WHO PERFORMS ENDODONTIC TREATMENT?
All dentists receive basic endodontic training in dental school. However, your general dentist often refers patients needing endodontic treatment to an endodontist, who is a valuable partner to your general dentist’s team of trusted caregivers.
An endodontist is a dentist who specializes in saving teeth. Endodontists focus on specific procedures such as root canals, surgery, cracked teeth, and replantation of teeth that have been loosened or knocked completely out by trauma. Endodontists become specialists by completing dental school, followed by additional two or more years of advanced training that includes the diagnosis and treatment of dental pain. With the lengthy education that an endodontist receives, they are able to perform all aspects of root canal therapy including complex root canals, retreatments of root canals, traumatically displaced teeth and endodontic surgery.
Some endodontists go on to become board certified in the specialty of endodontics. This means that they have achieved the highest level of recognition as experts in endodontics, and have proven their expertise before a Board of Examiners. Board certification requires the endodontist to successfully pass a series of oral and written examinations administered by the top endodontic specialists in the country. In addition, a series of completed difficult endodontic treatment cases must be presented to the Board, to demonstrate the proficiency of the endodontist seeking to become board certified.
Endodontists often utilize state-of-the-art technology such as digital imaging, operating microscopes, ultrasonic instrumentation and fiber optics while performing root canal treatment. Advanced technologies, together with specialized techniques, give endodontists a more accurate view of the tooth, and allow them to treat the tooth quickly and comfortably.
WHAT IS ENDODONTIC TREATMENT?
Endodontic treatment is a sequence of treatment for the pulp of a tooth which results in the elimination of infection and protection of the decontaminated tooth from future microbial invasion. This set of procedures is commonly referred to as a "root canal." It is a special filling placed inside the roots of the tooth.
To view videos or learn more about endodontic treatment visit the American Association of Endodontics patient education website.
WHY WOULD I NEED AN ENDODONTIC PROCEDURE?
Endodontic treatment is necessary when the pulp tissue inside the tooth (consisting of nerve tissue, blood vessels, and connective tissue), becomes inflamed or infected. The inflammation or infection can have a variety of causes: deep decay, repeated dental procedures on the tooth, trauma, or a crack or chip in the tooth. In addition, a blow to a tooth may cause pulp damage even if the tooth has no visible chips or cracks. If pulp inflammation or infection is left untreated, it can cause pain or lead to an abscess.
Signs of pulp damage include pain, prolonged sensitivity to hot or cold, discoloration of the tooth, and swelling and tenderness to the nearby gums. Sometimes, there are no symptoms, even though damage may have occurred.
HOW DOES ENDODONTIC TREATMENT SAVE THE TOOTH?
The endodontist removes the inflamed or infected pulp, carefully cleans and shapes the inside of the tooth, then fills and seals the space. Afterwards, you will return to your dentist, who will place a crown or other restoration on the tooth to protect and restore it to full function. After restoration, the tooth continues to function like any other tooth.
WILL I FEEL PAIN DURING OR AFTER THE PROCEDURE?
Many root canal procedures are performed to relive the pain of the toothaches caused by pulp inflammation or infection. With modern techniques and anesthetics, most patients report that they are comfortable during the procedure. We work very hard to keep you as comfortable as possible.
For the first few days after treatment, your tooth may feel tender or sensitive especially if there was pain or infection before the procedure. This discomfort can be relieved with over-the-counter or prescription medications; follow your endodontists instructions carefully.
Your tooth may continue to feel slightly different from your other teeth for some time after your root canal treatment is completed. However, if you have severe pain or pressure, or pain that lasts more than a few days, call your endodontist.
Most patients return to work or other routine activities the same day.
WILL THE TOOTH NEED ANY SPECIAL CARE OR ADDITIONAL TREATMENT?
You should not chew or bite on the treated tooth until you have had it restored by your dentist. The unrestored tooth is susceptible to fracture, so you should see your dentist for a full restoration as soon as possible. Otherwise you need only practice good oral hygiene, including bushing, flossing, and regular checkups and cleanings.
Most endodontically treated teeth last as long as other natural teeth. In a few cases, a tooth that has undergone root canal treatment fails to heal or the pain continues. Occasionally, the tooth may become painful or diseased months, or even years, after successful treatment. Often when this happens, another endodontic procedure can save the tooth.
WHAT CAUSES AN ENDODONTICALLY TREATED TOOTH TO NEED ADDITIONAL TREATMENT?
New trauma, deep decay, or a loose, cracked or broken filling, or a leaking crown, can cause new infection in your tooth. In some cases, the endodontist may discover very narrow or curved canals that could not be treated during the initial procedure.
CAN ALL TEETH BE TREATED ENDODONTICALLY?
Most teeth can be treated. Occasionally, a tooth cannot be saved because the root canals are not accessible, the root is severely fractured, the tooth does not have adequate bone support or the tooth cannot be restored. However, advances in endodontics are making it possible to save teeth that even a few years ago would have been lost. When endodontic treatment in not effective, endodontic surgery may be able to save the tooth.
WHAT IS ENDODONTIC SURGERY?
The most common endodontic surgical procedure is called an apicoectomy or root-end resection. When inflammation or infection persists in the bony area around the end of your tooth after endodontic treatment, your endodontist may perform an apicoectomy. In this procedure, the endodontist opens the gum tissue near the tooth to expose the underlying bone. The infected tissue is removed, and a small filling may be placed in the end of the root to seal the root canal. Local anesthetics make the procedure comfortable, and most patients return to their normal activities the next day.