Root canal treatment (root canal treatment)

When it pounds and hurts in the mouth, it is often a hole in the tooth to blame. If tooth decay has spread to the tooth nerve, often only a root canal treatment can save the tooth. With the right anesthetic, the root canal treatment usually causes no pain, even if such an operation is of course not pleasant. Before the treatment, it should always be clarified with the dentist, whether the health insurance company takes over the costs of root canal treatment, because this is only under certain conditions a cash benefit.

When is a root canal treatment necessary?

A root canal treatment is usually performed by the dentist when caries has spread through the pulp to the nerve of the tooth where it has caused inflammation (pulpitis). The first signs of such pulpitis are increased sensitivity to heat and cold and severe toothache. These are caused by the fact that the tooth tissue swells and presses on the tooth nerve. The inflammation leads in most cases to a death of the Zahnmarks (irreversible Pulpitis). In rare cases, however, the inflammation may go unnoticed. This is particularly fatal, as it can lead to a spread of inflammation to the jawbone.

If the dental pulp has died, there is often only the choice between a root canal treatment or a complete removal of the tooth. Often the preservation of the tooth by a root canal treatment is the better alternative. Correctly performed procedures have a high success rate and give the treated tooth a long service life.

Procedure and duration of a root canal treatment

Root canal treatment usually takes place under local anesthesia. The area around the affected tooth is locally anesthetized, so that the patient should not feel any pain during the root canal treatment. Once the anesthetic works, the dentist must first gain access to the root canal. There he removes the damaged dental pulp, the tissue and the inflamed or dead nerve. Then the tooth canal is carefully cleaned and smoothed. Thereafter, the canal is disinfected, filled with an antibacterial drug and temporarily sealed.

At the next treatment, the tooth is finally closed, if there have been no complications. Depending on the case, the dentist will choose either a normal filling, a pin anchor or a dental crown. The latter is often also used for cosmetic reasons, because a root-treated tooth is dead and is thus no longer supplied with blood by the body. As a result, it can break faster and also takes on a greyish color over time.

The duration of root canal treatment depends largely on the number of root canals and their accessibility. In addition, how many sessions are required at the dentist also depends on the healing process of the tooth. Because only when the inflammation has completely subsided, the tooth can be finally closed. Depending on the healing process, at least two sessions are usually required until the root canal treatment is complete.

Advantages and chances of a root canal treatment

The great advantage of a root canal treatment is that in case of success, a sick, inflamed tooth with dead tooth pulp can be maintained in its normal functioning. Root canal treatment is successful in about 70 to 95 percent of all cases. The treated tooth differs only insignificantly from the rest of the teeth after treatment in its lifetime.

The likelihood of a positive outcome depends, among other things, on the size and progress of the inflammation and on the anatomy of the patient's teeth. For example, if the root canal is curved, this can be an exclusion criterion for root canal treatment.

Risks in root canal treatment

However, root canal treatment not only offers opportunities, but also involves some risks. This allows the dentist's fine instruments to break off and become stuck when working on the tooth root. Often the instruments can then be difficult to remove. When hollowing or smoothing the root, it can also happen that the tooth wall is accidentally pierced. When filling the root canal, it can also lead to overfilling of the channels, which can lead to impairment of the nerves in the lower jaw.

If not all bacteria are removed from the channels, it can also lead to a re-inflammation. In some cases, there may still be a long time after the procedure to pain on the tooth, which is why regular control appointments are of great importance. As a rule of thumb, it can be stated that root canal treatment should only be regarded as successful after two years without symptoms.

Incidentally, you should refrain from coffee and nicotine as well as physical activity in the first few days in order not to endanger the healing process immediately after the treatment.

Health insurance and root treatments

The costs of a root canal treatment are only covered by the health insurance in certain circumstances. So the services must be sufficient, appropriate and economical. Because of this, some techniques, such as a microscopic root canal treatment, are privately paid. In addition, treatments that have no clear chance of success, as well as treatment repeats are not supported by the health insurance. In addition, the roots must be able to be filled up to the tips. This is not always the case with the frequently curved roots of the molars.

If a molar is affected, however, further conditions must be fulfilled for the health insurance to cover the costs:

  • The molar must be part of a complete row of teeth without gaps.
  • The root canal treatment of the molar can prevent a free end situation - a one-sided shortening of the row of teeth to the rear.
  • By treating the molar, existing dentures can be obtained.

If this is not the case with molars, the health insurance only covers the costs of pulling the tooth. Those who still want to preserve their teeth can have the root canal treatment performed as a private service. The cost of such a treatment is about 1000 euros per tooth. For more information about financing the root canal treatment, please contact your dentist or health insurance company.

Root Canal Treatment: The 4 Best-Known Errors

The four best-known mistakes that exist around the subject of root-canal treatments are (following the DGET):

  1. Root canal treatments cause pain. Root canal treatments do not have to be painful. If the dentist sets the anesthesia properly, you will not feel pain during the procedure.
  2. Root treatments lowered the durability of the tooth. Root canal treatment does not significantly affect the durability of the tooth. A root-treated tooth hardly differs in its life from a healthy tooth. With appropriate care, he can be maintained for a lifetime.
  3. Root canal treatments make the teeth brittle. After a root canal treatment, the teeth often have to be covered with a crown or a partial crown. This is because the tooth has a greater loss of substance than healthy teeth. The resistance of the teeth, however, is not changed.
  4. Root canal treatments have only a low success rate. With a qualified dentist and enough treatment time, the success rates of root treatments are between 70 and 95 percent.
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