Why is the microscope so crucial in endodontic treatment carried out by a registered specialist?

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Specialist Endodontist
Endodontic Care
BDS (Otago), DClinDent (Otago)

Endodontic TreatmentEndodontic treatment or Root canal treatment is a familiar concept for many dental patients. It has often been described as the epitome of discomfort, made worse by urban legends giving endodontics a bad name. This field of dentistry is also associated with the highest number of litigations in the Victorian dental industry.

Why is this the case, when studies shows that endodontic treatment has a success rate of over 90 per cent?

Answer: Endodontists are dentists who have trained for a further three years after their basic dentist’s training so as to become a specialist in the field of endodontic treatment or root canal treatment. This advanced training includes the use of specialised equipment.

If root canal treatment is performed by a general dentist who is not an endodontist, or it’s not given the attention to detail it requires, it can fail in a catastrophic manner. The most common reason for failure is infection. This is when patients are often referred by a general dentist to an endodontist for further management (that is, re-treatment of the root canal) – or advised to have an extraction.

A key development in the success of root canal treatment is the use of high-powered microscopes. Pioneered in the late 1990s, the operating dental microscope allows the operator to see the inside of a tooth and the root canal system at a magnification of up to 20 times, with added lighting.

This is important because:

  • teeth often have extra roots or canals that cannot be seen with the naked eye or loupes (glasses with magnification)
  • crowns or big fillings in teeth often make it difficult to see the inside of a tooth, and special light from the microscope is required to see the floor of these teeth
  • often teeth can have fractures or other abnormal anatomy, and these can be detected and treated early, rather than after the event – when treatment fails.

Advances in technology and training have for some time allowed endodontists to enjoy a high success rate. Contrary to outdated perceptions, treatment doesn’t require multiple visits and need not be painful at all.

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