What is an Endodontist?
Endodontists are experts in saving teeth and are committed to helping you maintain your natural smile. They have at least two years of additional education to become experts in performing root canal treatment and diagnosing and treating tooth pain.
Endodontists are dentists who specialize in saving teeth through different procedures which involve the pulp (nerve) and root of tooth. An endodontist, is a dental specialist in the treatment of diseases and injuries to the dental pulp, root and surrounding tissues of the teeth.
What is a Root Canal?
A root canal is a dental treatment done under local anesthesia to remove a damaged nerve while saving the tooth. The procedure is done under a sheet of latex called the “rubber dam” (we’ve got non-latex ones too) placed around the tooth to isolate it, hence keeping it clean and dry during treatment. The treatment consists of three or four basic steps, but the number of visits will depend on your particular case. Some treatments take 2 visits but many are just a single visit. Occasionally 3 appointments are needed. It all depends on the degree of infection/inflammation and degree of treatment difficulty.
We believe it is more important to do it the very best we can than to meet a specific time criteria. Endodontic therapy when done properly and under ideal circumstances has a very high degree of success, up to 90%. Since all teeth do not always follow this criteria, we will discuss with you the chances of success for your specific tooth, before any endodontic procedure is done to help you make an informed decision.
Diagnosing and Treating Dental/Facial Pain
Oral pain such as toothaches or cracked / fractured teeth can often be difficult to pinpoint. Because of the vast network of nerves in the mouth, the pain of a damaged or diseased tooth often is felt in another tooth and/or in the head, neck, or ear. An endodontist is a specialist in diagnosing and treating this type of pain.
Dental Traumatic Injuries
Pulp damage is sometimes caused by a blow to the mouth, and the endodontist specializes in treating these traumatic injuries. For example, a blow to a child’s permanent tooth that is not fully developed can cause the root to stop growing. A procedure called apexification stimulates bone to be deposited at the end of the root which makes it possible to then save the tooth through a root canal procedure. An endodontist is specially trained in procedures for replanting teeth that have been knocked out of their sockets.
Endodontic therapy can be done in one, two or multiple visits depending on the tooth, the number of roots, the current condition of the tooth and the time available. Once endodontic therapy is completed a follow up exam and x-ray should be done about 12 months later. This allows us to make sure the tooth has healed or is healing properly.
Root Canal Retreatment
Occasionally a tooth that has undergone endodontic treatment fails to heal or pain continues despite therapy. Although rare, sometimes a tooth initially responds to root canal therapy but becomes painful or diseased months or years later. When either of these situations occur, the tooth often can be maintained with a second endodontic treatment. Retreatments can be done in two different ways: surgical or apicoectomies or non-surgical retreatments. The endodontist will determine which might be the best approach for your specific case.
With all the new technology and the evolution of finer dental materials, your tooth should NOT discolor after endodontic treatment. Nevertheless, especially with OLD root canal techniques, materials and cements, a tooth may appear discolored.
Signs of a Root Canal
A single dark tooth possibly indicates that the tooth might need a root canal because it has a dead nerve giving the tooth a darker gray/brownish hue. Discoloration might also be present in a tooth that had had a root canal treatment done many years ago, using older techniques, material and cements. The patient should see an endodontist for a consultation to determine if the tooth can undergo a procedure called “non-vital bleaching” to restore the color to a more natural color. This procedure requires the endodontist to re-enter the old root canal to activate strong chemicals “inside” the tooth to whiten it. This is an “in-office” visit, not to be confused with over the counter dental bleaching, which is whitening from the “outside.” Tooth discoloration can also be a sign of nerve damage or death, in which case, doing a root canal and non-vital bleaching is all that may be needed to restore the tooth.
Non-vital or Internal Bleaching
Single discolored tooth due to having a dead nerve. Treatment: Root Canal and Internal Bleaching.
What is an Apicoectomy?
Root canal therapy is generally all that is needed to save a tooth from extraction. However, there are occasions when after a root canal, a surgery is necessary to save a tooth. This is known as an apicoectomy or root-end resection. An incision is made in the gum and through a curettage, any inflamed or infected tissue is removed. The tip of the root is also removed and a root-end filling is placed to prevent reinfection of the root. The gum is then closed with a few sutures. The bone heals around the root over the next several months. This procedure is done usually under local anesthetic and patients can return to work immediately after the procedure.
What is Pulpal Regeneration and Apexification?
These procedures are performed on permanent teeth that are not fully developed, most often in children. They take the patient out of pain, and the goal is to allow the root of the tooth to continue to develop. The root will grow in length, the tip of the root will close and the walls of the root canal will thicken. A fully mature tooth with thicker dentine walls is desirable for long term retention. In other words, the tooth longevity will improve.