Endodontists and Endodontic Therapy

Treatment of tooth pulp and tissues surrounding the root of a tooth


Last modified: September 16, 2011


Alejandro Romero DMD
Orthodontist/General Dentist

Romero Orthodontics & General Dentistry
and WhereismyDoctor.com Contributing Writer


Endodontists and Endodontic Therapy

Endodontists and Endodontic Therapy Defined


Endodontics is best understood by separating these two concepts:

Endodontists

Endodontists are specialized dentists that work with endodontic therapy (all treatments dealing with the tooth pulp and the tissues surrounding the root of a tooth). Specialists in endodontics are experts at saving teeth that have had diseased or injured dental pulp, most commonly by utilizing root canal therapy. If root canal therapy is performed, the treated tooth will be cleaned and sealed and will be able to remain in the patient’s mouth, without needing to extract the entire tooth.

 

Endodontic Therapy

Endodontic therapy in itself can refer to the cleaning, shaping, and decontamination of the dental pulp with very small files and irrigating solutions, and the obturation (filling) of the root canals themselves.

Endodontic therapy is not limited to root canal therapy; however it is the most common procedure that an endodontist will perform.

A Good Candidate for Endodontic Therapy

Any patient who has had a breach of the dental pulp (which contains nerves, arterioles, venules, lymphatic tissue, and fibrous tissue) will develop an infection within that tooth. Once microorganisms, such as bacteria, invade the inner chamber of a tooth, that tooth is said to be infected and will result in a process of inflammation and disease that is usually manifest with what most people experience as “severe dental pain.’’

In other words, when there is severe dental pain, there is usually a dental infection on that tooth. In order to preserve that tooth in the mouth, endodontic therapy is indicated to clean, disinfect and seal up the dental pulp. Root canal therapy may also be indicated when severe trauma to a tooth has caused a breach of the dental pulp. Endodontic therapy will be able to save most of the dental structure that makes up a tooth intact in the patient’s mouth.

 

Endodontic Therapy Procedure


Once it has been established that an infection has occurred, Endodontists will be able to perform this procedure on most patient´s teeth. Depending on the severity of the case, previous to starting the actual root canal therapy, a dose of antibiotics will be prescribed in order to start reducing the infectious levels. Otherwise, the procedure can be started immediately.

Treatment itself is done with local anesthesia. After anesthetizing, the dentist will drill an opening into the affected tooth. This will enable all work to be done. When the affected tooth is properly numbed, endodontists will place a special rubber barrier around the tooth and will hold it in place with a metal clip in order to keep it in place.

This rubber ‘’dam’’ will protect the patient from any mishaps during the treatment as well as provide the dentist with a better field of vision. With the dam in place and anesthesia set in, very small files will be used to penetrate and remove all the canals contained within the affected tooth. Once a measurement has been determined of the correct root length, subsequent filing will be performed in order to increase the diameter of the root canals themselves.

Irrigation and disinfection will follow. At the moment a proper size has been reached, the decontaminated canals will be filled with special materials (such the latex called ‘’Gutta-percha’’) that will seal up correctly the inner chamber from the outside elements.


After root canal therapy, it is common that antibiotics and analgesics be prescribed. Removal of the pulp is for the most part painless, because of the anesthesia, but some discomfort can occur once its effects are gone. A recuperation time of 7 to 10 days is common to relieve any soreness. At the end of endodontic therapy, the tooth will have a permanent seal inside the root, but will, for the most part remain hollow due to the fact that a hole needs to be drilled in order to perform the procedure.

Patients should expect the affected tooth will need to be rehabilitated from this risky situation by means of a dental post and/or a dental crown.

Risks and Side Effects of Endodontic Therapy

One negative aspect of endodontic therapy is that the procedure is not 100% guaranteed to succeed. Another possible negative aspect is that the affected tooth might have a bigger number of root canals than usual, or ones so small that proper disinfection will be almost impossible.

There is also a chance that one of the files used to clean out the root canals can break inside the tooth and would require further treatment. That being said, recent studies published in the Journal of Endodontics show about a 97% long-term success rate on endodontically treated teeth.

[1] Probably the most important thing to remember about endodontic therapy is that, contrary to popular belief, ‘’root canals’’ (as they are commonly called), are not painful procedures. If the patient is properly anesthetized, the treating endodontist will be able to perform the procedure with minimal discomfort. And of course, the best part of all would be that the patient would continue to have his/her tooth in place, eliminating the need for dental extractions and their associated and expensive restoration solutions.

In other words, endodontic therapy is the best solution to treat infected teeth available in modern dentistry!

Find Endodontists in your area.

[1] Rotstein I., Salehrabi R. (December 2004), "Endodontic treatment outcomes in a large patient population in the USA: an epidemiological study", Journal of Endodontics 12 (30): 846–50













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