Endodontics (from the Greek roots endo- “inside” and odont- “tooth”) is the dental specialty concerned with the study and treatment of the dental pulp.
The word Endodontics is originally from the Greek words endo- (inside) and odont- (tooth). Endodontics (known as root canal) treats the dental pulp, in other words, endodontics is the area of Dental Medicine responsible for the prevention, diagnosis and treatment of the dental pulp pathology and its sequelae.
The dental pulp is the inner most structure of the tooth, constituted by nerves, blood vessels, fibers and conjunctive tissue and it fulfills a channel system from the tooth crown until the tip of the roots where it connects with the tissues surrounding the teeth. The pulp represents a fundamental role during the development and growth of the tooth, however, once the development is over, the tooth may survive without the pulp, as it continues Beijing nurtured by the surrounding tissues.
Generally, the main objective of endodontic treatment (root canal) consists on the maintenance of the tooth’s vitality; in the preservation and restoration of the tooth which presents an infected dental pulp and also, in the preservation and restoration of the teeth already submitted to a prior endodontic treatment but where the total elimination of the bacteria responsible for secondary inflammation wasn’t possible, therefore, an endodontic retreatment is necessary.
There are several causes responsible for the dental pulp destruction, namely, dental cavities, periodontitis (gum disease), dental fractures among others.
The infection of the dental pulp results in an abnormal sensitivity to cold and/or hot food or drinks, spontaneous pain, pain when chewing, exacerbating pain when the patient is in the lying position, emergence of edema (swelling), abscess with or without fistula. However, there are cases where the infection in the dental pulp does not present symptoms. In situations where infection caused a big destruction of the tooth, which makes its recover practically impossible, dental extraction is the only alternative. Thus, the endodontic treatment is done in order to prevent the bacterial recontamination of the tooth, allowing the tooth to be permanently restored and continue its function in the mouth.
Over the years there has been great advances in the Endodontic field that allow to reduce the levels of bacterial infection, namely new chemical agents and biomechanical preparation techniques that improve the cleansing and conformation of the dental channels’ system. The increase of the dental channel treatment efficiency is due to the emergence of rotational instruments (mechanized files) that allow bigger ease, efficiency and safety in the cleansing and removal of the infected tissue present inside the tooth. Another significant innovation in Endodontics is related to the optical microscope usage, that can be used in all phases of the treatment, allowing to see possible anatomical variations or obstructions that may be hampering the correct disinfection and preparation of the inside of the tooth.
Currently, with the presence of the new materials and techniques, it is possible to do an endodontic treatment in almost every tooth, except scarce exceptions like the presence of calcified channels, fracture of the root of the tooth, impossibility to restore the tooth, absence of bone support, etc. However, you can save teeth that many years ago would be considered lost. Also due to all these advances, most patients feel comfortable during all phases that constitute the endodontic treatment.
Opinion article from Dr. Manuel Pinto de Almeida Read Dr. Manuel Pinto de Almeida’s opinion article published in the newspaper “Jornal de Notícias”: "Currently oral health is an important problem of public health. Good oral health is associated to the general...