Endodontics (Root Canal Therapy) is a branch of dentistry recognized by the American Dental Association involving treatment of the pulp (root canal) and surrounding tissues of the tooth. 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 a pulp of soft tissue, blood vessels and nerves. Bacteria that are introduced into the pulp as a result of tooth decay, periodontal disease, tooth fracture or other problems, can severely damage the pulp. When the pulp is damaged, an endodontic specialist removes the tissue to save the tooth and prevent further infection and inflammation. After successful endodontic treatment, the tooth continues to perform normally.
All dentists, including your general dentist, receive basic training in endodontic treatment in dental school. General dentists often refer patients needing endodontic treatment to endodontists.
An endodontist is a dentist with special training in diagnosing and treating problems associated with the inside of the tooth. They do only endodontic procedures in their practices because they are specialists. To become specialists, they complete dental school and an additional two or more years of advanced training in endodontics, one of the nine specialties recognized by the American Dental Association. They perform routine as well as very complex endodontic procedures, including retreatment of previous root canals that have not healed completely, as well as endodontic surgery. Endodontists are also experienced at finding the cause of oral and facial pain that has been difficult to diagnose.
Endodontic treatment is necessary when the pulp, the soft tissue inside the root canal, becomes inflamed or infected. The inflammation or infection can have a variety of causes: deep decay, repeated dental procedures on the tooth, or a crack or chip in the tooth. In addition, an injury to a tooth may cause pulp damage even if the tooth has no visible chips or cracks. If pulp inflammation or infection is left untreated, it can cause pain or lead to an abscess.
Signs to look for include pain, prolonged sensitivity to heat or cold, tenderness to touch and chewing, discoloration of the tooth, and swelling, drainage and tenderness in the lymph nodes as well as nearby bone and gingival tissues. Sometimes, however, there are no symptoms.
The endodontist removes the inflamed or infected pulp, carefully cleans and shapes the inside of the canal, then fills and seals the space. Afterwards, you will return to your dentist, who will place a crown or other restoration on the tooth to protect and restore it to full function. After restoration, the tooth continues to function like any other tooth.
Many endodontic procedures are performed to relieve the pain of toothaches caused by pulp inflammation or infection. With modern techniques and anesthetics, most patients report that they are comfortable during the procedure. For the first few days after treatment, your tooth may feel sensitive, especially if there was pain or infection before the procedure. Your tooth may also continue to feel slightly different from your other teeth for some time after your endodontic treatment is completed. This discomfort can be relieved with over-the-counter or prescription medications. Follow your endodontist’s instructions carefully. However, if you have severe pain or pressure or pain that lasts more than a few days, call your endodontist.
The cost varies on the complexity of your procedure. It will most likely be more complicated than your first root canal treatment due to restoration and filing material which may need to be removed to accomplish the new procedure. Most dental insurance policies provide some coverage for endodontic treatment. Generally, endodontic treatment and restoration of the natural tooth are less expensive than the alternative of having the tooth extracted. An extracted tooth must be replaced with a bridge or implant to restore chewing function and prevent adjacent teeth from shifting. These procedures tend to cost more than endodontic treatment and appropriate restoration. With root canal treatment you save your natural teeth and money.
You should not chew or bite on the treated tooth until you have had it restored by your dentist. The unrestored tooth is susceptible to fracture, so you should see your dentist for a full restoration as soon as possible. Otherwise, you need only practice good oral hygiene, including brushing, flossing, and regular checkups and cleanings. Most endodontically treated teeth last as long as other natural teeth. In a few cases, a tooth that has undergone endodontic treatment does not heal or the pain continues. Occasionally, the tooth may become painful or diseased months or even years after successful treatment. Often when this occurs, revising the original endodontic procedure can save the tooth.
New trauma, deep decay, or a loose, cracked or broken filling can cause new infection in your tooth. In some cases, the endodontist may discover additional very narrow or curved canals that could not be treated during the initial procedure.
Most teeth can be treated. Occasionally, a tooth can’t be saved because the root canals are not accessible, the root is severely fractured, the tooth doesn’t have adequate bone support, or the tooth cannot be restored. However, advances in endodontics are making it possible to save teeth that even a few years ago would have been lost. When endodontic treatment is not effective, endodontic surgery may be able to save the tooth.
When your root canal therapy has been completed, a record of your treatment will be sent to your general dentist. You should contact your general dentist’s office for a follow-up restoration within one week of completion of your root canal therapy at our office. Your general dentist will decide 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.
The risks associated with radiation exposure from dental radiographs are very minimal. While x-rays will be necessary during your endodontic treatment, we use a system called computerized digital radiography. The radiation levels used by this system can be up to 90 percent lower than those of conventional dental x-ray systems.
We adhere to the rigorous standards of infection control advocated by Occupational Safety and Health Administration (OSHA), the Centers for Disease Control, and the American Dental Association. We use autoclave sterilization and disposable barrier techniques to help prevent infection.
Information on this procedure has been adopted from the copyrighted literary content of the American Association of Endodontics.