What is an Endodontist?

An Endodontist is a dentist who has undergone a minimum of 2 years of additional postgraduate training. This Specialist training allows an Endodontist to:

Manage and treat diseases of the dental pulp and supporting structures.
Diagnose facial pain and related problems.

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

What is Endodontics?

"Endo" is the Greek word for "inside" and "odont" is Greek for "tooth."Endodontic treatment treats the inside of the tooth. 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 tooth function of the tooth. The tooth continues to be nourished by the tissues surrounding it even after the pulp is removed.

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.

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.

What are the signs of needing endodontic treatment?

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.

How does endodontic treatment save the tooth?

Dr. Wilson removes the inflamed or infected pulp, carefully cleans and prepares the canal system and then seals the prepared space. Most treatment is now performed in a single appointment ranging from 60-90 minutes. More complicated cases may require additional appointments. 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?

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. Seeking treatment early makes the procedure more comfortable, so it is important not to wait until the pain is severe. For the first few days after treatment, there may be a mild ache in the area and some sensitivity to biting pressure, especially if there was pain or infection before the procedure. This discomfort can be relieved with over-the-counter or prescription medications. Please see our section on post root canal information for further information on post-visit instructions. It is not uncommon for your tooth 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 that lasts more than a few days, please call our office.

Endodontic Procedure

Endodontic treatment can often be performed in one or two visits. The number of visits and time required to for treatment depends on your particular case. The root canal procedure involves the following steps:

Dr. Wilson will administer local anesthetic to anesthetize the area of treatment. After the tooth is numb, we will place a small protective sheet called a "dental dam" over the area to isolate the tooth and keep it clean and free of saliva during the procedure.
Dr. Wilson will make 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.
After the space is cleaned and shaped, Dr. Wilson 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. A filling is placed to close the opening. In most cases this will be a temporary filling which will be removed by your dentist before the tooth is restored.
After the final visit with Dr. Wilson, 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 Dr. Wilson may place a post inside the tooth. Ask your dentist or Dr. Wilson for more details about the specific restoration planned for your tooth.

Will the tooth need any special care or additional treatment after treatment?

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, redoing the endodontic procedure can save the tooth.

What causes an endodontically treated tooth to need additional treatment?

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.

Can all teeth be treated endodontically?

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