About Endodontics
Endodontics is a specialized field of dentistry that focuses on the research and treatment of blood vessels, neural and connective tissues inside the roots of a tooth in an effort to alleviate pain, swelling and infection inside the tooth and in the tissues surrounding the tooth.
When you look at one of your teeth in the mirror, what you see is the crown. The rest of the tooth, hidden beneath the gum line, is called the root. While the outer layer 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 enter as a result of tooth decay, fracture, gum disease or other problems, can severely damage the pulp. When that happens, the endodontist removes the diseased pulp to save the tooth and prevent further infection and inflammation.
Endodontic treatment is a process that incorporates medicinal chemicals to clean the inner structure of a tooth and a physical cleansing technique to maintain the function and health of the tooth and bone supporting and surrounding it.
How will I know when I need it?
Endodontic treatment is necessary when the pulp becomes inflamed or infected. Symptoms of pulp damage include pain, prolonged sensitivity to heat or cold, tooth discoloration, and swelling. Occasionally, the tooth may have no symptoms. Endodontic therapy is concerned with removing the pulp tissue, cleaning and filling/sealing the space. Other treatment modalities involve surgical root canal therapy.
How can endodontic treatment help my tooth?
The endodontist removes the inflamed 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). After successful endodontic treatment, the tooth continues to function normally.
How is root canal therapy performed?
If it is determined that root canal therapy is needed to save your tooth, endodontic treatment will be initiated.
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With appropriate care, teeth that have received endodontic treatment will be as durable as natural teeth. Occasionally, a tooth may need retreatment, presenting symptoms that can include pain or sensitivity. Symptoms might occur months or even years after treatment.
These are a result of: 1) insufficiency of previous treatment (improper cleaning, shaping and obturating of the canal systems in the tooth, and/or 2) leakage into a previously treated canal system due to failure of a permanent coronal restoration (crown or filling) due to excessive wear or recurrent decay, which can yield bacterial recontamination of the canal systems.
If your tooth has failed to heal or developed new problems, endodontic retreatment can save it.
Endodontic retreatment begins with removing restorative materials such as a crown or filling to allow access to the root canals. Next, the root canals are examined, cleaned, and shaped.
In addition, exploring for untreated canals is done. After the canals are cleaned, shaped and measured, the endodontist fills and seals the canals. The tooth is then restored with a temporary filling, which your general dentist will replace with a permanent one.
In this procedure, the endodontist opens gum tissue near the tooth to view the underlying bone and remove inflamed or infected tissue. The very end of the root is also removed.
A small filling may be placed in the root to seal the end of the root canal, and a few stitches or sutures are placed to help the tissue heal properly.
Over a period of months, the bone heals around the end of the root.
Patient tooth with previous endodontic treatment failing. Note the bone loss at the end of the roots which is indicative of a periapical infection.
The ends of the roots (apices) have been shorted, the bone has manually been cleaned and the ends of the roots have been filled or plugged with a biocompatible sealer. This will help the bone regenerate.
