The most popular question we get is What is Endodontics? Endodontics is a branch of dentistry recognized by the American Dental Association involving diagnosis and 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, trauma, periodontal disease, tooth fracture or other problems, can severely damage the pulp. When that happens, an endodontic specialist removes the diseased pulp to save the tooth and prevent further inflammation and infection. After successful endodontic treatment, the tooth continues to perform normally. Here are some other popular Frequently Asked Questions…

What are the signs of needing endodontic treatment?

Look for signs of discoloration of the tooth, prolonged sensitivity to hot or cold temperatures, tenderness to chewing or to the touch, pain and swelling, drainage and tenderness in the lymph nodes and nearby bone and gum tissues. Sometimes, there may be no symptoms or signs at all.

How does endodontic treatment save the tooth?

The Endodontist removes the inflamed or infected pulp, carefully cleans and shapes the inside of the root canal, then fills and seals the space. Afterward, 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.

Will the tooth need any special care or additional treatment after endodontic 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.

If implants are so good, why not just place an implant and forego a root cancel endodontic treatment?

The biggest criticism of the implant world today is that far too many teeth are being removed that could have been saved with a good long-term prognosis with correct endodontic treatment or re-treatment. Our observation over the years is that every single implant course shows cases where implant placement was unnecessary, and this is simply wrong. That is why it is important to consult with an endodontist who also does implants so you will receive the best possible advice before removing a tooth.

What happens when a tooth is lost?

The bone socket resorbs away, adjacent teeth shift opposite teeth extrude out of the socket. A healthy bite will collapse with remaining teeth in the area, causing them to become crooked. All this deterioration is associated with lip and cheek wrinkling with time. Today, a dental implant is the ideal way to prevent these problems associated with early tooth loss when successful endodontic treatment is not possible.

Why would I need a root canal treatment?

Endodontic treatment is necessary when the pulp of a tooth becomes inflamed or infected. The causes of the inflammation or infection include deep decay, repeated dental procedures on a 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.

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. 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, call your Endodontist.

What are the alternatives to endodontic retreatment and/or endodontic surgery?

The only other alternative is the extraction of the tooth. The extracted tooth must then be replaced with an implant, bridge or removable partial denture to restore chewing function and to prevent adjacent teeth from shifting. Because these options require extensive surgery or dental procedures on adjacent healthy teeth, they can be far more costly and time-consuming than retreatment and restoration of the natural tooth. No matter how effective tooth replacements are—nothing is as good as your own natural tooth. You’ve already made an investment in saving your tooth. The payoff for choosing retreatment could be a healthy, functioning natural tooth for many years to come.

If a tooth is already missing or cannot be saved with endodontic treatment, why is an implant a good option for replacement?

Implant technology, advancing both surgical and restorative aspects, has made dental implants the optimal tooth replacement in almost all clinical cases. The dental implant simply and predictably prevents bone loss and restores function and esthetics without impacting or involving adjacent teeth. Bridge replacement opens a Pandora’s box for future dental problems on adjacent abutment teeth and simply does not have as good a long-term prognosis as a dental implant replacement.

What happens after treatment?

When your root canal therapy has been completed, a record of your treatment will be sent to your restorative dentist. You should contact their office for a follow-up restoration 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. If a problem does occur, however, we are available after hours.