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Endodontics & Diagnostics

Endodontics

Your general dentist sometimes refers patients for consultation and possible treatment when the diagnosis is complicated or when treatment is more difficult than normal. Aside from providing treatment, our doctor's role is also that of educators. It is important that patients understand why they require treatment, what treatment involves and what they can do to ensure the best possible outcome. Our doctors believe that a properly informed patient has the best chance of achieving the optimal result.

What is Endodontics?

Endodontics is a specialty of dentistry that deals with diseases of the dental pulp and its supporting structures. Endodontists are dentists with special post-graduate training in this field. Endodontists are also experienced at finding the cause of oral and facial pain that has been difficult to diagnose.

Although general dentists can perform endodontic treatment, patients are often referred to an endodontist when the case is complicated or more difficult than usual.

In order to understand endodontic treatment, it helps to know something about the anatomy of a tooth. Teeth have several layers. The outside layer of the tooth is composed of a hard layer called enamel. Enamel is supported by an inner layer called dentin, which has at its center a soft tissue known as the pulp.

The pulp contains blood vessels, nerves, and connective tissue that are responsible for forming the surrounding dentin and enamel during tooth development. The pulp receives its nourishment supply from vessels which enter the end of the root. Although the pulp is important during development of the tooth, it is not necessary for function of the tooth. The tooth continues to be nourished by the tissues surrounding it even after the pulp is removed.

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, 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.

Signs and Symptoms

Indications for treatment include prolonged sensitivity to heat or cold, discoloration of the tooth, swelling or tenderness of the tooth or adjacent gums. Sometimes there are no symptoms.

How Can Endodontic Treatment help me?

The endodontist removes the inflammed or infected pulp, carefully cleans and shapes the canal system and then seals the prepared space. Most treatment is now performed in a single appointment ranging from 30-90 minutes (depending on the number of canals). Once treatment is completed, you may be instructed to return to your dentist for permanent reconstruction. The restoration of the tooth is an important part of treatment because it seals the cleaned canals from the oral environment, protects the tooth and restores it to function.

Will I feel pain during or after the procedure?

Toothache pain is the main reason for patients seeking 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 pressure, especially if there was pain or infection before the procedure. Sometimes over-the-counter anti-inflammatory medications (like Advil) are recommended for a day or two. Our doctors can prescribe other medications but they are rarely required.

Understanding Endodontics helps when you have some basic facts about tooth anatomy.

There are several layers of a tooth. The hard outer layer is the enamel. The supportive inner layer is the dentin and in the center of the tooth is the pulp which is a soft tissue. The pulp contains blood vessels, nerves and connective tissues. The pulp receives its nourishment from the vessels which enter the tooth at the root. The pulp is not necessary for the function of the tooth. The tooth can be nourished by the tissues surrounding it after the pulp is removed.

Endodontic treatment is necessary when the pulp becomes inflamed or infected. Common reasons for this inflammation or infection are cavities/caries, cracks, and trauma. If pulp inflammation and infection are not treated, it can cause pain or lead to an abscess. Signs and/or symptoms could be prolonged sensitivity to hot or cold temperatures, discoloration of the tooth, swelling or tenderness of the tooth or gums. Seeking treatment early can make the procedure more comfortable. Don't wait if you can help it!

Steps of a root canal: The Endodontist removes the inflamed or infected pulp, carefully cleans and shapes the canals of the tooth, and then seals the canals. This can be done in a single appointment, depending on the complexity and severity of your case. For the first few days after treatment, you may have some sensitivity.

Now that treatment is complete, we have you return to your general dentist. This should be done within 30 days of completing your root canal treatment. The restoration of your tooth is hugely important! If you do not have your tooth restored in a timely manner, the tooth can become contaminated and re-infected. The tooth needs to be sealed properly by your general dentist which protects your tooth and restores its function.

After treatment: 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 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. Should you have any questions or concerns before or after treatment, we welcome you to call or visit the office. We will be glad to assist you and will do our best to ensure your comfort.

Occasionally a tooth that has undergone endodontic, treatment fails to heal or pain continues despite therapy. 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 often can be maintained with a second endodontic treatment.

There are, of course, no guarantees. Root canal or endodontic therapy has a very high degree of success. Teeth which can be treated near ideal have a success rate up to ninety percent! We will discuss with you the chances of success before any endodontic procedure to help you make an informed decision. If a root canal or endodontic therapy is unsuccessful or fails you still have options. Our endodontists work closely with your general dentist. We will work together and discuss your treatment so that we can give you the best possible options while keeping your best interests in mind.