The treatment of pulpitis is called endodontic treatment (root canal treatment). It goes through several stages of varying duration, depending on how many canals are in the affected tooth and how advanced the disease is.
The endodontic treatment of pulpitis has the following stages – killing of the nerve/ relieving of the pain with an anesthetic, opening in the tooth, removal of the nerve, shaping the root canal, filling the shaped canals, and a restoration.
The treatment starts with killing of the nerve /relieving the pain with an anesthetic – at the discretion of the dentist, a medicine is applied for several days to kill and make the nerve insensible or an anesthetic is used to relieve the tooth pain.

This is due to the fact that in pulpitis, the nerve is alive and very painful on touch and there is severe pain even with just breathing in cold air, which makes impossible removing the tooth.

Only after the nerve pain is managed, an opening is made in the tooth to reach the pulp chamber and to see the root canals – this is done by going through the crown of the tooth.

Reaching the pulp chamber – scheme

Reached pulp chamber

After the nerve is exposed and visible, it is removed from both the pulp chamber and the root canals. Then the root canal is cleaned, expanded and shaped in a specific way that allows proper filling. The biggest difficulty in endodontic treatment is treatment of curvy, narrow root canals and that can cause failure of this type of treatment and the need for removal of the tooth.

Cleaning and shaping of the root canals with special instruments

In some cases, at the discretion of the dentist, a special medicine can be applied in the root canals that helps the elimination of bacteria that have caused the pulpitis.

After the root canal is shaped appropriately and the infection is under control, the next stage is filling it. A special paste with healing properties and Gutta-Percha Points are used. The purpose of the filling of the root canal is to pressurize the interior of the tooth and to prevent the entry of bacteria therein. After the root canal is sealed properly, a dental filling and perhaps an intra-root pin are used to reinforce the dental crown.

Well treated root canals – how it looks in the mouth/ x-ray of the tooth

Important! Teeth with a removed nerve change their colour and become more brittle. As a result of the endodontic treatment much of the walls of the tooth are removed, making it extremely fragile. It is therefore recommended to put metal-ceramic crowns on teeth which have been treated endodontically.

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