What is an Endodontist and what do they do?
Endodontists are dentists who specialize in maintaining teeth through endodontic therapy — procedures, involving the soft inner tissue of the teeth, called the pulp. The word “endodontic” comes from “endo” meaning inside and “odont” meaning tooth. Like many medical terms, it’s Greek. All dentists are trained in diagnosis and endodontic therapy, however, some teeth can be especially difficult to diagnose and treat. That’s why you may have been referred to an endodontic specialist.
In addition to dental school, endodontists receive two or more years of advanced education in this kind of treatment. They study root canal techniques and procedures in greater depth, for diagnosis and treatment of more difficult cases. For this reason, many dentists choose to refer their patients to endodontists.
What Happens During Endodontic Treatment? or What is a Root Canal?
Root canal therapy is one of the most common dental procedures performed, well over 14 million every year. This simple treatment can save your natural teeth and prevent the need of dental implants or bridges.
A local anesthetic will be given. A sheet of latex called the “rubber dam” (we’ve got non-latex ones too) will be placed around the tooth to isolate it, hence keeping it clean and dry during treatment. The treatment consists of three or four basic steps, but the number of visits will depend on your particular case. Some treatments take two visits but many are just a single visit. Occasionally three appointments are needed.
In any case, it depends on the degree of infection/inflammation and degree of treatment difficulty. To us, it’s more important to do it the very best we can than to meet a specific time criteria. Let’s look at the basic steps for nonsurgical endodontic therapy.
- Accessing the pulp chamber (or nerve).
- Cleaning and shaping the root canals.
- Obturating (or filling) the root canals.
Of course, there are no guarantees. Teeth which can be treated near ideal have a success rate up to ninety percent! We will discuss with you the chances of success before any endodontic procedure to help you make an informed decision. If a root canal or endodontic therapy is unsuccessful or fails you still have options.
Diagnoses and Treats Pain
Oral pain such as toothaches or cracked / fractured teeth can often be difficult to pinpoint. Because of the vast network of nerves in the mouth, the pain of a damaged or diseased tooth often is felt in another tooth and/or in the head, neck, or ear. An endodontist is a specialist in diagnosing and treating this type of pain.
Treats Traumatic Injuries
Pulp damage is sometimes caused by a blow to the mouth, and the endodontist specializes in treating these traumatic injuries. For example, a blow to a child’s permanent tooth that is not fully developed can cause the root to stop growing. A procedure called apexification stimulates bone to be deposited at the end of the root which makes it possible to then save the tooth through a root canal procedure. An endodontist is specially trained in procedures for replanting teeth that have been knocked out of their sockets.
Will I need to Return to your Office for Additional Visits?
- To make sure your tooth is healing properly, it should be examined periodically, usually every 6-12 months
- Since an abscess may take two years to heal, our office will reevaluate the tooth for at least two years
Occasionally a tooth that has undergone endodontic, treatment fails to heal or pain continues despite therapy. Although rare, sometimes a tooth initially responds to root canal therapy but becomes painful or diseased months or years later. When either of these situations occur, the tooth often can be maintained with a second endodontic treatment.
Generally, a root canal is all that is needed to save teeth with injured pulp from extraction. Occasionally, this non-surgical procedure will not be sufficient to heal the tooth and your endodontist will recommend surgery.
Endodontic surgery can be used to locate fractures or hidden canals that do not appear on x-rays but still manifest pain in the tooth. Damaged root surfaces or the surrounding bone may also be treated with this procedure. The most common surgery used to save damaged teeth is an apicoectomy or root-end resection.
An incision is made in the gum tissue to expose the bone and surrounding inflamed tissue. The damaged tissue is removed along with a small amount of the root tip. A root-end filling is placed to prevent reinfection of the root and the gum is sutured. The bone naturally heals around the root over a period of months restoring full function.
Following the procedure, there may be some discomfort or slight swelling while the incision heals. This is normal for any surgical procedure. To alleviate any discomfort, an appropriate pain medication will be recommended. If you have pain that does not respond to medication, please call our office. We routinely see our surgery patients for a post-surgical check 5-7 days after surgery, and then again in six months for a recall examination.