, due to the postoperative inflammation of the tissues surrounding the tooth. In that case, adequate post-operative medication is required.

Can I have an endodontic procedure if I have an abscess?

It can be done, but in most cases, it is the ideal treatment to solve this problem. An abscess is produced by the existence of an infectious process in the tissues surrounding the tooth, often due to a disease of the pulp (nerve). With endodontics, we eliminate the infected pulp and clean the tooth's ducts.

Can a tooth be treated again?

In cases where there are painful teeth that have been treated previously, there is usually an infectious process caused by microfiltration of bacteria or by fracture. These cases are very complex and should be evaluated and treated by an expert. In cases where the tooth or molar needs to be treated again, an extraction will be performed which consists of cleaning and disinfecting the affected tooth.

Does my tooth need any special care?

After a proper treatment of endodontics and a definitive restoration of the tooth, the tooth will be as the others both in its function and in its duration, requiring the same hygiene care, prevention, and periodic check-ups as any other tooth. In some cases in which there are previous injuries in the tissues surrounding the tooth, it will be necessary to treat them.

Are teeth more fragile after an endodontic treatment?

The endodontics teeth do not have to be more fragile than the rest, as long as they are properly restored. It is advisable to protect the cusps with adequate crowns, for greater durability. It is important to go to the dentist periodically to avoid the appearance of cavities or other factors that could influence the prognosis of the tooth. It is essential not to overdo the restoration of the teeth to avoid any complication.

Is there any alternative to endodontics?

Our first priority should be to try to maintain the natural dentition. When it is not possible, the alternative is the extraction and replacement of the tooth, but we must consider that no form of substitution, including the implant, can compete with a natural tooth in terms of aesthetics.

The only three contraindications to maintain a tooth in the mouth by means of a root canal are:

  1. Presence of a vertical fracture.
  2. The unfavorable proportion between the crown and the root.
  3. Insufficient periodontal support.

These are the only cases in which the alternative to endodontics should be evaluated.

What other cases should be treated by an endodontist?

Dental trauma without nerve exposure

Although in some fractures of teeth, or molars, there is no nerve exposure, it is very important to go to the dental clinic to be assessed and controlled by the specialist. Derived from this kind of injury, and with over the months, changes may occur bringing negative consequences to the affected teeth.

Dental fracture

Only fracture without exposing the nerve to the surface. In this case, a checkup is recommended.

Dental pain while chewing or touching

Trauma with or without fracture without exposing the nerve, producing pain while chewing or touching. It can occur when there is an inflammation of the tissues around the tooth. Therefore, an evaluation of the nerve will be required to assess whether the nerve is affected or not. Several check-ups will be required for a period of up to one year.

Dental mobility

Trauma with or without dental fracture, without exposing the nerve to the surface, can produce mobility and pain with any contact of the affected tooth. In this case, the specialist must also evaluate the tooth and the nerve, and have constant check-ups for one year.

Dental intrusion or dental extrusion

Trauma with or without fracture without exposing the nerve to the surface the tooth can get inserted in the gums, looks shorter or stands out of the gum and remains longer than normal. In both cases, it must be assessed and treated by the specialist.