What is an Endodontist?
An Endodontist is a dentist who has undergone a minimum of 2 years of extra postgraduate training after dental school. This training allows an Endodontist to diagnose and treat diseases of the dental pulp and surrounding tissues, as well as differentiating between different types of orofacial pain. General dentists typically refer their patients to an endodontist when the diagnosis is complicated or treatment may be more challenging. Endodontists offices are equipped with specialized Operating Microscopes which greatly enhance diagnostic capabilities and technical precision during treatment. It is important to us that our patients understand why they need Endodontic Treatment and that they are aware of the steps that they must follow to optimize treatment results. Therefore, do not hesitate to ask us for clarification or explanation at any time during consultation or treatment.
What is Endodontics?
Endodontics is the branch of dentistry dedicated to treating the dental pulp. When you look at your tooth in the mirror, what you see is the crown. The rest of the tooth, the portion hidden beneath the gum line, is called the root. Though the outer portion of the root is a hard tissue called dentin, the inside channel or “root canal” contains pulp consisting of soft tissue, blood vessels and nerves. Bacteria and bacterial products that are introduced into the pulp as a result of tooth decay, periodontal disease, trauma, tooth fracture or other problems, can severely damage the pulp. When that happens, an endodontist removes the diseased pulp to save the tooth and prevent further infection and inflammation. After successful Endodontic Treatment, the tooth will continue to function normally.
Why would I need Endodontic Treatment?
Endodontic treatment is necessary when the pulp becomes inflamed or infected. The most common reasons for inflammation or infection are deep cavities (caries), repeated dental procedures, and cracks or chips. Trauma can also cause inflammation and often shows up as discoloration of the tooth. If pulp inflammation or infection is left untreated, it can cause pain or lead to an abscess. In certain instances, your general dentist may recommend endodontic treatment for restorative purposes even if the pulp is not inflamed or infected.
How Can Endodontic Treatment help me?
Endodontic treatment enables an inflamed or infected tooth to be saved. After a tooth is endodontically treated and subsequently restored with a crown or filling by your general dentist, it should not hurt and continue to function normally. The success rate of endodontic treatment is very high, between 90% and 95%, and is typically less expensive and less invasive than replacing a lost tooth with a bridge or dental implant.
Signs and Symptoms that a tooth may require Endodontic Treatment
Indications for Endodontic Treatment include prolonged sensitivity to heat or cold, discoloration of the tooth, pain on biting, swelling or tenderness of the tooth or adjacent gums, and the appearance of an abscess on an x-ray. Sometimes there are no signs and symptoms.
What can I expect during Endodontic Treatment?
The Endodontist removes the inflamed or infected pulp from the inside of the tooth, carefully cleans and shapes the root canal system and then seals the prepared space. Most procedures are now performed in a single appointment ranging from 60-90 minutes (depending on the complexity of the case). However, some teeth may require additional appointments, particularly if the tooth is found to be inflamed or infected. Once treatment is completed, you will be instructed to return to your dentist for permanent crown or filling. This permanent restoration of the tooth is an important part of treatment because it seals the cleaned canals from the rest of your mouth, protects the tooth and restores it to function.
Will I feel pain during or after the procedure?
Tooth pain is the main reason for patients seeking treatment; therefore many patients may experience discomfort prior to having Endodontic 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 and tenderness in the gums and jaw, especially if there was pain or infection before the procedure. Our doctors will typically prescribe high-dose non-steroidal anti-inflammatory medication (ibuprofen) to minimize post-operative sensitivity. Occasionally, stronger pain medications and/or antibiotics are also prescribed as needed.
I’m worried about x-rays. Should I be?
No. While a series of x-rays will be necessary during your endodontic 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 your general dentist via e-mail or standard mail.
What about infection?
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 state-of-the-art autoclave sterilization and barrier techniques to eliminate any risk of infection.
What new technologies are being used?
In addition to digital radiography, we utilize dental operating microscopes equipped with xenon fiber optic illumination, which aids the doctor in seeing the tiny details inside your tooth. Also, a small video camera on the operating microscope can record images of your tooth to further document the doctor’s findings.
Please see above
Ultrasonic instrumentation is a newer type of instrument used in Endodontic Treatment. Ultrasonic instruments are used during complex root canal procedures, including chemical debridement or management of calcified canals and removal of broken instruments. They are also used to make the root end filling spaces during apical surgery cases.
Electronic Apex Locators:
Apex Locators are small electronic machines used during Endodontic Treatment to determine the precise length of the root canal. They are often used in conjunction with traditional x-rays to provide the Endodontist with extremely accurate and reliable results.