Endodontics is the specialty associated with the famous tooth decay, abscesses, and also with dental infections, focusing on the diagnosis and treatment of the nerves and tissues surrounding the roots of the teeth.

This specialty comes into play when decay begins to reach deeper parts of the tooth, leading to inflammation of the nerves, which causes sensitivity and discomfort.

In cases where the situation is irreversible, the tooth is devitalized, and at the end of the treatment the tooth is generally restored with temporary material until definitive rehabilitation is carried out.

What symptoms should I look out for?

If you experience severe pain in large areas of your face, prolonged sensitivity to heat and/or cold, pain when chewing or touching your tooth, tooth color change, or swelling of the gums, it is important to see a dentist as soon as possible to evaluate the need for treatment.

Is it important to restore the tooth after devitalization?

It is important to restore a devitalized tooth immediately after treatment to regain chewing function and strength. Otherwise, the risk of fracture increases significantly, which can result in the need for extraction and loss of the entire investment made in the treatment.

What treatments are performed in Endodontics?

An Endodontist is responsible for treatments such as:

• Root canal treatments
• Diagnosis and treatment of complex root anatomy cases
• Periapical surgery using a clinical microscope
• Root canal retreatment, when it is necessary to correct an already devitalized tooth that presents problems.

These procedures are more complex than the first devitalization and are best performed by a specialist to increase the chances of success.

Why is it important to treat a tooth that has lost its vitality?

The goal of endodontic treatment is to preserve the tooth by restoring healthy tissues.

This includes removing all tissue, whether living or not, from the pulp chamber and root canals, and sealing them to prevent pain, inflammation, and infection.

This treatment is an important part of tooth preservation.

Can an X-ray indicate whether endodontic treatment is necessary?

In many cases yes, such as when deep caries is detected, periapical images such as granulomas or small cysts, and old root canal treatments performed poorly.

However, in some cases, the radiograph may not be informative enough and clinical observation, along with pulp vitality tests and the patient’s complaints, will be decisive in determining whether or not to perform endodontic treatment.

What is the impact of tooth loss?

By devitalizing a tooth, its resistance to fracture may be reduced due to its state of fragility.

Also, in some cases, teeth may become darker over time due to the loss of their vitality.

Should I protect the tooth with a dental crown after root canal treatment?

It is important to protect the tooth with a dental crown after root canal treatment, especially on posterior teeth, premolars and molars, which are subject to greater chewing pressure.

When a tooth needs to be root canalized, it usually means that there has already been a great loss of tooth structure. With root canal treatment, the tooth becomes even more fragile, as it loses its internal nutrition.

If it is not protected with a crown, overlay, or intraradicular pin, there is a risk of the tooth suffering a fracture that extends to the root, which may result in the need for extraction.

This means that all the investment made in the root canal treatment will be lost, and it will now be necessary to place an implant and a crown over it.

After a root canal treatment, can a devitalized tooth reappear with symptoms?

Yes, if the fillings are not done correctly, there is a risk of causing pain to patients. If the outer surface of the tooth after treatment shows an imbalance in occlusion, i.e. is higher, chewing hard food can cause pain.

To avoid this, it is important to check that the tooth is not “high” after the restoration and that when you close your mouth there is no change. If there is any abnormality, mention it to your dentist before you leave the appointment. He or she should make sure that everything is correct.