An Endodontist is a dentist with extensive training in the treatment of problems in the root canal of a tooth. This specialty training takes two or more years beyond dental school which means an Endodontist is an expert in the various root canal treatments. Endodontics is a branch of dentistry recognized by the American Dental Association involving treatment of the pulp (root canal) and surrounding tissues of the tooth. After successful endodontic treatment, the tooth continues to perform normally.
What is a Root Canal?
Endodontic treatment can often be performed in one or two visits and involves the following steps:
1. The endodontist examines and x-rays the tooth, then administers local anesthetic. After the tooth is numb, the endodontist places 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.
2. The endodontist makes 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.
3. After the space is cleaned and shaped, the endodontist 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. In most cases, a temporary filling is placed to close the opening. The temporary filling will be removed by your dentist before the tooth is restored.
4. After the final visit with your endodontist, 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 endodontist may place a post inside the tooth. Ask your dentist or endodontist for more details about the specific restoration planned for your tooth.
An Overview of Endodontic Surgery
Why would I need Endodontic Surgery? Generally, a root canal is all that is needed to save teeth with injured pulp from extraction. Occasionally, this non-surgical procedure will not be sufficient to heal the tooth and your Endodontist will recommend surgery. Endodontic surgery can be used to locate fractures or hidden canals that do not appear on x-rays but still manifest pain in the tooth. Damaged root surfaces or the surrounding bone may also be treated with this procedure. The most common surgery used to save damaged teeth is an apicoectomy or root-end resection.
What is an Apicoectomy? An incision is made in the gum tissue to expose the bone and surrounding inflamed tissue. The damaged tissue is removed along with the end of the root tip. A root-end filling is placed to prevent reinfection of the root and the gum is sutured. The bone naturally heals around the root over a period of months restoring full function.
Following the procedure, there may be some discomfort or slight swelling while the incision heals. This is normal for any surgical procedure. To alleviate any discomfort, an appropriate pain medication will be recommended. If you have pain that does not respond to medication, please call our office.
With the appropriate care, your teeth that have had Endodontic treatment will last as long as other natural teeth. Yet, a tooth that has received treatment may fail to heal or pain may continue to exist. Sometimes, the pain may occur months or years after treatment. If so, Endodontic Retreatment may be needed.
Improper healing may be caused by:
Curved or narrow canals were not treated during the initial treatment
Complicated canals went undetected during the initial treatment
The crown or restoration was not placed within the appropriate amount of time following the procedure
The crown or restoration did not prevent saliva from contaminating the inside of the tooth
In some cases, new problems can influence a tooth that was successfully treated:
New decay can expose a root canal filling material, causing infection
A cracked or loose filling or crown can expose the tooth to new infection
Once retreatment has been selected as a solution to your problem, the doctor will reopen your tooth to gain access to the root canal filling material. This restorative material will be removed to enable access to the root canal. Your canals are cleaned and carefully examined to assess the nature of the problematic tooth. Once cleaned, the doctor will fill and seal the canals and place a temporary filling in the tooth. At this point, most likely you will need to return to your dentist as soon as possible in order to have a new crown or restoration placed on the tooth to ensure full functionality.
When the outer hard tissues of the tooth are cracked, chewing can cause movement of the pieces, and the pulp can become irritated. When biting pressure is released, the crack can close quickly, resulting in a momentary, sharp pain, Irritation of the dental pulp can be repeated many times by chewing. Eventually, the pulp will become damaged to the point that it can no longer heal itself. The tooth will not only hurt when chewing but may also become sensitive to temperature extremes. In time, a cracked tooth may begin to hurt all by itself. Extensive cracks can lead to infection of the pulp tissue, which can spread to the bone and gum tissue surrounding the tooth.
The Team at Anchor Endodontics understands the "reputation" associated with Root Canal treatment. While some patients sleep through their treatment others have a high level of fear and anxiety. For these patients we offer three different sedation options. Our goal is to remove any barriers that would prevent a patient from seeking tooth saving treatment. Below are descriptions of the various types of sedation we offer. Please consider which option might be right for you.
Feel free to call our office for more information- 253-268-0097.
Root Canal Treatment is Safe and Effective
Internet claims that root canal treatment causes cancer or other health problems are unfounded. Decades of research—and millions of successful treatments annually—prove that endodontic treatment is safe and effective.
If you are concerned about the safety of root canal treatment, you may find these AAE resources useful:
Focal Infection Theory Fact Sheet – explains the history of focal infection and research showing that there is no valid, scientific evidence linking endodontically treated teeth and systemic disease.
Myths About Root Canals and Root Canal Pain – this information on the AAE website explains the safety and effectiveness of root canal treatment.
Tooth Saving Tips – another resource explaining why saving a tooth should always be the first choice for the greatest health and cosmetic results
Please Call or Email our office with any questions or concerns regarding Root Canal Treatment and safety.