What is Root Canal Treatment? | How to Treat Cavities Reaching the Nerve

Root canal treatment is performed when a cavity has progressed to reach the tooth’s nerve (pulp) or when pus has accumulated at the tip of the tooth’s root. It is commonly referred to as “nerve removal treatment” or “nerve treatment.” The goal is to save the tooth without extraction by removing the contaminated nerve and bacteria, thoroughly cleaning and disinfecting the inside of the root canal, and then sealing it with medication.

The main symptoms requiring root canal treatment are as follows:

• Severe throbbing pain
• Sensitivity to cold or hot things
• Pain when chewing
• Swollen gums
• Pus accumulation at the tip of the tooth root

If you have these symptoms, root canal treatment may be necessary. Neglecting root canal treatment carries the risk of eventual tooth extraction or bacteria spreading throughout the body. If you feel any discomfort, visit a dental clinic promptly.

Difference Between Pulpectomy and Infected Root Canal Treatment

Root canal treatment is broadly divided into two types: “Pulpectomy” and “Infected Root Canal Treatment.” At SACHI Dental Clinic, for both types of treatment, we strive to perform precise procedures using tools like microscopes and rubber dams, aiming to reduce the risk of recurrence and preserve the tooth whenever possible.

Pulpectomy – Treatment When Cavity Reaches the Nerve

Pulpectomy is the treatment performed when a cavity is large and has reached the nerve. The nerve infected by cavity-causing bacteria is removed, and the inside of the root canal is thoroughly cleaned and disinfected. We offer precise treatment for those searching for “pulpectomy Mita.”

The pulpectomy procedure is as follows:

1. Anesthesia: Local anesthesia is administered to suppress pain during treatment. Our clinic uses topical anesthesia and electric anesthesia injectors, considering the pain of the injection itself.
2. Cavity Removal: Using a caries detection fluid that stains the decayed area, the cavity is thoroughly removed. Using a microscope allows confirmation of areas difficult to see with the naked eye, enabling precise cavity removal.
3. Nerve Removal: Using specialized instruments called reamers and files, the infected nerve is removed.
4. Root Canal Cleaning & Disinfection: The inside of the root canal is cleaned and disinfected using medication. Our clinic may also use ultrasonic cleaning to enhance the cleaning effect.
5. Root Canal Filling: Once the root canal is clean, a rubber-like material called gutta-percha points is tightly packed into the canal (root canal filling).
6. Core Build-up & Crown Placement: Teeth that have undergone root canal treatment often have little remaining tooth structure and are thin. Therefore, a core is placed for reinforcement, and a crown is fitted over it.

Our clinic uses rubber dam isolation, covering teeth other than the one being treated with a rubber sheet, to prevent saliva and bacteria intrusion and perform treatment in a clean environment. We also use instruments made of a special metal called NiTi files, which allows for more precise treatment even in complexly shaped root canals. Through these efforts, we strive to improve the “root canal treatment success rate.”

Infected Root Canal Treatment – Treatment for Previously Treated or Non-Vital Teeth

Infected root canal treatment is performed on teeth where a previous nerve treatment has become re-infected, or where the nerve has died due to neglected cavities, etc. Many cases requiring “root canal retreatment” fall under this category.

The main causes requiring infected root canal treatment are:

• Incomplete treatment in a previous root canal procedure
• Bacteria entering through gaps between the crown and the tooth
• Bacteria entering through gaps around the tooth due to gum disease, etc.
• Progression of cavities or gum disease leading to pus accumulation at the root tip

Infected root canal treatment differs from pulpectomy in the following ways:

• Requires removal of previously placed crowns, cores, and medications
• The root canal often has a complex morphology, increasing treatment difficulty
• Recurrence is more common, and treatment may take longer

In infected root canal treatment, it is crucial to thoroughly remove bacteria left from previous treatments or newly intruded bacteria. Our clinic uses a microscope to meticulously observe the root canal interior, identify the source of infection, and remove it.

SACHI Dental Clinic’s Root Canal Treatment Flow

At our clinic, root canal treatment follows this general flow:

Pulpectomy Treatment Flow

1. Anesthesia & Cavity Removal

First, local anesthesia is administered to suppress pain during treatment. Then, using caries detection fluid, the cavity is thoroughly removed. Using a microscope allows for the precise removal of even small cavities that might be missed by the naked eye.

We also check for any cracks or fractures in the tooth at the same time. Cracks and fractures can not only cause pain but also affect the success rate of root canal treatment, making early detection important.

If the cavity is large and little tooth structure remains, a temporary wall (build-up) may be created using resin to facilitate placing the rubber dam. This prevents saliva and bacteria from entering the root canal during treatment, increasing the success rate.

2. Nerve Removal & Canal Cleaning/Disinfection

After removing the decay, specialized instruments called reamers and files are used to remove the infected nerve. Next, the inside of the root canal is thoroughly cleaned and disinfected using chemicals such as sodium hypochlorite. Using rubber dam isolation ensures treatment is performed in a clean environment, preventing contamination by saliva and bacteria.

Our clinic also uses instruments made of a special metal called NiTi files. NiTi files are more flexible than traditional stainless steel files, allowing them to navigate complex root canal shapes. Furthermore, using them in conjunction with a microscope allows detailed observation of the canal interior, enabling the most thorough removal possible of infected nerves and bacteria.

3. Root Canal Filling

Once the root canal is clean, the final medication is packed inside (root canal filling). Typically, a rubber-like material called gutta-percha points is used for this purpose.

The goal of root canal filling is to completely seal the canal and prevent bacterial re-entry. Incomplete filling increases the risk of recurrence, making this a very important step.

4. Core Build-up & Crown Placement

Teeth that have undergone root canal treatment are often weakened as the tooth structure itself is thinner. Therefore, a core is placed for reinforcement, and a crown is fitted over it. Various types of cores exist, such as metal or fiber posts. Our clinic proposes the optimal core and crown based on the patient’s tooth condition and preferences.

Infected Root Canal Treatment Flow

The flow for infected root canal treatment is fundamentally similar to pulpectomy, but includes the additional step of removing previously placed crowns, cores, medications, etc. Also, because infection has recurred, more cautious treatment is necessary.

1. Anesthesia & Infection Source Removal

Local anesthesia is administered if necessary, and cavities, old crowns, previously placed medications, etc., are removed. Using a microscope makes it possible to identify the source of infection and remove it as thoroughly as possible. Using a “root canal microscope” is essential for precise treatment.

Additionally, rubber dam isolation is used, covering teeth other than the one being treated with a rubber sheet, to prevent saliva and bacteria intrusion and ensure treatment in a clean environment. This reduces the risk of re-infection. Using a “root canal rubber dam” is important for increasing the treatment success rate.

2. Root Canal Cleaning/Disinfection

After removing the source of infection, the inside of the root canal is thoroughly cleaned and disinfected using medication. Our clinic may also use ultrasonic cleaning to enhance the cleaning effect. Furthermore, by observing the canal interior with a microscope and using NiTi files, bacteria can be effectively removed even in complexly shaped canals.

Especially in retreatment cases, bacteria left from previous treatments or newly intruded bacteria can hide in complex grooves within the canal. Thoroughly removing these bacteria while observing magnified views with a microscope is crucial to prevent recurrence. Therefore, the number of treatment sessions may increase.

3. Root Canal Filling

Once the root canal is clean, similar to pulpectomy, root canal filling is performed using materials like gutta-percha points. The filling material is packed tightly into the canal, leaving no gaps.

4. Core Build-up & Crown Placement

Since teeth that have undergone root canal treatment are often brittle, a core is placed for reinforcement, and a crown is fitted over it. Our clinic proposes the optimal core and crown based on the patient’s tooth condition and preferences.

Perforation Repair | Special Treatment When a Hole Forms in the Tooth

Perforation refers to a situation where a hole has formed in the tooth, either because a cavity was too large or due to accidental perforation by instruments during root canal treatment. If a perforation is left untreated, bacteria can enter through it, spreading infection, which might typically necessitate extraction.

Our clinic performs a special treatment called perforation repair to seal the hole and explore the possibility of saving the tooth. Perforation repair uses a special material called MTA cement to seal the hole. MTA cement is suitable for perforation repair due to its excellent biocompatibility and sealing properties. Even if diagnosed as needing “perforation repair,” please consult us without giving up.

However, not all perforations can be repaired. Depending on the size and location of the hole, the extent of infection, etc., extraction may still be necessary. Our clinic uses dental CT scans and microscopes to accurately diagnose the perforation’s condition and propose the optimal treatment plan.

Why SACHI Dental Clinic is Chosen | Commitment to Precision Root Canal Treatment

To provide precise root canal treatment, SACHI Dental Clinic incorporates the following equipment and technologies:

Utilization of Microscope

Our clinic uses a microscope for root canal treatments. The microscope allows us to magnify the inside of the root canal, invisible to the naked eye, by about 20 times, enabling more precise treatment. A “root canal microscope” is indispensable for increasing treatment success rates.

Precision root canal treatment using a microscope

Rubber Dam Isolation

During root canal treatment, we use a method called rubber dam isolation, covering teeth other than the one being treated with a rubber sheet. This prevents contamination from saliva and bacteria, allows treatment in a clean environment, and increases the success rate of root canal treatment. A “root canal rubber dam” is a very effective method for preventing re-infection.

Utilization of NiTi Files

Our clinic uses instruments made of a special metal called NiTi files for root canal treatment. NiTi files are more flexible than traditional stainless steel files, allowing them to navigate complex root canal shapes. Using NiTi files also enables efficient cleaning and shaping of the canal, leading to shorter treatment times. “NiTi files” make complex root canal treatments possible.

Precision Diagnosis with Dental CT

Our clinic has introduced dental CT for precise diagnosis before root canal treatment. Dental CT allows for a three-dimensional understanding of root canal morphology, lesion size and location, etc., which was not possible with conventional X-rays, enabling safer and more reliable treatment planning. “Root canal CT” examinations improve treatment accuracy and safety.

Treatment Considering Pain

Our clinic employs various methods to ensure patients can receive treatment without pain. We use techniques like topical anesthesia, electric anesthesia injectors, and fine needles to minimize the pain of anesthetic injections.

Careful Explanation and Treatment by Female Director

Our clinic prides itself on careful explanations and treatment provided by our female director. We empathize with patients’ anxieties and questions, striving for clear and thorough explanations. Furthermore, with a detailed perspective unique to a female dentist, we propose the optimal treatment for each individual patient. Even those anxious about “painful root canal treatment” can consult us with confidence.

Common Questions About Root Canal Treatment (FAQ)

Is root canal treatment painful?

Anesthesia is used during root canal treatment, so you will feel almost no pain. If inflammation is severe, anesthesia may be less effective, so we will perform anti-inflammatory treatment before starting. However, you may experience pain or discomfort after the anesthesia wears off. This usually subsides within a few days, but please contact us if the pain persists or is severe.

How many visits does root canal treatment take?

The number of visits for root canal treatment varies depending on the size of the cavity, the morphology of the root canal, the degree of infection, etc. Usually, 3-4 visits are necessary, but complex cases may require more. Our clinic strives to minimize the number of visits as much as possible by performing precision treatment using a microscope.

What is the success rate of root canal treatment?

The success rate of root canal treatment varies depending on the type of tooth, root canal morphology, degree of infection, etc. Our clinic endeavors to increase the success rate of root canal treatment by utilizing the latest equipment and techniques such as microscopes, rubber dam isolation, and NiTi files. Post-operative care is also important for increasing the “root canal treatment success rate.”

What are the precautions after root canal treatment?

Please note the following points after root canal treatment:

• Avoid chewing hard foods with the treated tooth
• Avoid touching the treated tooth with your finger or tongue
• Take prescribed medications as directed
• Contact us promptly if pain or swelling persists

How much does root canal treatment cost?

Root canal treatment is generally performed within the scope of health insurance. However, the cost may vary depending on the instruments and materials used, the difficulty of the treatment, etc. Also, the crown placed after root canal treatment can be either covered by insurance or be self-pay. We will explain the details during the counseling session.