Recent research has suggested that the majority of patients would opt for endodontic treatments that would preserve their natural teeth rather than having them extracted and replaced with dental implants.
Indeed, with a consistent success rate of approximately 90 per cent, modern endodontics is the most effective means of treating and maintaining patients’ natural teeth. And a person’s natural teeth are an indescribably precious commodity. They provide better function than implants and are infinitely more effective than bridges and dentures. Taking masticatory efficiency as an example, it has been shown that fully dentate patients have a far greater bite force than both implant patients and those with dentures. This allows for far better quality of life and helps sustain a healthy, balanced diet – as well as boosting self esteem – making these treatments a far better course of action to preserve an individual’s natural teeth rather than replace them.
As we are all aware, endodontics is a GDC-recognised specialism and, as such, requires training beyond a standard BDS degree. This training lasts for a minimum of two years, after which a practitioner will have acquired the necessary skills to provide safe and efficient endodontic treatments. Despite this, less complicated endodontics are an option available to GDPs and, thanks to the quality of training available – not to mention the standard of endodontic products now on the market – the results that can be achieved by those who have not undergone specialist training are impressive.
Indeed, the tools that are necessary to perform endodontic procedures can make all the difference between a successful treatment and a failure – making it very important for any professional undertaking endodontics in their practice to be aware of the items they need for best practice.
For example, it is necessary to use a front surface reflecting mouth mirror to prevent the double image of the fine detail in an access cavity that can occur with a conventional mirror. Also, the use of endolocking tweezers is advised, in order to safely transfer small items between practitioner and nurse. An endodontic probe is similarly vital, in order to detect canal orifices.
Practitioners should also make use of rubber dams. These are important in providing an isolated operatory field free from oral contamination, as well as preventing patients from accidently swallowing or inhaling small root canal instruments.
While it may seem like a relatively minor consideration, it is also important to use suitable protective coverings for the patient’s clothes – since the accidental spillage of sodium hypochlorite can lead to complaints and even litigation.
An endodontic practice will also require a long-cone parallel radiographic system. This has been shown to be the most effective form of radiography for endodontic cases, since it allows practitioners to capture an undistorted view of the teeth and surrounding structures. Another benefit is that this system easily allows repeats, allowing for a more accurate assessment of periapical healing.
Of course, digital radiography is now being used to exceptional effect and many modern systems can be preset specifically for endodontic requirements. This technology also allows practitioners to view scans almost instantaneously, effectively streamlining the diagnostic process and allowing for a better standard of care.
Obviously, endodontic treatments are conducted on an incredibly small and complex level. Therefore, magnification is particularly useful and many practitioners opt for using dental loupes or surgical microscopes in order to complete even more intricate procedures.
A practitioner must also choose an appropriate endodontic handpiece. As always, it is vital to find a handpiece that will suit an individual’s ergonomic and clinical needs – one that will be reliable and effective and, crucially, cost effective. Low-speed models, with precise torque control and auto-reverse are ideal for endodontics, as are models with ‘micro’ heads to improve operatory visibility.
Along with this, practitioners must choose a file system that they can rely on to achieve excellent canal shaping and debridement. Often, it is the quality of the file that determines the overall success of the treatment, making the choice of instrument incredibly important.
The new HyFlex EDM NiTi file from COLTENE is an excellent example of a high quality endodontic file. With over 700 per cent higher fracture resistance than previous files, this product allows for precise and reliable canal shaping, shorter treatment times and better overall results.
When it comes to endodontics, dental professionals should have a varied toolbox at their disposal, comprised of the best products available. With these in hand, patients can receive first-class treatment and pain relief.
 D. Re et al. ‘Natural tooth preservation versus extraction and implant placement: patient preferences and analysis of the willingness to pay.’ British Dental Journal 222, 467 - 471 (2017) Published online 24/03/17. Link: http://www.nature.com/bdj/journal/v222/n6/full/sj.bdj.2017.271.html [accessed 24/05/17]
 British Endodontic Society. Further information: Can the treatment fail? Link: https://www.britishendodonticsociety.org.uk/patients/further-information.html [accessed 24/05/17]