When do teeth need root canal treatment?

Even frequent visits to the dentist are not able to protect the patient from caries, but the quick detection of cavities allows them to be healed with minimal interference in the tooth. However, there are situations where, as a result of a tooth injury or the action of bacteria (advanced caries), inflammation or necrosis of the pulp (tissue filling the chamber and root canals) develops. There is pain that often makes it difficult to function normally. In this case, the only solution to preserve the tooth while getting rid of pain is root canal treatment, also known as endodontic treatment.

How long does root canal treatment take?

The duration of root canal treatment depends on the condition of the tooth, the type of tooth being treated, the structure of the roots and other conditions in the patient’s oral cavity. Modern endodontic devices, which we have at our disposal in Mediss Dental Offices in Gdańsk, allow for very quick root canal treatment. If possible, we try to carry out root canal treatment during one visit. In fact, the time of the visit depends on the number of root canals and the difficulty of their preparation. Root canal treatment of a tooth that has 3 or 4 roots (e.g. upper six) may take from 1 to 3 hours. There are of course cases when, either for technical reasons or for medical reasons, it is not possible to complete the root canal treatment during one visit.

What is root canal treatment?

Root canal treatment consists in thorough cleaning of the root canals of infected or dead pulp. The space filled with pulp in the tooth root is called canal – at least one in one root, and the pulp is the nerves and the accompanying blood vessels. The term “channel” is a bit of a misnomer as it implies that it is empty inside. However, it is actually filled with nerves and blood vessels. The essence of root canal treatment at Mediss Dental Offices in Gdańsk is thorough removal of the pulp infected with bacteria from the canals. In its place, we put a material that will tightly and completely fill the empty space. For this purpose, the dentist must clean the tooth of caries so that the canals are clearly visible and easily accessible for the canal instruments. In the next stage of treatment, with the use of specialized, very thin files, contaminated tissues are scraped from the canal walls along with bacteria, along the entire length of the root up to its apex. Through multiple chemical rinsing of the canal with special fluids, it becomes disinfected. The canal, prepared in this way and carefully measured earlier, is ready for filling.

Step by step root canal treatment

Root canal treatment consists in the thorough removal and cleaning of the root canals of the dead or changed inflammatory pulp of the tooth and filling the root canal system tightly with a biocompatible material. The root canal treatment procedure in the Mediss office in Gdańsk is a painless procedure performed under anesthesia. Root canal treatment is essential when the pulp becomes inflamed or infected. There can be many reasons: advanced caries, multiple treatments performed on the tooth, as well as mechanical damage to the tooth. Root canal treatment in the Mediss office can be performed during one visit. In some cases, it is necessary to carry out endodontic treatment during two (or several) visits (replacement of the dressing between visits).

How is the root canal treatment going

Step 1: Diagnosis – After the initial diadnosis, the doctor takes an X-ray or, if necessary, a 3D tomographic image, which can be taken in our facility in Morena, and on its basis determines the number of roots, their course and shape. It also assesses the condition of the bones around the root tips to check that the bacteria present in the root have not infected the bones for a long time. After administration of anesthesia and insertion of a cofferdam, i.e. a special rubber isolating the tooth from the mouth, which maintains dryness within the performed procedure, the tooth is opened and all the canals are found. This is a very difficult and time-consuming stage, because the omission of a canal leaves bacteria behind, which may lead to complications and, consequently, even tooth extraction. It is very important to determine the working length of the channels as accurately as possible. A specialized dental microscope is helpful at this stage.

Step 2: Mechanical preparation of channels – Lekarz dentysta usuwa zakażoną przez bakterie miazgę najpierw narzędziami ręcznymi, a potem mechanicznymi. Opracowanie kanałów odbywa się przy użyciu specjalnych narzędzi kanałowych. Narzędzia, używane przy maszynowym opracowaniu są specjalnie zaprojektowane i idealnie nadają się, aby bezpiecznie udrożnić nawet zakrzywione kanały. Na każdym etapie oczyszczania stosowany jest endometr, czyli elektroniczne urządzenie pokazujące na jakiej długości kanału znajduję się narzędzie. Lekarz dentysta usuwa zainfekowane tkanki z wnętrza wszystkich korzeni danego zęba. Proces ten jest wspomagany obfitym płukaniem kanałów środkami chemicznymi mającymi za zadanie dezynfekcję i pomoc w oczyszczeniu resztek substancji organicznej z całego systemu kanałowego.

Step 3: Filling the channels – After thorough preparation, cleaning and widening of the canal and its thorough drying, the doctor starts filling them. The roots are tightly filled using a special gutta-percha condensation method. Medisss offices use a system of filling the canal with hot gutta-percha, which also allows for filling all kinds of branches and side canals. This stage is aimed at tightly closing the lumen of the canal along its entire length. After the canal is filled, a dressing is applied to the tooth until the final reconstruction.

Step 4: Tooth reconstruction – The final step in endodontic treatment is the reconstruction of the tooth crown. To restore the full functionality of a tooth, it must be rebuilt with a composite material or a prosthetic crown. Most often, it is necessary to completely rebuild the tooth with a crown-root inlay and a prosthetic crown.

How are teeth whitened in a dentist’s office?

What you should know about teeth whitening

Hydrogen peroxide (hydrogen peroxide HP) and carbamide peroxide CP are active agents that whiten the teeth. Both peroxides break down into free radicals. These compounds are very reactive, and therefore, upon contact with the tooth surface, they immediately attach to the carbon double bonds in the tooth structure. This bond is responsible for most of the discoloration found on the teeth. During the bleaching process, the carbon double bonds either break apart completely (forming two smaller molecules) or react to form a single carbon bond. These transformed particles become brighter thanks to this process, making the teeth appear whiter.

Hydrogen peroxide (HP) vs carbamide peroxide (CP) Hydrogen peroxide (HP) decomposes completely in just 60 minutes. Only during this time the teeth are whitened. Carbamide peroxide (CP) first decomposes hydrogen peroxide and urea (urea), which extends its action up to 6 hours. By slowing down the oxidation process in preparations with carbamide peroxide, it was possible to reduce the concentration of the gel contained in them and extend the duration of the entire treatment, which significantly increased the comfort of the treatment.

Overlay whitening treatment

A professional teeth whitening procedure usually begins with a diagnostic visit at the dentist’s office. During this visit, the color of the patient’s teeth should be determined and the most appropriate preparation based on it (see “Guide to preparations”).

During the same visit, an impression of the patients’ teeth should also be taken, which will be used to make an individual overlay with which the patient will later apply the preparation. During the second visit, the doctor gives the patient the aforementioned individually prepared overlay and a whitening preparation. The patient should also be informed in detail about how to use the preparation. Each of our whitening kits includes instructions for both the doctor and the patient.

The entire whitening process actually takes place at home, but its effects should be checked every few days by the doctor performing the treatment.

ACP technology in Philips Zoom NiteWhite and DayWhite Nite White ACP and Day White ACP are the only whitening overlays that contain an amorphous calcium phosphate (ACP) formula that has become the new standard in modern dentistry.

Clinical studies prove that amorphous calcium phosphate (ACP) has the following properties:

  • rebuilds the enamel by creating a new hydroxyapatite coating on the surface of the teeth 1,2,3,4
  • reduces hypersensitivity by 30% 7.8
  • restores shine to the teeth by filling their surface with a new coating of hydroxyapatite 5
  • reduces the risk of recurrence of discoloration, which often appears 6 months after the end of the treatment 5

Thanks to this, DISCUS preparations are the first and only preparations for overlay teeth whitening, which, apart from removing discoloration, also rebuild the enamel of your patients. So it will be healthier and shinier. This is a great advantage over other preparations available on the market that do not contain this formula.

In addition, ACP significantly (clinical studies show that by as much as 30%) reduces the risk of tooth hypersensitivity during and after the procedure. It significantly increases the patient’s comfort during the procedure.

How does amorphous calcium phosphate (ACP) work?

Teeth surface before applying the preparation.

ACP particles get to the surface of the teeth along with the whitening gel.

ACP clogs dentin tubules significantly reducing hypersensitivity.

The new coating created on the tooth surface by ACP fills in imperfections and adds shine to the teeth.


The scope of application of Relief ACP is virtually unlimited. It is a typical prophylactic preparation that can be used in case of any problems related to the counteraction and subsequent treatment of hypersensitivity.

There are many causes of tooth hypersensitivity, but the most common ones include:

  • whitening
  • cold
  • hot
  • sweets
  • acids
  • touch

It is an ideal solution for toothache caused by thermal and chemical factors, periodontal conditions, gingival recessions or teeth whitening.

The duration of use of Relief ACP is not strictly defined. It is a prophylactic preparation, so there is no possibility of overdosing it. The length of the treatment should be individually adapted to each patient. Some patients will achieve a marked improvement after a few days of use, others whose hypersensitivity takes a more permanent and aggressive form will have to extend the treatment period a little.


As with all other whitening systems and methods, some patients may experience a temporary problem of hypersensitivity when using Nite White ACP and Day White ACP. However, it is not a sign that something is wrong with the teeth, but only a natural reaction of the teeth to their penetration by the whitening preparation. Unfortunately, hypersensitivity during and after the procedure is a very individual matter and it is difficult to predict when and in what form it will appear. However, there are conditions that are commonly known to aggravate this hypersensitivity. That is why the proper selection of patients is so important. It is a key element in controlling hypersensitivity. All the most important publications in this field recommend that patients should be disqualified who:

  • suffer from chronic periodontal diseases
  • their teeth are badly worn
  • with micro-leaks around fillings
  • have severe gagging or breathing problems
  • have unhealed cavities
  • or they have an unhealthy cavity for some other reason.

All the conditions mentioned above should be completely healed before allowing the patient to undergo the whitening treatment. Hypersensitivity is also one of the topics that undoubtedly should also be raised with the patient during a diagnostic visit. Inform the patient that the sensitivity comes from the nerve of the tooth, which is excited by hydrogen peroxide. Therefore, tooth sensitivity may persist for 24 to 48 hours after the end of the procedure. It can be manifested by the suppressed pain of the entire dental arch, or the so-called point pain. “prick”. It is extremely important for the patient to know that NOTHING WRONG is happening to his teeth, and that the reaction that may appear is only a reversible inflammation of the tooth pulp.

Nite White ACP Day White ACP are the only preparations available on the market that already contain 3 anti-hypersensitivity compounds: potassium nitrate, fluorine and amorphous calcium phosphate (ACP). No other whitening preparation contains all three extremely effective ingredients at the same time. For more information on how the Amorphous Calcium Phosphate formula works, see “About Teeth Whitening”.

The preparations have obtained all the necessary certificates, allowing them to be sold and used in the European Union for over 12 years.

In fact, there are no serious, clinically proven contraindications to the use of whitening preparations. However, it is important that the patient undergoing the procedure is in good health.

All of our preparations should absolutely not be used by pregnant and breastfeeding women. No clinical trials have been conducted on this group of patients, therefore, for complete safety, they should not undergo bleaching during pregnancy and lactation.

Moreover, people who have whitening should be excluded from the whitening treatment unprotected cavities (caries)and a large number of inserted fills (after the end of the procedure, the patient would have to replace them all). The use of overlay preparations can also be very burdensome and sometimes even impossible for people who have strong gag reflex. Due to the need to wear overlays with gel on their teeth, these patients have to decide for themselves whether they will be able to accept such conditions or not.

There are also no formal restrictions on the minimum age of patients undergoing bleaching treatments. Virtually every country decides this issue on its own and there is no single universally binding “border”. In Poland, it is recommended that only people who;re are 18 years of age or older. However, this is dictated only by legal reasons, as many patients who have not yet reached the age of majority have successfully undergone the procedure.