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. 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, fracture, or trauma can severely damage the pulp. When this happens, an endodontic specialist removes the diseased pulp to save the tooth and prevent further infection and inflammation. After successful endodontic treatment, the tooth continues to function normally.
Endodontists are dentists who specialize in treating diseases of the dental pulp and supporting structures, diagnosing facial pain and related problems, and treating traumatic dental injuries. All dentists are trained in diagnosis and endodontic therapy; however, some teeth can be especially difficult to diagnose and treat. That’s why you have been referred to an endodontic specialist. In addition to dental school, endodontists receive at least two additional years of advanced education in this kind of treatment. They study root canal techniques and procedures in greater depth for diagnosis and treatment of more difficult cases.
Board-certified endodontists have completed the highest level of education in the specialty. Board certification requires a challenging and lengthy process that spans over several years including written, oral, and case history exams. Becoming a Diplomate of the American Board of Endodontics places one in a distinguished group of endodontists who have demonstrated exceptional knowledge and skill, dedication to continued professional growth, and a commitment to providing the highest quality of patient care. Less than 25% of endodontists are Board-Certified.
Symptoms indicating possible need for root canal treatment include: pain, prolonged sensitivity to cold or heat, tenderness to touch and chewing, a ‘pimple’ on the gum, discoloration of the tooth, swelling, drainage, and tenderness in the lymph nodes or gums. However, it is not uncommon to have no symptoms at all.
Your initial appointment will consist of an examination followed by a consultation to explain your diagnosis and treatment options. Occasionally, treatment can be started on the same day as the consultation.
To provide you with a painless and comfortable experience, small amount of anesthetic will be placed to gently numb a concentrated area of your mouth. A sheet of synthetic material called the “rubber dam” will be placed around the tooth to isolate it, thus keeping it clean and dry during treatment. The procedure consists of removing the inflamed or infected pulp, carefully cleaning and shaping the inside of the canals, and filling and sealing the tooth. Most treatments are completed in just a single visit. Occasionally, 2 or 3 appointments are necessary depending on the degree of infection/inflammation and treatment difficulty.
When your root canal therapy has been completed, a detailed record of your treatment will be sent to your referring dentist. You should contact his or her office for a follow-up restoration within a few weeks of completion at our office. Your dentist will decide which type of restoration is necessary to protect your tooth. It is rare for endodontic patients to experience complications after routine endodontic treatment or microsurgery.
For most root canal treatments, we recommend that patients return to our office at approximately 1 year after completion of the procedure. Our office will send a reminder notice when you are due for a follow-up appointment.
In most cases you will need to see your general dentist for follow-up care after the root canal has been completed. Many teeth will require a crown to protect the tooth after endodontic therapy is performed. In some circumstances our office will be able to provide the final restoration.
We will take every measure to ensure that your procedure is comfortable and painless. We will inject a small amount of anesthetic to gently numb a concentrated area of your mouth. For most patients, the feeling of numbness usually subsides after 2-3 hours. Your tooth may feel sensitive for two to seven days after treatment. Your body needs time to repair the damage that the original irritant caused. This is normally relieved with over-the-counter medications such as Advil. We will provide you with thorough instructions for managing any discomfort. Your tooth may continue to feel slightly different than 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 do not hesitate to contact our office.
In most cases we will have a copy of a recent X-ray provided to us by your dentist. Additional X-rays will most likely be required to properly make a diagnosis. This may include a 3-D scan if your case is especially complex. Please understand that X-rays are the primary means by which endodontists are able to properly evaluate our work. They are an integral part of both the examination and treatment. We will only take those radiographs that are absolutely necessary for proper care and documentation.
The cost of root canal treatment varies depending on which tooth is affected and the complexity of the treatment. Molars are more difficult to treat thus the fee is usually higher. Generally, endodontic treatment and restoration of the natural tooth are less expensive than the alternative: tooth extraction and replacement with a bridge or an implant to restore chewing function and prevent adjacent teeth from shifting. During your consultation we will thoroughly discuss the fees involved and will review your expected insurance coverage.
All of our rooms are equipped with nitrous oxide (laughing gas). If you are nervous about the procedure please let us know so that we can take the extra steps to alleviate your anxiety. While were are able to painlessly and comfortably treat most of our patients with local anesthetic and nitrous oxide, there are some who require a bit more relaxation. For these patients we can prescribe medications that provide a deeper level of relaxation. These patients will be required to be escorted by a driver.
The majority of endodontically treated teeth last as long as other teeth. Occasionally, a tooth that has undergone endodontic treatment may not heal properly or the tooth may become painful or diseased months or years after successful treatment. When this occurs, the tooth can often be maintained with a second endodontic treatment or surgery.
Root canal treatment is a predictable procedure with a success rate of up to 95%. As with any medical or dental treatment, occasionally teeth do not respond to traditional root canal therapy. There are specific factors that can increase or decrease the success of root canal treatment. We will thoroughly discuss our long-term expectations for your tooth before any endodontic procedure in order to help you make an informed decision. If root canal treatment is unsuccessful, there are other options that we may recommend to help you maintain your teeth, including endodontic retreatment or surgery.
New trauma, deep decay, or a cracked or broken restoration can cause new infection in your tooth. Lack of proper disinfection or lack of infected tissue removal from the first root canal can also cause the need for an endodontic retreatment.
Although root canal procedures are intended to help save your tooth, this is not always possible. Often, the only alternative to endodontic treatment is extraction of the tooth. Missing teeth can affect your ability to chew, cause other healthy teeth to shift, and have a negative impact on your overall health.
Root canal treatment has been performed regularly since the early 19th century. Over 25 million endodontic treatments are performed every year. Many published articles of scientific research have looked at the lasting health effects and found no long-term health risks associated with root canal treatment. The American Medical Association, American Dental Association and the National Institutes of Health all independently recognize root canal treatment as a safe and effective procedure.