~The “Visible World” Transformed by Microscopes~

Among dental treatments, “root canal therapy (treatment of the tooth’s nerve)” is one of the most difficult to understand for patients and simultaneously one of the most challenging fields for dentists. In fact, it’s not uncommon to hear concerns like, “Even after multiple visits under insurance coverage, the pain doesn’t go away,” or “No matter how many times it’s treated, the pus keeps coming back.” Behind this lies the reality of “treating the invisible by feel.”

The Greatest Value Brought by the Microscope

Root canals are only about 0.1 to 0.3 mm in diameter and have complex branching patterns unique to each tooth. They are naturally invisible to the naked eye, and even traditional loupes had their limitations. Using a microscope allows for over 20x magnification and observation of the root canal interior under bright illumination.

For example, many cases previously labeled “cause unknown” are actually due to:

• – Fine cracks (fractures) within the root canal
• – Multiple root canal branches that were overlooked
• – Residual old medication or fillings causing recurrent inflammation

These facts become apparent under the magnified view.

The Difference in Actual Clinical Practice

One patient came to our clinic after over six months of repeated “disinfection” at another clinic failed to resolve their issue. Examination under the microscope revealed a tiny “fourth root canal,” invisible to the naked eye. The source of infection remained there, explaining why disinfection failed to improve the condition. After locating and properly treating this canal, the inflammation resolved within a few months.

This is not an exceptional case. **Cases that couldn’t be cured because they were invisible are routinely solved by making them visible.**

The same standard applies even under insurance coverage

Since opening my practice, I have performed all root canal treatments under a microscope, regardless of whether they are covered by insurance or paid out-of-pocket. The reason is simple: “treating without seeing” itself is a risk.

While the success rate for root canal treatment is generally said to be around 50%, utilizing a microscope and rubber dam increases the success rate to over 90%. Of course, even then, not every case is cured, and some may require surgical procedures or extraction, but those are exceptions.

Providing Patient Peace of Mind

An even greater benefit is the ability to “share what we see directly with the patient.” I record and photograph the procedure, then review it together with the patient on a monitor after treatment. Visually understanding “what was happening inside their own tooth” helps patients feel reassured and significantly reduces their anxiety.

Summary

Microscope-assisted root canal treatment delivers three key values:

• Enhanced diagnostic accuracy
• Increased treatment success rate
• Providing patient reassurance

Making the invisible visible—that is the key to fundamentally transforming dental treatment.

In the next installment, Series ⑥, we will discuss how the “Ceramic Treatment Edition” utilizing microscopes achieves both aesthetics and function.