Endodontics

Pulpitis is defined as the inflammation of the dental pulp (the inner part of our tooth). It can be non-destructive (acute serous pulpitis) or destructive/necrotic (acute suppurative pulpitis). The bacteria of our oral cavity (caries germs) cause this disease. Sometimes pulpitis can also be caused by chemical, thermal or mechanical stimuli (e.g. broken tooth or chewing very cold or very hot food).

Acute pulpitis is manifested by very intense pain, which lasts a few minutes or is continuous. It is usually caused after some stimulus (cold water, ice cream, etc.). A characteristic of this pain is that it continues even after the absence of the stimuli. In its serious stages (acute inflammatory pulpitis), the pain is unbearable and diffuse, especially when the patient lies down. The pain can also occur suddenly, without any stimulus.

The diagnosis of pulpitis is easy and it is based on the symptoms and characteristics of the pain, the clinical examination and the radiographic techniques (e.g. panoramic radiography/ x-ray). The disease is treatable if it is diagnosed in early stages. Therefore, it is very important to visit your dentist every 6 months!

Endodontics is a very common dental procedure, which can be curative (pulpitis, injury, caries) or adjuvant (e.g preparing a tooth to bond a bridge). The main purpose of this method, however, is to preserve the tooth as much as possible and avoid its extraction.

In addition to treating tooth decay, other conditions that can be treated with endodontics are:

• Tooth fracture with affected pulp
• Pulp necrosis
• Dental abscess

Endodontics takes place in a complete sterilized room, in one or several sessions. This depends on the stage of the pulpitis. The dentist has to fully explain how the procedure will be done and take a medical and dental history. After the diagnosis and the preparation, the dentist administers local anesthesia to the patient, isolates the tooth with a rubber dam and opens the pulp chamber. After that, the dentist takes x- rays with a measuring wire inserted into the canal, and then the length of the root canal is estimated by establishing a ratio between the length of the tooth over the length of wire inserted with the lengths found on the film. By using dental tools, the doctor removes the pulp. At the same time, the pulp is bleached with hydrogen peroxide and sodium hypochlorite solutions. When the pulp is removed, some cotton pellet moistened with eugenol is placed and temporarily sealed. Antibiotics are used for approximately 48 hours to completely eliminate the bacteria in the oral cavity. To be sure that the pulp has been completely removed, the specialists have to take x-rays during the procedure, and also after it is over for confirmation. Finally, after 10 days, the tooth is permanently sealed.

Endodontics is a safe method. However, the two most common complications that may occur are periodontal inflammation and root perforations. Both cases are treatable.