|
Endodontics 101 What is a Root Canal? The Endodontic Procedure What is Endodontic Surgery? What are the alternatives? Who Performs Endodontic Treatment? Why would I need endodontic treatment? Will I feel pain during or after the procedure? Post-Treatment Care The Basics |
|
| What is a
Root Canal? |
|
 |
"Endo" is the Greek word for "inside"
and "odont" is the Greek word for "tooth." Endodontic treatment
or "root canal" involves "treating the inside of the teeth".
To understand endodontic treatment, it helps to know something about the anatomy of the tooth. Inside the tooth, under the white enamel and a hard layer called the dentin, is a soft white tissue called the pulp. The pulp contains blood vessels, nerves, and connective tissue and creates the surrounding hard tissues of the tooth during development. The pulp extends from the crown of the tooth to the tip if the roots where it connects to the tissues surrounding the root. The pulp is important during a tooth's growth and development. However, once a tooth is fully mature it can survive without the pulp, because the tooth continues to be nourished by the tissues surrounding it. |
| In order to save a tooth, an endodontist removes the
inflamed or infected pulp, carefully cleans and shapes the
inside of the tooth, then fills and seals the space. Afterwards,
the patient returns to his or her dentist, who will place a
crown or other restoration on the tooth to protect and restore
it to full function. Once the dentist has completed this step,
the 'saved' tooth continues to function like any other tooth.
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. And, when endodontic treatment is not effective, endodontic surgery may still be able to save the tooth. |
 |
| Endodontic treatment (a root canal) can often be performed in either one or two visits and involves the following steps: | |
| 1. The endodontist examines and X-rays the tooth, then administers local anesthetic. After the tooth is numb the endodontist places a small protective sheet called a "infectious barrier" over the area to isolate the tooth and keep it clean and free of saliva during the procedure. |
 |
| 2. The endodontist makes an opening in the crown of the tooth. Very small instruments are used to clean the pulp from the pulp chamber and root canals and to shape the space for filling. |  |
| 3. After the space is cleaned and shaped, the endodontist
fills the root canals with a biocompatible material, usually a
rubber-like material called "gutta-percha." The gutta-percha is
placed with an adhesive cement to ensure complete sealing of the
root canals. In most cases, a temporary filling is placed to
close the opening. The temporary filling will be removed by your
dentist before the tooth is restored. |
 |
| 4. After the final visit with your endodontist, you must
return to your dentist to have a crown or other restoration
placed on the tooth to protect and restore it to full function.
|
 |
| If the tooth lacks sufficient structure to hold the restoration in place, your dentist or endodontist may place a post inside the tooth. Ask your dentist or endodontist for more details about the specific restoration planned for your tooth. |
 |
| What is
Endodontic Surgery? |
|
| The most common endodontic surgical procedure is called an
apicoectomy or root-end resection. When inflammation or
infection persists in the bony area around the end of your tooth
after endodontic treatment, your endodontist may perform an
apicoectomy. In this procedure, the endodontist opens the gum tissue near the tooth to expose the underlying bone, and the infected tissue is removed. The very end of the root is also removed, and a small filling may be placed to seal the root canal. Local anesthetics make the procedure relatively painless, and most patients return to their normal activities the next day. |
 |
| What are
the Alternatives? |
|
| When the pulp of a tooth is damaged, the only
alternative to endodontic treatment is extraction of the tooth.
To restore chewing function and to prevent adjacent teeth from
shifting, the extracted tooth should be replaced with an implant
or bridge. This requires surgery or dental procedures on
adjacent healthy teeth and is far more costly and time-consuming
than a combined endodontic treatment and restoration of the
natural tooth. No matter how effective modern tooth replacements are--and they can be effective--nothing is as good as a natural tooth. Thank you. |
|
|
The Specialization
|
|
| Who Performs Endodontic Treatment? | |
All dentists, including your general dentist, received training in endodontic treatment during dental school. General dentists can perform endodontic procedures along with most other dental procedures, but often they refer patients needing endodontic treatment to endodontists. Endodontists are dentists with specialty training in endodontic treatment. As specialists, they practice only endodontics. To become an Endodontist, one has to complete both dental school and an additional two or more years of advanced training. They are trained to perform routine as well as very complex endodontic procedures, e.g. endodontic surgery. Endodontists are also experts in determining the cause of oral and facial pain. |
|
| Additional Questions and Answers | |
| Why would
I need endodontic treatment? |
|
| Endodontic treatment is necessary when the pulp
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, a
blow to a tooth may cause damage even if the tooth has no
visible chips or cracks. If the pulp inflammation or infection
is left untreated, it can cause pain or lead to an abscess
(infection of the root). Signs of pulp damage include pain, prolonged sensitivity to heat or cold, discoloration of the tooth, and swelling and tenderness in the nearby gums. Sometimes, there are initially no symptoms. |
|
|
Will I feel pain during or after the
procedure? |
|
| Many endodontic procedures are performed to
relieve the pain of toothaches caused by pulp inflammation or
infection. With modern techniques and anesthesia, most patients
report little pain 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. This discomfort can be relieved with over-the-counter or prescription medications. Follow your endodontist's post-treatment instructions carefully. Your tooth may continue to feel slightly different from your other teeth for some time after your endodontic treatment is completed. However, if you have severe pain or pressure / pain that lasts longer than a few days, you should call your endodontist for advice. |
|
|
Post-Treatment Care |
|
| You should not chew or bite with the treated
tooth until you have had it restored by your general dentist. An
unrestored tooth is susceptible to fracture, so you should see
your dentist for 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 some cases, a tooth that has undergone endodontic treatment may fail to heal or continue to cause pain. In other cases, the tooth may become painful or diseased months or even years after successful treatment. In either case, another endodontic procedure can often still save the tooth and eliminate the pain.. Additional trauma, deep decay or a faulty filling can lead to new infection in your tooth. In some cases, an endodontist may only later discover very narrow or curved portions of canals that were not treated during the initial procedure. |
|
910-762-1000
910-251-8850
Wilmington, NC
Endodontic Care