Complications of advanced caries or the consequences of its poor-quality treatment lead to pulpitis or periodontitis. Pulpitis is an inflammation of the nerve, in which there is unbearable pain that occurs unexpectedly from exposure to cold or hot food or when eating sweets. Often appears suddenly at night. Pulpitis can be complicated by turning into periodontitis, characterized by the destruction of the nerve. The ligament holding the tooth in the jaw is affected. The inflammatory process continues to develop, spreading to the bone tissue around the upper part of the roots of the teeth, which leads to the destruction of the bone. Pathological foci are formed - a granuloma, a cyst (in the common people - a sac with pus).
Aching, sharp pain in the tooth, possibly with swelling of the gums, cheeks, tooth mobility, increased pain at the moment of touching it, sometimes fistulas on the gums - all these are signs of periodontitis.
Sometimes injuries also lead to periodontitis. A common cause of this disease is, unfortunately, poor-quality treatment in the past (when the tooth was poorly sealed). In such cases, rapidly developing microorganisms are found in leaky closed channels. Their vital activity causes foci of bone destruction around the tooth.
Both diseases often proceed imperceptibly, without complaints, acquiring a chronic form. Sometimes they appear after stress, hypothermia or exacerbation of other diseases in the body. If the tooth does not hurt, there is no desire to treat it. Therefore, the disease begins to be treated already at a direct examination, after an x-ray examination, if pathology is present, despite the absence of complaints.
Treatment
The obligatory use of modern painkillers makes the procedure of tooth treatment painless. With advanced inflammation, it may be necessary to use an additional injection of the drug. This is another argument convincing that treatment should not be delayed for a long time. No need to wait until the tooth is thoroughly damaged and starts to hurt badly.
The cavity formed as a result of caries expands. If it is necessary to improve the view, then another access to the channel is created. Tubercles are leveled, thin walls are removed. Having reached the root canal system, they are processed, cleaned, washed with medicines, and mechanically processed. Subsequently, when filling, all removed tissues will be restored.
The most important stage of root canal treatment is its treatment. This is a responsible and laborious process. A well-treated canal is the key to successful treatment of a diseased tooth. The channel is expanded, cleaned, washed with the use of medicines. All mechanical processing is carried out with special tools. They have a certain size, shape, roughness. Dentists call them files.
The root canal along the entire length, but not further than the apex, is processed with files. It is very important to correctly determine the length of the channel. This is done using a special device - an apex locator - or by X-ray control.
After completing a thorough cleaning and drying the canal, the doctor proceeds to filling the tooth. The better the canal is cleaned, the more successful the filling.
For filling, special dental preparations are used: gutta-percha, special pastes and sealants. Gutta-percha is made from rubber and is commensurate with the size and shape of the tools that a dentist uses when filling a tooth. A gutta-percha cone covered with paste is placed into the root canal. For compaction and sealing, the cone already placed in the canal is displaced by the tool to the wall of the tooth root, a second cone, smaller in size, is inserted into the gap formed. The procedure is repeated until the appropriate density is reached. Having filled the canal with gutta-percha, the excessively protruding tops of the cones are cut off. The channel to the top is closed with a seal.
Tooth restoration
After completing the root canal treatment, the doctor decides on the possibility of restoring the tooth.
To restore a tooth, one of the methods is used - filling or applying a crown. Due to the fact that during the treatment the tooth loses a large amount of dense tissues, the doctor chooses which method is acceptable in each individual case during a direct examination after receiving the results of the examination.
Treatment of pulpitis is usually performed in one visit (1-2.5 hours). The duration of treatment depends on the degree of tooth disease.
However, sometimes the disease is complicated, the diseased tooth requires more attention. In this case, the treatment is delayed for 1-2 weeks, depending on his condition. With advanced disease, 2 or even 4 visits to the dentist are required. In one visit, the canal is cleaned, after which the tooth is temporarily filled with therapeutic pastes, closed with a temporary filling. Depending on the condition of the tooth, it can be under a temporary filling for quite a long time. The final filling is performed after the tumor subsides, the pain subsides, and the inflammatory processes stop.
In some cases, a temporary filling can be on the tooth for a long time - about six months. The paste is periodically replaced until complete recovery. In the presence of positive results of the examination, the final filling is performed. Sometimes, despite all efforts, it is not possible to restore a tooth. Then you have to truncate the top of the root, remove the root.
Not so long ago, many teeth had to be removed. Modern methods of treatment allow saving up to 80% of teeth affected by periodontitis.
Unfortunately, it is impossible to save absolutely all diseased teeth or roots, regardless of the condition of the tooth. Depending on the degree of its destruction, the decision on the possibility of saving the tooth is decided by the dentist individually in each individual case.
