Endodontics (root canal treatments)

Every tooth has the same structure. The exterior of the tooth above the gum is made from a dead, hard layer called enamel that encloses the tooth like a protective shield. Enamel is the hardest material in the human body. It is made up mostly of hydroxyapatite.

> Larger view of a model of a tooth!

Within the enamel the tooth has less hydroxyapatite and is therefore more porous. This is a living layer. It is made up of thousands of small rods that end in the pulp chamber or in the nerve canal. This layer is called dentin.

In the centre of the tooth lives the nerve and blood vessels (the pulp). The nerve extends from the pulp chamber to the apex of the tooth root. The apex, the entry point for the nerve ending, is very narrow.

The nerve lives in an enclosed space. In case of an inflammation the space cannot expand like other parts of the body to attract inflammation-inhibiting cells. If the pulp itself is inflamed, the blood vessel strangles the nerve and it dies. The decay products of the nerve can then leach out of the root tip and cause abscesses, cysts and blood poisoning. Root canal treatment is often the last resort to avoid having to extract a tooth. Root canal treatments are up to 98% successful.

Root canal treatment (endodontics) involves the gentle and sterile removal of the tooth pulp (nerve and blood vessels) as well as thoroughly cleaning and shaping the root canal. This is done using special files and needles that expand the root canal and clean the walls.

Because the tooth has several nerve canals and dentin tubules that may be infected and that cannot be cleaned using files, calcium hydroxide or sometimes other not entirely safe medicated rootfillers are often inserted into the root canal. Even so, it is not possible to adequately sterilise the root canal because these medications can only penetrate a few hundredths of a millimetre into the adjacent canals.

To achieve the best possible disinfection, we therefore use a diode laser that can penetrate up to two millimetres into the hard tooth tissue of the adjacent canals, sterilising and sealing them. In many cases this allows us to carry out the treatment in a single sitting and to avoid medications.

After eliminating the infection, the root canal is finally sealed using a two-component paste (a substance similar to epoxy resin) and a gutta percha point and the tooth crown is restored.

Because all endodonticly treated teeth can become brittle over time, we recommend having the tooth checked after 1–5 years and, depending on the tooth, to have it crowned or covered to guarantee the tooth’s stability.