Endodontics is a specialty of dentistry that deals with diseases of the dental pulp and its supporting structures. Endodontists are dentists with additional specialized post-graduate training in this field. Endodontists are also experienced at finding the cause of oral and facial pain that has been difficult to diagnose. Although general dentists can perform endodontic treatment, patients are often referred to an endodontist when the case is complicated or more difficult than usual. Teeth have several layers. The outside layer of the tooth is composed of a hard layer called enamel. Enamel is supported by an inner layer called dentin, which has at its center a soft tissue known as the pulp.

A 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. At the center of your tooth is pulp. Pulp is a collection of blood vessels that helps to build the surrounding tooth. A root canal is necessary when the pulp becomes unhealthy and infected. The most common reasons for needing a root canal are deep cavities, cracked teeth or fillings, and trauma. Success for this type of treatment occurs in about 90% of cases. Indications for treatment include prolonged sensitivity to heat or cold, discoloration of the tooth, swelling or tenderness of the tooth or adjacent gums. Sometimes there are no symptoms and x-rays have detected an existing infection.

The endodontist removes the inflamed or infected pulp, carefully cleans and shapes the canal system and then seals the prepared space. Most treatment is now performed in a single appointment ranging from 60-90 minutes (depending on the number of roots). Once treatment is completed, you will be instructed to return to your dentist for a permanent reconstruction. The restoration of the tooth is an important part of treatment because it seals and protects the tooth and restores it to function.

Toothache pain is the main reason for patients seeking treatment. Fortunately, modern anesthetics can make the procedure pain free in most cases. Seeking treatment early makes the procedure more comfortable, so don’t wait. When caught early, treatment should feel no different than having a regular filling. For the first few days after treatment, there may be some sensitivity to biting pressure, especially if there was pain or infection before the procedure. Sometimes over-the-counter anti-inflammatory medications (like Advil) are recommended for a day or two.

With the appropriate care, your teeth that have had endodontic treatment will last as long as other natural teeth. Yet, a tooth that has received treatment may fail to heal or pain may continue to exist. Sometimes, the pain may occur months or years after treatment. If so, Endodontic Retreatment may be needed. Improper healing may be caused by: •Curved or narrow canals that were not treated during the initial treatment. •Complicated canals that went undetected during the initial treatment. •The crown or restoration was not placed within the appropriate amount of time following the procedure. •The crown or restoration that did not prevent saliva from contaminating the inside of the tooth. In some cases, new problems can influence a tooth that was successfully treated: •New decay can expose a root canal filling material, causing infection. •A cracked or loose filling or crown can expose the tooth to new infection. Once retreatment has been selected as a solution to your problem, the doctors will reopen your tooth to gain access to the root canal filling material. This restorative material will be removed to enable access to the root canal. The doctors will now clean your canals and carefully examine the inside of the problematic tooth. Once cleaned, the doctors will fill and seal the canals and place a temporary filling in the tooth. At this point, you will need to return to your dentist as soon as possible in order to have a new crown or restoration placed on the tooth to restore full functionality.

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 the end 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.

No. While x-rays will be necessary during your endodontics treatment, we use an advanced non-film computerized system, called digital radiography, that produces radiation levels up to 90 percent lower than those of already low dose conventional dental x-ray machinery. These digital images can be optimized, archived, printed and sent to cotherapists via e-mail or CD-ROM. For more information contact Sirona Dental Systems, Inc.

Again, there’s no need for concern. We adhere to the most rigorous standards of infection control advocated by OSHA, the Centers for Disease Control and the American Dental Association. We utilize autoclave sterilization and barrier techniques to eliminate any risk of infection.

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.

In addition to digital radiography, we utilize special operating microscopes. Magnification and fiber optic illumination are helpful in aiding the doctor to see tiny details inside your tooth. Our office utilizes Cone Beam CT 3D imaging as well to help us identify and locate structures that cannot be seen with a regular 2D xray images. This tool greatly improves our diagosis and planning and treatment of endodontic disease.