What are Endodontists?

Endodontists are dentists who specialize in maintaining teeth through endodontic therapy -- procedures, involving the soft inner tissue of the teeth, called the pulp. 

In addition to dental school, endodontists receive 2+ 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. 

When do you need a root canal? 

Patients typically need a root canal when there is inflammation or infection of the pulp tissue. Root canal treatment is a procedure to relieve dental pain and save your teeth!

What happens during a root canal?

1. A local anesthetic will be given.

2. A sheet of latex called the "rubber dam" (we've got nonlatex ones too) will be placed around the tooth to isolate it (keeping it clean and dry).

3. During root canal treatment, the specialist carefully removes the pulp inside the tooth, cleans, disinfects, and shapes the root canals.

4. The specialist then places a filling to seal the space.

What is the success rate of a root canal?

While there are, of course, no guarantees,  root canals have a very high degree of success, up to 90%.  We will discuss with you the likelihood of success before any endodontic procedure to help you make an informed decision. Even if the root canal is unsuccessful, there are various other options!

How can an endodontist diagnose and treat 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.

What is a CBCT (Cone beam computed tomography) scan?

A CBCT is a 3- dimensional picture of your tooth.  With this new and invaluable technology we can better see the inside of the tooth. It gives us more information to better advise you on treatment options.  Sometimes a tooth may have unusual anatomy or extra root canals within the tooth that can be seen on a CBCT.  

What is retreatment? 

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.

Steps: 

1. Accessing the previously treated area by making a small opening in the tooth.  

2. The contents of the nerve tunnels are cleaned out.  The contents could be filling material, necrotic tissue, and bacteria.  

3. Finally, a rubber filling material called Gutta Percha is placed inside the tunnels to seal them. 

Click on the following link to watch a video about root canal retreatment: https://www.youtube.com/watch?v=PHxlvvo0-Po

What is an apicoectomy?

An apicoectomy is minor surgical procedure to remove the end of the roots of the tooth.  

Steps:

1. A local anesthetic will be given. 

2. The specialist opens the gum tissue near the tooth to remove inflamed or infected tissue from the end of the root.

3. The end of the root is removed. The "new" end of the root is disinfected, and the canal recleaned. A filling is placed in the root to seal the end of the root canal.  

4. A few stitches are placed in the gums to help heal the tissues.  

How does an endodontist manage dental trauma?

Pulp damage can be caused by trauma to the mouth. The endodontist specializes in treating these traumatic injuries.

Example 1:  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.

Example 2: An endodontist is specially trained in procedures for replanting teeth that have been knocked out of their sockets.

How does an endodontist manage cracked teeth?

Endodontists specialize in saving cracked teeth and will cater treatment to the type, location, and extent of the crack.

What happens after the root canal treatment? 

When your root canal therapy has been completed, a record of your treatment will be sent to your restorative dentist. You should contact his office for a follow-up restoration within a few weeks of completion at our office. Your restorative dentist will decide on what type of restoration is necessary to protect your tooth. It is rare for endodontic patients to experience complications after routine endodontic treatment or microsurgery. If a problem does occur, however, we are available at all times to respond.

Will I need to return to your office for Additional Visits?

The number of visits will depend on your particular case.  Majority of treatments are just a single visit. However, some treatments take 2 visits or more. In any case, it depends on the degree of infection/inflammation and degree of treatment difficulty.  It is more important to do the very best we can, rather than meet a specific time criteria.

Once endodontic therapy is completed your tooth should be examined periodically, usually every 6 - 12 months.  This allows us to make sure the tooth has healed or is healing properly. You will be sent a notice in the mail when we feel it is appropriate to reevaluate the area.  Since an abscess may take 2 years to heal, our office will often reevaluate the tooth for at least 2 years.