- What is Endodontics?
- Why Choose an Endodontist?
- What is a root canal?
- Why does a toothache cause pain?
- Why do I need root canal therapy?
- What is involved in root canal therapy?
- What happens after treatment?
Endodontics is one of the nine dental specialties recognized by the American Dental Association and focuses on the treatment of diseases or injuries that affect the root tip or nerve of the tooth and the structures called the pulp chambers, pulp, and root canal of the tooth. Root canal therapy is the most common endodontic procedure.
Endodontists are dentists with at least two additional years of advanced specialty education in diagnosis and root canal treatment.
Since Endodontists limit their practices specifically to endodontics, they treat these types of problems every day. They use their special training and experience in treating difficult cases, such as teeth with narrow or blocked canals, or unusual anatomy.
Endodontists may also use advanced technology, such as operating microscopes, ultrasonics and digital imaging, to perform these endodontic services.
Underneath your tooth’s outer enamel and within the dentin is an area of soft tissue called the pulp, which carries the tooth’s nerves, veins, arteries and lymph vessels. Root canals are very small, thin divisions that branch off from the top pulp chamber down to the tip of the root. A tooth has at least one canal but many have 4 or more.
When the pulp becomes infected due to a deep cavity or fracture that allows bacteria to seep in, or injury due to trauma, it can die. Damaged or dead pulp causes increased blood flow, and this pressure cannot be relieved from inside the tooth. Pain in the tooth is commonly felt when biting down, chewing, or applying hot or cold foods and drinks.
Because the tooth will not heal by itself. Without treatment, the infection will spread, bone around the tooth will begin to degenerate, and the tooth may get loose and eventually fall out. Pain usually worsens until one is forced to seek emergency dental treatment. The only alternative is usually extraction of the tooth, which can cause surrounding teeth to shift, resulting in a bad bite. Though an extraction is cheaper, the space left behind will require an implant or a bridge, which is typically much more expensive than root canal therapy. Implants are great once your teeth are gone but if you have the choice, it’s always best to keep your original teeth.
First, a local anesthetic is given to numb the area. Once Dr. Fortman tests for depth of anesthesia a rubber sheet is placed around the tooth to isolate it and keep his instruments out of your mouth. Next, a small hole is drilled into the biting surface of the tooth and any affected tissue is cleaned and the canals reshaped. Disinfectants are used during reshaping to kill bacteria and remove residual pulp tissue. Depending on the condition of the tooth, the crown may then be sealed temporarily to guard against recontamination, or we may complete the root canal by placing the root filling. If the treated tooth has not had a crown then your general dentist will replace the missing tooth structure and temporary filling with a core build up and new crown. If a crown is present it can often be saved and the access filled with a tooth filling.
Bite sensitivity, sore chewing muscles and jaw discomfort are the typical symptoms our patients report post treatment but only for a few days. This can commonly be controlled by an over-the-counter pain killer like Ibuprofen or acetaminophen. On occasion a follow-up exam is scheduled to monitor tissue healing. Unless instructed not to do so brush and floss regularly, avoid chewing hard foods on the treated tooth, and see your dentist as soon as possible for your permanent restoration. See a more detailed list of instructions on our Post-Treatment Care page.