In order to best understand what an endodontist does, you need to know a little something about root canals. When an infection such as a cavity reaches the tooth’s roots, it infects the pulp and nerves and kills the tooth. Endodontic therapy is often the only option to save the tooth from a tooth extraction.
Endodontists may use any of the following procedures to do so:
Endodontic Therapy — Commonly known as root canal treatment, endodontic therapy is used to remove the infected pulp and nerves from the tooth’s root canals. During endodontic treatment, your root canal dentist uses small files to clean the pulp from the chamber and shape the canals. The canals are then filled to seal the chamber off from infection. A dental crown is usually placed to restore and protect your tooth from further damage. After your visit to your dental endodontist is complete, you may return to your general dentist to for your restoration.
Endodontic Retreatment — Endodontic therapy has over a 95 percent success rate. But in the cases where a root canal fails, endodontic retreatment is often necessary. A tooth can become re-infected at any time — sometimes months or years after the original treatment. Retreatment is often referred to dental endodontists due to the complexity of their nature. During retreatment, endodontists remove the crown and dental filling material to regain access to the root canals. Your endodontist will thoroughly clean the canals and remove any infection left behind.
Endodontic Surgery — If endodontic retreatment fails or is not an option, endodontic surgery may be used to save the tooth. Types of endodontic surgery include:
- Apicoectomy: The most common type of endodontic surgery is an apicoectomy, or root-end resection. An apicoectomy removes the tip of the root and relieves the infection surrounding the end of your tooth’s root. During the procedure, your dental endodontist will access the area via the gums to remove the infection, then fill the area and stitch the gums to help them heal.
- Exploratory Surgery: When the source of your pain can’t be detected on an X-ray, your endodontist can use surgery to detect the problem and provide treatment. Exploratory surgery is often used to detect root fractures and problems in the bone.
- Intentional Replantation: During intentional replantation, the tooth is extracted, given endodontic treatment and re-implanted back into its socket.
- Other Types of Surgery: Endodontists are trained in several other types of surgery, which may include dividing the tooth in half, repairing injured roots or removing one or more of the roots entirely. Surgery may also be used if your canal has a significant blockage that cannot easily be removed with the files.
Endodontic treatment is a very detailed procedure. Whether you need an endodontist depends on the complexity of your endodontic procedure. Your general dentist may refer you to an endodontist if his or her practice doesn’t offer endodontic services, your case is beyond their expertise or endodontic retreatment or surgery is recommended.
It’s important for dentists to remove all of the infection to prevent a tooth abscess or relapse. If your canals are unusually shaped or curved, you’re at greater risk of leaving infection behind. If the filling doesn’t go deep enough into the canal or breaks down over time, bacteria can get back into the root canal and re-infect the area. Narrow canals put you at risk of the files getting stuck or not fitting, and blocked canals mean your root canal dentist may not be able to do the treatment at all. Some canals are hard to detect and may be missed during treatment. A dentist with root canal experience can lessen these risks, which is why some patients may choose an endodontist for their procedure.
Your endodontist will help you determine which type of endodontic treatment is best for you. With root canal treatment, there is nothing to fear. Endodontists are highly trained to provide you with the best treatment possible. Many dental endodontists use advanced technology and sedation techniques for a practically painless dental experience. Laser dentistry is also becoming a part of many endodontists’ practices.
Whenever possible, it’s always preferable to save a tooth rather than extract it. Missing teeth can cause shifting teeth, malocclusions and jawbone loss. But a root canal can last the rest of your life if taken care of properly.
Endodontics (from the Greek endo “inside”; and odons “tooth”) is the dental specialty concerned with the study and treatment of the dental pulp. Endodontists perform a variety of procedures including endodontic therapy (commonly known as “root canal therapy”), endodontic retreatment, surgery, treating cracked teeth, and treating dental trauma. Root canal therapy is one of the most common procedures. If the pulp (containing nerves, arterioles, venules, lymphatic tissue, and fibrous tissue) becomes diseased or injured, endodontic treatment is required to save the tooth. Endodontics is recognized as a specialty by many national dental organisations including the American Dental Association, Royal College of Dentists of Canada, and Royal Australasian College of Dental Surgeons.
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