What is an Endodontist and Endodontics?

An endodontist is a dentist who specializes in the treatment of oral conditions that arise as a result of disease or injury to the dental pulp of a tooth.

Endodontics is the more scientific term for what is usually called "root canal treatment".

The dental pulp is a soft tissue comprised primarily of blood vessels and nerves. It is located in the innermost core of a tooth called the root canal space. The pulp is most often injured by deep dental caries, a direct blow to a tooth, or sometimes periodontal disease. If the pulp is so damaged that it cannot repair itself, it dies and becomes a source of infection. This infection spreads through the pulp to the tissues (ligament and bone) that surround and support the tooth in the jaw. A dental abscess then forms at the end of the root if this condition is neglected or not treated promptly.

What exactly is involved?

Endodontic treatment, in most cases, is painless. To insure your comfort, a local anesthetic will be administered before beginning treatment. The first step in root canal therapy is to locate all of the root canals within the tooth, remove the pulp tissue, and clean and shape the canals. The final step of root canal treatment is to seal the root canals with an inert, rubber-type filling called gutta percha that will help prevent the canals from becoming reinfected. A temporary filling will be placed in the top of the tooth to insure that the canals will not become contaminated by saliva until you can get a permanent restoration by your general dentist.

How many visits and what to expect after treatment?

It varies, but usually one or two. Although treatment is normally painless, occasionally reactions (i.e. discomfort and even swelling) can occur after root canal therapy. After your appointment you may be given a prescription for antibiotics and/or pain medications depending upon your particular case.

After treatment, you may have mild to moderate discomfort in the area of your root canal for a few days. The area may be tender for about a week and your tooth may actually feel "different" than the others for about a month.

What is the success rate?

When done by a specialist, endodontic treatment is successful in approximately 90% of the cases. If the chances of success are estimated below this average, you will be informed of this and given the decision to continue with treatment or have the tooth extracted by your general dentist or an oral surgeon. In the event initial healing does not occur as expected, secondary procedures may be indicated that will allow you to maintain the tooth such as retreating the root canals or doing a surgical procedure.

Why a specialist?

There are several possible reasons why your general dentist may have referred you here. Quite simply, it is usually because your general dentist wants to provide you with the best possible treatment available. Root canal anatomy can be quite variable and the canals difficult to locate. The canals of some teeth may be tiny or curved which makes instrumentation difficult.

In other instances, your general dentist may feel your case is atypical in some way, and requires the attention of a specialist. The microbiology of root canal systems can be rather complex. For example, an abscess is usually a "mixed infection". That is, several different types of bacteria are present and each may respond differently to the antibiotic of choice. Sometimes, patients simply do not respond to our routine methods. When this occurs, a specialist's opinion is probably indicated.