Endodontics is a specialty of dental medicine that deals with the treatment of pulp or “dental nerve” disorders. The term “endodontics” derives from the Greek language from the words “endo” which means “inside” and “dont” which means tooth.

Anatomically, the tooth has a dental crown and one or more dental roots. Inside the tooth we can find the pulp chamber (at the crown level) and the root canal (at the root level). The pulp chamber and the root canal (s) are made up of blood vessels and nervous tissue that ensure the vitality of the tooth. At the time of infection or inflammation of this pulp tissue, the so-called “toothache” appears.

Infection of dental pulp (“nerve“) can be caused by:
• Dental caries not treated on time – is the most common cause;
• Dental trauma;
• Teeth with very deep obturation (fillings);
• Teeth that, for various reasons, have been fractured or a dental obturation (filling) has fallen off, thus leaving a very thin layer of hard dental tissue between the outside part and the nerve, the latter being in close contact with various agents that can sensitize it, it gets swollen and infected;
• Tooth abscess etc.

In the first stage of tooth damage, dental pain is bearable and yields to medication (Attention! once the “nerve” gets swollen or infected, the process is irreversible!!!). Dental pain may reoccur and it will be difficult to bear, it will not give up with medication or other “cure“. Sometimes, it may even start under this form of unbearable dental pain.

Symptoms of toothache are vast, and they may occur:
• short-term dental pains that occur upon contact with different chemical agents (sweet), thermal agents (cold / hot) or mechanic agents;
• persistent, intense dental pain that can irradiate towards the neck, eyes or ears;
• dental pain to the touch, the patient avoids chewing on that side and keeps his/her mouth slightly open to remove any contact with the tooth in question;
• unbearable dental pain, which does not yield to medication;
• dental pains that decrease in intensity along with the formation of dental abscess (pus bags). In case the pain disappears, it does not mean that everything is good and the patient no longer needs to go to a dental check-up. If not treated, the infection of the nerve will gradually extend to the bone where the tooth lies on the arch, leading to complications.

Regardless the toothache, the treatment is the same: removing the infected nerve from the dental canal! After the infected tissue is completely removed, an antibiotic shall be placed on the canal, and during the following session (sessions) the dental canal shall be filled/sealed with a material biologically compatible with the dental tissue represented by the natural rubber gutta percha.

The purpose of the canal treatment is to prevent bacteria from the infected dental canal from reaching the alveolar bone and for the tooth to be preserved in the oral cavity.

If the tooth has a very serious infection at the top of the root and has extremely high mobility within the bone, then the decision shall be the extraction, with the impossibility to save the tooth using endodontic treatment.

The images below will help you get an idea of what the canal treatment of an infected tooth is.

What should you do if you experience toothache before getting to the dentist? To relieve toothache, you can take analgesics such as: ibuprofen, nurofen, antineural, ketonal, etc. remembering to take into consideration the drug leaflet, some drugs being contraindicated in certain conditions. Wash the area in question thoroughly, make mouth-watering gargle (warning! do not use alcohol, it severely irritates the mucous membranes, resulting even in burns), keep cold compresses on the cheek in the area where you experience toothache, avoid eating food which is very cold or very hot and avoid applying all kinds of home remedies, because you can complicate the situation.

Contact your dentist, he is the only person to help you get rid of dental pain!

Dr. Diana Portasa

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