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What is used now instead of arsenic?

Painless removal of a nerve from a tooth: how it goes and consequences

Many people are familiar with the procedure of removing a nerve from a tooth, which was accompanied by the mandatory placement of arsenic. Previously, this method took several days, during which the substance killed the nerve, after which the doctor removed the pulp and installed a filling or crown. Modern methods make it possible not to resort to arsenic, using more effective and painless methods. The pulp or neurovascular bundle performs important functions; it nourishes and protects tooth tissue from infection. Without it, the enamel changes color, hard tissues are destroyed faster, but in some situations, removal of the nerve is necessary.

Causes of dental pulp damage

The dentist is often visited because of caries – damage and destruction of enamel, which at the initial stage causes aesthetic discomfort. Important: if the disease is started, the process affects the deeper layers of the tooth and pulpitis develops, that is, the neurovascular bundle becomes inflamed. Pathologies arise due to the rapid proliferation of microbes, but in addition, the pulp can be damaged for the following reasons:

  • gum disease, in which the neck of the tooth is exposed, the bone tissue is destroyed and harmful bacteria penetrate inside;
  • trauma, as a result of which part of the tooth may break off, and then microbes enter the resulting cavity;
  • mistake by the dentist who installed the filling or crown. If some actions were incorrect, then the nerve will make itself felt after a while.

These are the main causes of pulp damage. The symptoms of this condition will be acute. The pulp will begin to react to cold, hot, too spicy, sweet foods. Removing the nerve in such situations is a necessity, despite the fact that minerals and nutrients will stop flowing to the tooth.

Why do you need to remove the pulp?

We talked about the main reasons why nerve inflammation occurs, but most often pulpitis becomes a consequence of advanced caries. Therefore, it is very important to visit a dentist, even if nothing bothers you. The decision to remove the pulp is made in the following situations:

  • pulpitis has passed into the stage of periodontitis, when inflammation affects the whole complex of connective tissue in the tooth;
  • large area of ​​carious lesion;
  • the infection spreads through the apex of the tooth root;
  • the appearance of unbearable, prolonged pain;
  • spread of infection under an artificial crown;
  • consequences of improper treatment.

The nerve can be removed either completely or partially, it all depends on the degree of tissue damage. Depulpation will prevent the spread of the inflammatory process under the crown and preserve the natural tooth, which is a priority for endodontic therapy.

How does the pulp removal process work?

We mentioned the method using arsenic at the very beginning. Some dentists still use it. The disadvantages of this treatment include its duration and pain. Before administering arsenic, the doctor must widen the root canal and place the substance into it. He then seals the area with a temporary filling. After two days, the arsenic kills the nerve, then the dentist cleans the substance from the tooth cavity and removes the pulp.

Important! Arsenic should not remain longer than expected in the oral cavity, as it is a poison and can be destructive to tissue.

There are more modern ways of performing the procedure, which are both safer and more painless. Before any action, an x-ray is required, which shows the vitality of the pulp, the length of the canal and other features.

Pulp removal is carried out using the vital and devital method. The first option is used for patients of any age. Its stages are as follows:

  • the tooth is exposed;
  • the pulp is removed with a special tool – a pulp extractor;
  • a filling is installed.

In some situations it may be temporary and after a few days it changes to permanent.

Note: all stages of treatment are performed under anesthesia, so they will not be painful or uncomfortable for the patient.

The devital method is similar to what was used ten or more years ago, only instead of arsenic, a non-toxic substance is installed in the tooth cavity. The main method of pulp removal in modern dentistry is the vital method, when in just 1 visit to the doctor you can undergo complete painless dental treatment.

Important: temporary pain after a dental procedure is considered normal, as tissue intervention has occurred. If severe pain does not go away within 3 days, you should consult a doctor.

In what situations should a nerve not be removed?

We are talking not only about contraindications, but also about cases in which the pulp can be preserved. The procedure is not performed if the patient has:

  • any infectious disease;
  • one of the forms of stomatitis;
  • psychoemotional disorders;
  • acute pathologies of the heart and blood vessels;
  • unsatisfactory condition of the oral cavity with suppuration and inflammation.

The nerve is preserved if it is not subject to inflammation due to caries or other pathologies and injuries. The dentist’s task is to save the pulp and remove it only in case of emergency.

Important: you cannot endure a toothache and hope that the pain in your nerve will stop. Inflammation can become chronic and show almost no effect, but any provoking factor will affect the development of a purulent abscess. In this case, the minimal consequence will be tooth loss, and the possible consequence will be the spread of infection to other tissues.

Consequences of nerve removal

If the treatment was carried out by a professional and experienced dentist, then apart from slight pain the patient will not be bothered by anything. Otherwise, there may be such complications:

  • a fragment of the instrument remains in the dental canal;
  • the nerve was partially removed;
  • incorrect or poor-quality filling of the canal;
  • mechanical damage to the root or wall;
  • rapid darkening of the enamel;
  • suppuration due to poor disinfection.

Important! Depulpation at the Crystal clinic is carried out with the minimum possible complications, since all procedures are carried out by certified doctors with extensive experience using high-tech equipment and tools.

After depulpation, it is recommended not to eat for 2-3 hours, not to eat cold, hot, hard or other foods that irritate the mucous membrane. Your doctor will tell you in more detail about the necessary actions after removing the nerve.

Feedback from our customers

Rated 5 /5 based on 4 customer reviews

I discovered a good dental clinic, where I underwent comprehensive caries treatment at a reasonable price, then had professional cleaning and, after some time, whitening. I am very pleased with the results, so I sincerely thank my doctor! There was no need to remove teeth, but the treatment of caries was painless, and after restoration there was not even a trace of the former problem left.

I underwent treatment and then had dental prosthetics done in this clinic. What can I say briefly: it is clean, cozy, the staff is very polite and attentive. I would like to express my special gratitude to the doctor, who was able to find the optimal solution and helped save most of the teeth. As for the prosthesis: it fit like a glove, I didn’t even experience any discomfort. Thanks for a job well done!

I’ve been going to this clinic for several years now, and I don’t even plan to change doctors, because I trust her completely. Here they always solve the problem in a targeted manner, do not try to impose their services in order to extract more money – such an attitude deserves respect. They always explain everything, answer questions, and provide very valuable recommendations on oral care. I am very glad that I came here, I recommend it to everyone!

An excellent clinic that I can confidently recommend to absolutely everyone who wants to have healthy and beautiful teeth! I was convinced from personal experience that not only the result, but also how long it will last directly depends on the doctor’s competence. It took us a long time to treat caries, since some of the teeth were badly damaged and the pulp needed to be removed. Thanks to you, I now feel more confident and smile more often).

Patient K. came to the clinic with complaints of severe pain in the gums in the area of ​​the 47th tooth. The tooth was treated 3 days ago in the self-supporting department of the district clinic for chronic pulpitis.

PHOTO 1: Visible devitalizing material at the mouth of the root canal and necrotic gums between the teeth against the background of inflamed soft tissues. PHOTO 2: On the day of contacting our clinic, the canals were processed and sealed, the gums were treated, and a sealed temporary filling was placed (see x-ray).
PHOTO 3: Photo after 1 week: inflammation of the gums and soft tissues has been eliminated. PHOTO 4: a month later, the tooth was completely restored with a ceramic inlay.

For reference: Treatment methods for pulpitis differ in the method of anesthetizing the pulp. If devitalizing pastes (paraformaldehyde, paste with arsenic, etc.) are used to “kill the nerve,” then the methods are called devitalizing. And if the treatment takes place under anesthesia and without the use of drugs that kill the pulp, then such methods are called vital. Everyone knows that arsenic is a poison. But it can be used for peaceful purposes. And the older generation probably remembers that arsenic was previously used by dentists to “kill the nerve.” At the same time, with arsenic in the tooth, it was under no circumstances possible to “walk” for more than the appointed time. Why was it used? To treat pulpitis (inflammation of the “nerve”), the dental pulp must be removed and the cleaned canals of the tooth must be sealed. Since earlier anesthetics were not “strong” enough, and the instruments for working in the canals were not thin and flexible enough, the dentist used arsenic to be on the safe side, so that there would be no pain in the tooth during or after the manipulation. And even then the terms “arsenic periodontitis” and “arsenic periodontitis” arose, and scary pictures appeared in dental textbooks illustrating complications caused by the use of arsenic, such as osteomyelitis and mediastenitis. Every dental office even had an antidote – unithiol in case of an overdose of the drug. It would seem that everything is in the past. But the incident with which I began the story happened the other day. The photograph (PHOTO 1) shows a “dead” gum. In order to treat chronic pulpitis, the dentist at the district clinic applied a devitalizing agent (one of the most popular in our time) to the patient’s pulp of the 47th tooth, after which he installed a temporary filling. And on the third day the patient came to me complaining of pain in her gums. The material for the temporary filling turned out to be insufficiently airtight, and the toxic drug “leaked” into the gum, causing necrosis and inflammation of the surrounding tissues. The final consequences will become clear after some time and will depend on whether the toxic drug has had time to act on the jaw bone. Currently, devitalizing agents (literally can be translated as “depriving life”) contain paraformaldehyde instead of arsenic, the toxic effect of which “poisons” the pulp and leads to its death. But if the drug turns out to be more than required, then in addition to the pulp, other tissues surrounding the tooth will be poisoned. And as a result, toxic periodontitis will develop. The annotation for such a drug does not indicate exactly how much of the substance to use in a particular case. The manufacturers vaguely wrote: “at the discretion of the doctor.” As a doctor, I understand that every living organism is individual, so a safe amount of a product for one patient may be toxic for another. This depends on many factors: the stage of pulp inflammation, the volume of pulp tissue, the shape of the canal and the age of the patient, etc. There is a high probability of error when using devitalizing agents. But the main thing is: why use a potentially dangerous technique? After all, a modern doctor has a wide arsenal of tools, tools and methods for the safe treatment of pulpitis. The choice of anesthetics allows one or another to achieve anesthesia in any patient; nickel-titanium instruments allow one to climb into curved canals and clean out the pulp under microscopic control, and rinsing the canals with antiseptics dissolves the remaining living tissue inside the canal and neutralizes microorganisms. If a dentist uses modern techniques, why should he return to devitalizing agents?! I admit only one reason for using a devitalizing drug – lack of time for the doctor or patient to fully treat the canals during that visit. Fortunately, these are isolated cases in practice.

23 years in the medical services market
St. Petersburg Subscribe to news

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