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. Although dentists are trained in the diagnosis of endodontic therapy, some teeth can be especially difficult to diagnose and treat. That is why you may have been referred to an endodontist, specializing in root canal treatment.
In addition to dental school, endodontists receive two or more years of advanced education in this specialty. Endodontists study root canal techniques and procedures in much greater depth for proper diagnosis and treatment of more difficult cases. For this reason, many dentists choose to refer their patients to endodontists.
The space inside the tooth from the center, known as the pulp chamber, that travels down the length of the root to the tip (or apex) is called a "canal", or more specifically, a root canal. Human teeth may have one to four root canals, depending on the anatomy of the tooth. Molars may have 2 to 4 canals, premolars may have 1 to 2 canals, cuspids may have 1 to 2 canals, and finally incisors generally have 1 canal. Extra canals may branch out from the main canal, called "accesory canals." The number of canals and the anatomy can vary among teeth.
Root canal therapy can be performed in single or multiple visits. Before the procedure, you will be advised as to the number of appointments necessary to complete your treatment. If you had an infection, you may be advised to start antibiotics before completing the root canal. You will begin the appointment with local anesthetic to "numb" the tooth that is being worked on. After your tooth is "numb", you may expect the following procedures:
There are, of course, no guarantees. Root canal or endodontic therapy has a very high degree of success, with most cases up to 90%. We will discuss with you the chances of success before any endodontic procedure begins to help you make an informed decision. If a root canal or endodontic therapy is unsuccessful or fails, there are various options to accomodate your needs.
Oral pain such as toothaches or cracked / fractured teeth can often be difficult to detect. Because of the vast network of nerves 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, often called referred pain. An endodontist is a specialist in diagnosing and treating this type of pain.
During an initial consultation, your appointment will consist of a consultation explaining your diagnosis and treatment options. Occasionally, treatment can be done the same day as the consultation. However, a complex medical history or treatment plan will require an evaluation and a second appointment to provide treatment on another day.
Pulp (nerve) damage is sometimes caused by an injury or trauma to the mouth, and the endodontist specializes in treating these traumatic injuries. For example, an injury 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 by having a root canal procedure. An endodontist is specially trained in procedures for replanting teeth that have been knocked out of their sockets.
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. We will contact you 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.
Occasionally, a tooth that has undergone endodontic treatment fails to heal or pain continues. 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 can often be maintained with a second endodontic treatment.