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Dentist When is a root canal treatment really necessary?
In most cases, tooth decay is responsible for treating the tooth root. Because when the destructive bacteria have made their way into the interior of the tooth, an inflammation of the tooth nerve threatens. Root canal treatment is usually performed so that the nerve does not die or the inflammation spreads to the surrounding periodontium. In an interview with the "dpa", experts explain how this is done and what chances of success exist.
Proper dental hygiene protects against tooth decay
Careful dental hygiene is the best protection against tooth decay, periodontal disease and other dental diseases. Because removing existing plaque by regular brushing and using floss as much as possible helps to keep teeth and gums healthy. Those who are not so careful with oral hygiene, on the other hand, risk unpleasant consequences. The same applies if you do not go to the dentist regularly and have your teeth checked for changes.
If the dental pulp has become heavily inflamed, root canal treatment is often the only alternative to pulling the tooth. (Image: Kzenon / fotolia.com) Bacteria can get into the tooth interior
If the caries-causing bacteria (plaque) are not removed on a regular basis, they can destroy the tooth substance and thus penetrate the tooth interior. Here they can spread and lead to severe damage to the dental pulp, which fills the inner part of the tooth. The pulp - also known as "dental pulp" or "tooth nerve" - consists of delicate connective tissue, nerve fibers, blood and lymph vessels. It extends from the crown of the tooth to the tip of the root, where the vessels and nerves emerge and flow into the jawbone.
Typical are severe pain and increased sensitivity
If bacteria invade the pulp, an inflammation develops. "This is made noticeable by acute and usually stabbing pain," explains Dietmar Oesterreich, Vice President of the Federal Dental Association in Berlin, compared to the "dpa". In addition to the strong toothache, the diseased tooth can lead to hot and cold sensitivities, biting problems and extreme sensitivity to pressure. If the inflammation is already advanced, it may progress to the jawbone and the surrounding tissue. The result is an abscess, which is recognizable from the outside as facial swelling or "thick cheek".
Tooth is dying
If not treated at the latest, the germs can continue to spread through the bloodstream in the body. In the worst case, they can even migrate towards the heart or penetrate into the brain and lead to serious illnesses, warns the Federal Dental Dentistry Association (KZBV). In addition, the dental pulp may die as a result of the inflammation and a "dead tooth" remain behind.
Elaborate intervention through curved root canals
However, root canal treatment can prevent such ill effects and preserve the natural tooth. At the beginning of the procedure the anesthesia takes place, "then the dentist drills a hole in the tooth and locates the main channels of the individual root", so the dentist Joachim Hoffmann, chairman of the board of directors proDente in Cologne. Tiny instruments are then used to remove the painful inflamed or dead tissue in the affected root canal. A sometimes complicated matter, because the channels can be bent, emphasizes Hoffmann.
Often several treatment steps are necessary
Subsequently, the cavities are cleaned and disinfected to rid them of possible germs, according to the information of the KZBV. Then the filling of the root canals takes place, whereby under certain circumstances several treatment steps may be required. Because if there is a bacterial infection, usually first a drug insert is introduced 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 crowned or crowned for better protection.
Regular checks are important
It is important to have a regular check by the doctor after the procedure. X-rays are used to examine the bone for possible inflammation. "Basically there is no guarantee of success in root canal treatment," emphasizes Hoffmann. Because the dentist can not all the risk factors such. Pretap damage to the tooth. Therefore, the patient should be informed in advance about possible possible complications.
"After a root canal treatment, on average more than 90 percent of treated teeth can still be preserved in the oral cavity 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, it is possible to pull the affected tooth - but that may mean high costs for a denture.
Health insurance companies do not cover the costs in every case
Whether the costs of root canal treatment are covered by the statutory health insurance depends on various factors. If the anterior teeth and small molars have to be treated, the funds usually cover the costs. The situation is different in the case of large molars, for example: "Statutory health insurance companies usually pay for root canal treatment when it is clear that the tooth can actually be preserved," said Oesterreich.
Patients should therefore be informed in writing about their costs by their dentist before surgery. However, these can not always be calculated exactly. Is e.g. a root canal more branched than previously thought, the treatment can be more complex and may cost several hundred euros per tooth.
Sports injuries or teeth grinding can cause inflammation
In addition to tooth decay and mechanical triggers such as a blow to the tooth during sports or teeth grinding may trigger inflammation of the dental pulp. Other possible causes include obliquely grown wisdom teeth or inadequately treated periodontitis. In order to avoid costly rooting, one should therefore e.g. use a surgical mask for risky martial arts. In general, of course, it is important to pay attention to the correct dental hygiene and to have his teeth regularly checked by the dentist for tooth decay. (No)