Root canal treatment (Endodontics)

Endodontics is a field of dentistry focused on the treatment of the tooth’s root canals. Endodontic treatment is typically required in cases of severe tooth decay, pulpitis, dental trauma, or prior to prosthetic treatment.

Symptoms of root canal issues may include persistent sharp or dull pain, discomfort when biting or chewing food, and sensitivity to hot or cold substances. When the pulp that fills the tooth cavity is affected, symptoms may also include enamel discoloration, gum redness, and swelling.

If such symptoms appear, it is strongly recommended to consult a dentist immediately, as pain usually indicates significant damage to the tooth. That’s why regular preventive check-ups are essential for maintaining oral health.

When is endodontic treatment necessary?

Root canal treatment is prescribed in the following cases:

• Deep tooth decay, which often requires the removal of the dental nerve
• Acute or chronic pulpitis – inflammation of the tooth's connective tissue (pulp), which causes pain (dull or sharp), sensitivity to cold, heat, or sweets, enamel darkening, as well as swelling and bleeding of the gums
• Periodontitis – inflammation of the tissues surrounding the tooth root, where a purulent cavity forms and intense pain occurs
• Preparation for prosthetics – removal of the pulp (nerve) may be necessary before placing crowns or dentures

In certain cases, endodontic treatment may be considered inappropriate. Contraindications include vertical root fracture, irreversible periodontal damage, and cases where the tooth cannot be restored.

Goals of endodontic treatment

Endodontic treatment aims to achieve the following:

• Removal of infected tissues (pulp and dentin) from the root canal and periapical tissues
• Preparation of the root canal for filling
• Sealing of the root canal

Endodontics is divided into primary and secondary treatment. Primary treatment involves mechanical cleaning of the canal and sealing it. Afterward, restoration of the tooth crown is performed using filling materials or post-and-core systems. If the filling occupies a large portion of the crown (about 2/3), prosthetic treatment may be required.

Secondary endodontic treatment is necessary when primary treatment has failed. It involves the removal of the old filling material, thorough canal cleaning, and re-filling. The goal is to reduce inflammation, eliminate chronic pain, and preserve the tooth. However, secondary treatment is more complex, and its outcomes are not always stable, so ongoing monitoring by a dentist is crucial to prevent further infection.

If the necessary treatment is not carried out in time, it can lead to irreversible tooth damage requiring prosthetics or implants.

Main stages of root canal treatment

Endodontic treatment is a process that consists of several stages and requires precise adherence to a specific protocol:

1. Diagnosis. The patient in need of endodontic care undergoes a full examination. In addition to a standard visual check and clinical testing, the tooth’s vitality is assessed, and periodontal probing is done to detect possible vertical fractures. Computerised tomography (CT) may also be used. Assessing the condition of the tooth and predicting treatment outcomes are crucial. If a crown or post is present on the tooth, these structures must be removed.

2. Preparation. Preparatory measures may include treating concomitant periodontal conditions, filling carious lesions (not related to endodontic access), and rebuilding destroyed tooth walls. If the patient has excessive salivation, atropine mouth rinse may be administered 30 minutes before the treatment begins.

3. Treatment process. The procedure starts with local anesthesia. The dentist then opens the carious cavity to access the endodontic entrance. The pulp and debris are removed, and access to the root canal is provided. An apex locator and X-ray imaging are used to determine the exact length of the canal. The canal is then cleaned with special instruments and solutions. If there is inflammation in the periodontium, it is addressed. After cleaning, the canal is sealed. The final stage involves restoring the coronal portion of the tooth, which should be completed no later than two weeks after the procedure.

4. Follow-up. The result of the treatment often cannot be fully evaluated immediately, so the patient undergoes a CT scan six months later. Further check-ups are scheduled for 1, 2, and 4 years post-treatment. If apical pathology progresses, apical surgery with revision and outcome control may be necessary.

It is not recommended to complete endodontic treatment in a single visit. This process usually takes several days or weeks. After completing the treatment, it is important to restore the tooth’s anatomy and function. This may be done using filling materials or prosthetic constructions.

Why choose Gallant?

Our clinic offers advanced treatment methods using modern equipment and tools to ensure accurate diagnosis and complete control over the procedure.

Endodontic treatment at Gallant is performed according to high standards and involves the latest advancements in dental care. We use top-quality medications to eliminate inflammation, and the filling materials are chosen individually for each case.

Every treatment decision is based on a thorough analysis of the specific condition of the affected tooth.

The use of modern tools and sterilisation techniques ensures comfort during the procedure, and advanced anaesthetic methods guarantee a painless experience. Thanks to all of this, our endodontic treatment meets the highest expectations.