Endodontists are dentists who specialize in maintaining natural teeth through endodontic therapy -- procedures involving the pulp, the soft inner tissue, of the teeth. The word "endodontic" comes from "endo" meaning inside and "odont" meaning tooth. Like many medical terms, it has Greek origins. All dentists are trained in diagnosis and endodontic therapy; however, some teeth can be especially difficult to diagnose and treat, which is 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 specific kind of treatment. They study root canal techniques and procedures in greater depth, for specific diagnosis and treatment of more difficult cases. For this reason, many dentists choose to refer their patients to endodontists.
A local anesthetic will be given. A sheet of latex called the "rubber dam" (we also have latex free options) will be placed around the tooth to isolate it, 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 some are just a single visit. Occasionally, three or more appointments are needed. We will make an access through the top of the tooth, locate each canal, remove infected and inflamed tissue, clean the inside with an ultra-cleaning system called the GentleWave Procedure, and permanently seal and fill each canal. When each of these steps is complete, we will fill the access opening with a new build up of the tooth and in many cases you will need to return to your General Dentist for a new crown to preserve the stability and health of your tooth.
In any case, treatment depends on the degree of infection/inflammation and the degree of difficulty. To me, it's more important to do the very best treatment that we can than it is to meet a specific time criteria. Let's look at the basic steps for nonsurgical endodontic therapy.
As with any medical treatment, there are, of course, no guarantees; however, root canal treatment, or endodontic therapy, has a very high degree of success. Approximately 90% of root canal cases are successful. We will discuss with you the chances of success before any endodontic procedure to help you make an informed decision. If a root canal is unsuccessful or fails, you still have options.
Diagnosis & Pain Treatment
Oral pain, such as a toothache or pain from cracked or fractured teeth can often be difficult to pinpoint. Because of the vast nerve network in the mouth, the pain of a damaged or diseased tooth is often felt in another tooth and/or in the head, neck, or ear. This is called referred pain. An endodontist is a specialist in diagnosing and treating this type of pain.
Treating Traumatic Injuries
Pulp damage is sometimes caused by a blow to the mouth and the endodontist also specializes in treating these traumatic injuries. For example, a blow to a child's permanent tooth not fully developed can cause the root to stop growing. A procedure called apexification stimulates bone growth 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.
Occasionally a tooth that has undergone endodontic treatment fails to heal or pain continues despite therapy and although rare, a tooth can initially respond well to root canal therapy but become painful or diseased months or even years later. Every tooth is different, so it can be unpredictable. When either of these situations occur, the tooth can often be maintained with a second endodontic treatment called a retreat.
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 or a phone call when we feel it is appropriate to reevaluate the area. Since an abscess may take 2 years to heal, our office will reevaluate the tooth for at least 2 years.