Inflammation of the dental pulp is one of the most feared and most painful tooth problems. If tooth decay exceeds the enamel and dentin, then it spreads relatively quickly to the center of the tooth — the pulp. Dental pulp is a connective tissue that contains a neurovascular bundle. Its inflammation is the reaction to a microbial infection. Afferent arterioles expand, which causes swelling and pressure on efferent vessels that pass through a narrow opening at the tip of the root. This increases the pressure in the pulp and nerve fibers, in addition to the inflammation component, are irritated mechanically. The pain is very intense and it can be difficult to identify which tooth is its cause.
Long-term pulp inflammation may even cause death. Bacteria inhabit the entire pulp cavity and through holes in root tips spread further into the bone and into bloodstream. Blood infections can also get to the heart or brain, where there is a danger of serious, life-threatening complications. Therefore, these infections should not be underestimated and the tooth should be treated endodontically.
The goal of endodontics is removal of infected tooth pulp, chemi-mechanical cleaning of the root canal and hermetic filling of the medullary cavity. This prevents penetration of bacteria from the oral cavity into the bone.
Endodontic treatment consists of the following steps:
· drilling the access hole
· removing the diseased and dead pulp tissue
· shaping of the root canals to remove infectious content and prepare them for filling
· filling root canals
Root canal therapy is performed under local anesthesia and is therefore painless.