What is an Endodontist?

Endodontists are dentists with at least two additional years of advanced specialty education in diagnosis and root canal treatment, including apical surgery. Because they limit their practices to endodontics, they treat these types of problems every day. They use their special training and experience in treating difficult cases, such as teeth with narrow or blocked canals, or unusual anatomy. At Premier Endodontic Associates Inc., our three endodontists have access to state of art equipment and technology, such as operating microscopes, ultrasonics and digital imaging, to better perform these special services.

Why Would I Need Endodontic Treatment?

Endodontic treatment is necessary when the dental pulp has been irreversibly damaged by infection or inflammation. Deep caries [cavities] is the most common cause leading to a root canal procedure. Other causes include repeated dental procedures, cracks on the tooth, and trauma. If pulp inflammation or infection is left untreated, it can cause pain or lead to an abscess.

Signs & Symptoms Commonly Experienced by Patients With Endodontic Needs.

Patients often report prolonged sensitivity to heat and cold, tenderness to biting or discoloration of the tooth. Sometimes a pimple (called sinus tract) can be noticed on the gums around the infected tooth. Swelling inside and outside of the mouth can also be present. Sometimes there are no symptoms and the need for treatment is discovered on a routine xray.

What to Expect From Your Visit?

A typical visit to an endodontist begins with completing a medical history and consent forms. It is advisable to bring a list of all the medications (over-the-counter and prescription) that you regularly/have taken within the past month. Do not discontinue any prescription medication before your appointment. If any changes are necessary prior to your treatment, your endodontist will contact your physician. You should also bring the referral slip and any radiographs that your dentist may have given you. Once all forms are complete, an assistant will review and chart your chief complaint, referring dentist’s information and history of the tooth pain before taking x-rays of your teeth.

Once your first set of x-rays are complete, you will be greeted by your endodontist, who will review your paperwork and evaluate symptoms prior to testing the tooth in question along with adjacent teeth. After the tests are complete, a diagnosis will be given to determine the best treatment care and prognosis. Possible post-treatment decisions such as a crown on the treated tooth will be addressed.

Your endodontist will make you aware of the benefits, options and risks involved in order for you to understand how endodontic treatment can save your tooth. If you decide to receive treatment, the procedure may start immediately. Before treatment begins, you will receive local anesthesia to numb any sensations you may feel during the procedure. If the procedure is unable to be completed within one visit, medicine may be placed inside the tooth between appointments.

Once your procedure is complete, additional x-rays are taken to track the success of the treatment. You will be provided with review sheets that include your post-operation instructions and what to expect over the next few days. Patients usually can drive after the procedure and can go back to their normal activities right after endodontic treatment.

Is a Root Canal Painful?

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.

What should I expect following endodontic treatment?

The root canal system inside your tooth has been thoroughly cleaned, and the irritated tissue and bacteria that have caused you to need root canal treatment are gone. For the first few days after treatment, your tooth may feel sensitive, especially if there was pain or infection before the procedure. It is normal to feel some tenderness in the area over the next few days as your body undergoes the natural healing process. You may also feel some tenderness in your jaw from keeping it open for an extended period of time or from the numbing procedure. These symptoms are temporary and usually respond very well to over-the-counter or prescription pain medications. It is important for you to follow the instructions on how to take these medications.

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 swelling, severe pain or pressure or pain that lasts more than a few days, call your endodontist.

Remember that narcotic medications, if prescribed, may make you drowsy, and caution should be exercised in operating dangerous machinery or driving a car after taking them.

Taking Care of Your Tooth after Endodontic treatment

Root canal treatment is only one step in returning your tooth to full function. A proper final restoration of the tooth is essential in ensuring long-term success.Contact your dentist within four weeks to arrange your next appointment. If your tooth is being treated in more than one visit by an endodontist, do not return to your dentist for the final restoration until the root canal treatment is completed.

The tooth that has had appropriate endodontic treatment followed by a proper restoration can last as long as your other natural teeth. After the tooth has been restored, you need only practice good oral hygiene, including brushing, flossing, regular checkups and cleanings. Your dentist or endodontist may periodically x-ray the tooth to ensure that healing has occurred. Occasionally, a tooth that has undergone endodontic treatment does not heal or pain continues. At times, the tooth may become painful or diseased months or even years after successful treatment. Often when this occurs, repeating the endodontic procedure can save the tooth.

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 severely damaged by decay and cannot be properly 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.

How Does Endodontic Treatment Save the Tooth?

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

What are the Alternatives to Endodontic Treatment, Retreatment and/or Endodontic Surgery?

The only other alternative is 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 treatment and restoration of the natural tooth.

No matter how effective tooth replacements are—nothing is as good as your own natural tooth. The payoff for choosing endodontic treatment could be a healthy, functioning natural tooth for many years to come.