Dental devitalization

Many people hope to avoid sitting in the dentist's chair, but paradoxically, the best way to prevent invasive procedures is through regular checkups. Even a routine examination can help assess the health of your mouth and catch potential issues early. The Dental Implant House offers comprehensive care and support, with a team of dental professionals skilled in detecting even minor disturbances in the oral cavity and addressing them promptly.  

What is tooth devitalization?

Tooth devitalization is a procedure within one of the key branches of dentistry: endodontics. This field focuses on dental surgery and the internal anatomical structures of the tooth.  

Devitalization, also known as root canal treatment, is a painless procedure aimed at treating tooth infections. These infections are typically caused by bacterial colonies infiltrating interdental spaces, often as a result of trauma, aging, or untreated caries.  

Before diving into the specifics of this surgical practice, it’s helpful to provide a brief overview of tooth anatomy to better understand the structures involved. Let’s take a closer look!

Outline of the anatomy of the tooth

A tooth is a bony structure composed of multiple layers and components, each located at different depths and serving specific functions. A tooth consists of:

• The crown: The uppermost and visible part of the tooth, easily seen from the outside.

• The root: The innermost section, which anchors the tooth to the bone and jaw, ensuring it remains in a stable and secure position.

• The enamel: The hard outer covering of the tooth that protects it from impacts, scratches, and trauma.

• The dentin: A softer material located beneath the enamel that, together with the enamel, forms the main structure of the tooth.

• The cementum: A layer that covers the surface of the root, helping anchor the tooth to the surrounding bone via the periodontal ligament.

• The dental pulp: The innermost tissue, often referred to as the "heart" of the tooth, containing nerves, blood vessels, and connective tissue.

Dental devitalization: why it is necessary

Devitalization becomes essential when the dental pulp becomes inflamed or infected, often due to deep decay or a chipped or broken tooth.  

In many cases, trauma to a tooth can damage the pulp without any visible external signs. This allows the inflammation to progress silently, eventually leading to pain, infection, and, in severe cases, a dental abscess.  

Before performing a devitalization procedure, the dentist must conduct specific diagnostic tests, such as x-rays or panoramic dental imaging. These examinations provide a detailed view of the oral cavity, helping to detect hidden caries, abscesses, or fractures. Early detection enables timely intervention, preventing the necrosis of the affected tooth.  

Infection or inflammation in the pulp typically causes intense pain, especially when chewing or consuming hot or cold drinks. However, as the infection advances, symptoms may suddenly disappear. Unfortunately, this is not a sign of recovery but indicates that the infection has reached the root canal, necessitating immediate treatment.

Subsequently, symptoms such as gingival swelling, pus accumulation and discharge, swelling of the facial area near the affected dental arch, and discoloration of the tooth may occur.  

For this reason, it is crucial to consult your trusted dentist at the onset of these symptoms, even if they are only moderate. Early intervention allows for the correct therapy to address the problem effectively. 

Devitalization: how it is performed

Devitalization is a multi-step procedure. It begins with a preparatory phase that includes diagnostic examinations, such as dental radiographs, to determine the exact cause of the tooth's necrosis and assess whether the tooth requires removal. This initial step is essential for planning the appropriate course of treatment.  

The procedure begins with the administration of a local anesthetic, injected directly into the gum to numb the entire section of the oral cavity undergoing devitalization.  

Once the tooth and surrounding gingiva are fully anesthetized, the endodontist places a small rubber sheet, known as a dental dam, around the tooth. This isolates it from saliva, preventing accidental ingestion of any substances used during the procedure.  

Next, the crown of the tooth is incised to access the pulp. Using specialized surgical instruments, the pulp is completely removed. If purulent material is present, the dentist will drain it to thoroughly clean the tooth and eliminate any abscess.  

After the pulp is removed, the root canal is widened to facilitate filling in the subsequent steps. This phase of the procedure can take several hours. As a result, devitalization is often performed over multiple sessions. Between sessions, the dentist may apply antibiotic or anti-inflammatory medication within the canal to prevent bacterial growth and the recurrence of pus formation.  

The next session focuses on filling the root canal with a biocompatible material, while simultaneously removing the medication previously placed inside. At this stage, the opening is typically sealed with a temporary filling.  

The final session of devitalization involves reconstructing the tooth crown. Materials such as metal, porcelain, ceramic, or reinforced glass are used to create a durable, permanent filling.  

Following the procedure, the recovery phase begins, requiring the patient to follow specific post-operative guidelines. For instance, the dentist may advise avoiding chewing on the treated side to protect the newly restored tooth structure.  

Additionally, the patient must maintain proper daily oral hygiene, undergo regular professional cleanings, and limit the consumption of sugary foods. Eliminating habits like smoking is also strongly recommended to preserve oral health and support long-term success of the procedure.

Devitalization: the results of the surgery

It can be easily argued that devitalization is nothing less than a decisive and absolutely effective surgical procedure: in general, it saves the tooth by eliminating the infection at the root.

Data belonging to the medical literature confirm that 90 percent of teeth treated by devitalization can have a life of about 10 years before they are replaced, but in some cases they may be the final solution.

Obviously, this parameter will be influenced by the patient's oral hygiene, the chewing force imparted during meals, and the number of natural teeth in the oral cavity.

In addition, devitalization is a surgical treatment that can be repeated in case of recurrence or if the health status of another tooth requires it.

This treatment is suitable for all patients, including pregnant women. However, extra care is taken during the diagnostic phase. For pregnant patients, any necessary dental x-rays are performed with the use of a lead apron to protect the fetus from prolonged radiation exposure, which could potentially impact its genetic development.