2021-05-20 08:34:11
Tooth pain is triggered when the tooth nerve is reached. A deep cavity can be the cause, as well as a fracture or crack. This nerve circulates in a tissue called the pulp, itself located in the canal of each root. “When the pulp is too inflamed, we cannot treat it. We have to remove it, which is called a pulpectomie “, explains Dr. Elie Sfeir, vice-president of the union Dental Union, in charge of training.
Definition: what is the devitalization of a tooth?
The devitalization of a tooth is an act which consists in extract all the pulp tissue, then clean and disinfect the inside of the root canals.
in a tooth, the pulp represents the vital element.“It’s what gives it its sensitivity to hot and cold, it gives it its mechanical resistance. It triggers pain in case of caries. This is a real alarm signal, ”says the doctor.
Is a devitalized tooth “dead”?
Even devitalized, a tooth is not useless. And it is in this sense that one cannot say that she is “dead.” “It is possible to preserve it for a long time,” says Dr. Sfeir. “And above all, it remains functional since it still allows you to chew, smile and talk”.
Devitalization of a tooth: how does the dentist proceed?
The intervention usually takes place under local anesthesia. To remove the pulp, the practitioner is obliged towiden the canals of the tooth, as Dr. Sfeir explains: “this treatment called reaming consists of “sweeping” the canal by planing the edges to clean the walls”. Its mechanical action eliminates bacteria that may have lodged in the canal.
It also makes it possible to clear enough space to introduce a filling material, a cement or a paste.
On a necrotic tooth, there is no systematic need for local anesthesia. But the tooth could have become infected without an alarm signal going off. In this case, the dental surgeon will carry out a “canal disinfection”. A disinfectant solution introduced into the canal will eliminate the bacteria causing the infection. The channel will then be sealed.
Another precision, the devitalization of a tooth does not require the taking of antibiotics, except in certain very specific cases, for example in people at high risk of infectious endocarditis or immunocompromised.
Can it hurt, cause pain?
The devitalization of a tooth can cause a swelling and pain when chewing which will disappear in a few days. Painkillers may be prescribed by the dental surgeon.
Should a dental crown be placed on a devitalized tooth?
“Historically, the reflex was to put a crown on a devitalized tooth. But we do it less and less. Today, restorative materials have evolved in mechanical and aesthetic qualities. We can make a bonded and aesthetic piece, an inlay or an onlay, which will replace what has been destroyed by decay,” says the dental surgeon.
For what ? Because this allows the tooth to be kept longer and to preserve its enamel, that is, its strongest structure. It is a principle of tissue economy. However, if the residual walls of the tooth are too thin after the devitalization, it is still necessary to place a crown to ensure the solidity of the tooth”, specifies the dental surgeon.
Are there alternatives to dental devitalization?
L’endodontie, this specialty of dental surgery devoted to internal tooth treatments, continues to progress. Within certain limits, it offers alternatives to devitalization.
Today, new endodontic techniques make it possible to delay the devitalization of a tooth. The practitioner remains the sole judge of the possibility of using it, depending on different parameters and clinical signs. You should know that this is not always effective because we lack hindsight. Nevertheless these are future treatmentsobserve le Dr Sfeir.
Devitalization: what are the consequences (caries, infection, etc.)?
A tooth without pulp risk, over time, of drying out. And, after boring, its walls are less resistant. It will therefore inevitably be more vulnerable to attacks. This results in a higher risk of fracture or infection.
In the longer term, beware of the risk of infection. Indeed, during devitalization, the dental surgeon cleans and disinfects the canals. “But we can neither completely empty the tooth nor sterilize it,” emphasizes Dr. Sfeir. In the long run, bacteria may persist in areas inaccessible to the dental surgeon, and eventually trigger an infection and an abscess. In this case, a new visit to the dental office is necessary.
What is the lifespan of a devitalized tooth?
“Devitalization is a way of prolonging the life of a tooth, but in any case, to make it invulnerable. This is why dental surgeons have strongly focused their message on prevention and dental hygiene for many years. In respecting quality brushing (duration, frequency and effectiveness), the risk of caries appearing decreases. Visits upstream of the pain allow the interception of cavities at an early stage, which will avoid the most damaging and expensive treatments: root canals and prostheses,” concludes Dr. Sfeir.
How much does a tooth root canal cost? Is it reimbursed?
A devitalization costs between 30 and 80 euros depending on the devitalized tooth. Social Security pays for 70% this dental treatment, on a basis that varies according to the tooth treated: canine, incisor, molar or premolar.
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