What is Endodontics?
Endodontics is the branch of dentistry concerned with the form, function, and disease of the dental pulp (what many casually refer to as the “nerve”) inside the tooth/root, and the supporting structures (like the “socket” that houses the root). Its study and practice include the etiology, diagnosis, prevention, and treatment of diseases and injuries to the pulp and/or surrounding tissues.

What is an Endodontist?
An endodontist is a dentist who has completed an additional 2 or 3 years post-graduate program, who specializes in pulpal and periradicular disease (root canal problems). An endodontist focus is on patients who may need root canal therapy, root canal retreatment
(re-do’s), or endodontically related surgeries.

Root canal therapy is a procedure where the pulp or “nerve” inside the tooth is removed, and the remaining canal spaces are cleaned, disinfected, and filled with a “gutta percha” type filling material. Root canal therapy may be necessary for a number of reasons, some of which include:
• decay near or into the nerve
• excessively broken-down tooth structure
• a cracked tooth resulting in pain to biting pressure
• sensitivity to extreme temperatures (hot/cold)
• an infected nerve resulting in a dental abscess

In almost all cases, the need for a root canal arises from inflammation or infection inside the tooth or around the roots. Sometimes a tooth which needs a root canal will be very sensitive, while in other cases, the tooth may be absolutely pain-free.

Saving your natural tooth should always be your first choice when dental care is needed.
Do everything possible to save your teeth.

Sometimes a tooth that has undergone endodontic treatment fails to heal or continues to cause discomfort. On rare occasion, a tooth that had initially responded well to root canal therapy can become painful or diseased months or years later. In such situations, the tooth often can be maintained with a second endodontic treatment. This requires “undoing” the initial procedure, which may include removal of a crown, build-up, and post, root filling material; and re-cleansing and enlarging of the entire root canal system. Then the canal spaces are repacked, and a new build-up and crown may be necessary. Retreatment cases are frequently more technically demanding than first time in root canal therapy, and often carry a less favorable prognosis. There are instances in which extraction, rather than retreatment, may be the treatment of choice.

Most of the time, a tooth with a diseased pulp can be treated with a conventional root canal, and the surrounding tissue in the socket will subsequently heal on its own. There are times, however, when infection or inflammation of the tissues adjacent to the root end persist or develop, and it may be prudent to approach this affected area surgically, through the gums and jawbone. Once the area is surgically exposed, the doctor can curette and clean the site, remove any bad part of the root, and seal the canal system at the resected surface. The purpose of this procedure is to help you save the natural tooth for as long as possible.

Reasons for endodontic surgery after a conventional root canal may include: persistent pain, continued inflammation and infection, removal of a cracked root if the rest of the tooth can be saved, or removal or repair of damaged/contaminated root surfaces. Alternatives to endodontic surgery are typically root canal retreatment whenever possible, or finally extraction. Your doctor will discuss your options, prognoses, and post-operative expectations with you.

There are various types of endodontic surgery, such as apicoectomy (where just the root end is cut away), root amputation (where an entire root is removed, as long as the remaining roots are sound), or hemisection (where a two rooted tooth is halved). All can be done painlessly with the usual local anesthesia (numbing), so that you are able to drive yourself. You may generally resume normal activities by the next day.