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What is endodontic treatment?

“Endo” is the Greek word for “inside” and “odont” is the Greek word for tooth. Endodontic treatment treats the inside of the tooth.

To understand endodontic treatment, or more specifically, the procedure commonly called "a Root Canal", it helps to know something about the anatomy of the tooth. Inside the tooth, under the hard layers of enamel and dentin, is the soft tissue of the pulp or root canal space. The pulp contains blood vessels, nerves, lymphatics, and connective tissue. The role of the pulp is to create the surrounding hard tissues of the tooth during initial development.

The pulp extends from the crown of the tooth to the tip of the roots where it connects to the tissues surrounding the root. The pulp is important during the tooth’s growth and development. However, once a tooth is fully formed and mature, it can survive without the pulp, because the tooth continues to be nourished by the surrounding tissues of the attachment apparatus, for example, the periodontal ligament and the bone.

Who performs endodontic treatment?

All dentists receive training in endodontic treatment in dental school; however endodontists are dental specialists who received special, advanced training in endodontic procedures. Endodontists only provide endodontic services in their practices. To become an endodontist, an individual completes dental school and then spends an additional two or three more years of advanced training specifically in endodontics. Endodontists perform routine, as well as difficult and very complex endodontic procedures, including endodontic surgery. Endodontists are also very experienced at finding the cause of oral and facial pain.

Why would I need an endodontic procedure?

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 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 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 no symptoms.

The endodontist removes the inflamed or infected pulp, carefully cleans and shapes the inside of the tooth, then fills and seals the space. Afterwards, you will return to your dentist, who will place a crown or another restoration on the tooth to protect and restore it to full function. After the restoration, the tooth continues to function like any other tooth in the oral cavity.

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 feeling totally 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. This discomfort can be relieved with over-the-counter or prescription medications. Follow your endodontist’s 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, or pain that lasts more than a few days, please call your endodontist.

How much will the procedure cost?

The cost varies depending on how severe the problem is and which tooth is affected. 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 in order to restore chewing function and prevent adjacent teeth from shifting. These prosthetic procedures tend to cost more than endodontic treatment and appropriate restoration.

Should I be concerned with the x-rays?

No. While x-rays will be necessary during your endodontic treatment, we use an advanced non-film computerized system, called digital radiography, which produces radiation levels up to 90% less than those of conventional low dose dental x-ray machinery. These digital images can be optimized, archived, printed and sent to co-therapists via e-mail or diskette. For more information contact Kodak Dental Systems at carestreamdental.com/en-us.

Will the tooth need any special care or additional treatment?

You should not chew or bite on the treated tooth until you have had it restored by your dentist. The un-restored 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 fails to heal or the pain continues. Often when this happens, another 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, tooth fractures, and or coronal leakage can cause new infection in your tooth requiring treatment. In some cases, the endodontist may discover 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 cannot be treated because the root canals are not accessible, the root is severely fractured, the tooth does not 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. Furthermore, when endodontic treatment is not effective, endodontic surgery may be able to save the tooth.

What are the alternatives to endodontic treatment?

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 must be replaced with an implant or bridge. This requires surgery or dental procedures on adjacent healthy teeth and can be far more costly and time-consuming than endodontic treatment and restoration of the natural tooth.

No matter how effective modern tooth replacements are — and they can be very effective — nothing is as good as a natural tooth.

What new technologies are being used?

In addition to digital radiography, we utilize special microscopes, magnification and fiber optic illumination, and ultrasonics which all aide the doctor in seeing tiny details inside your tooth during surgery or other complex cases. In addition, we will soon have the capabilities of using a video camera on the microscope to record images of your tooth and the procedure. These images can be shared with your referring doctor.

What happens after treatment?

When your root canal therapy has been completed, a report of your treatment will be sent to your restorative dentist. You should contact their office for a follow-up restoration visit within a few weeks of completion at our office. Your restorative dentist will decide on 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. Nevertheless, we are available to respond at all times if a problem does occur.

What about Infection Control in the office?

Again, there's no need for concern. 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 advanced autoclave sterilization and barrier techniques to eliminate any risk of infection.