Endodontic Therapy
If you've never had endodontic treatment—also known as a "root canal"—or if it's been many years since your last procedure, you may have questions or uncertain expectations.

This page will hopefully answer your questions and explain how today's endodontic treatment saves teeth. More than 14 million teeth receive endodontic treatment each year. By choosing endodontic treatment, you are choosing to keep your natural teeth as a healthy foundation for chewing and biting for years to come.

The Endodontic Procedure

Following your examination visit, your endodontic treatment in our office is usually performed in a single visit and involves the following steps:

A local anesthetic is administered to numb the tooth. Nitrous Oxide is also available if you would like it. After the tooth is numb, a small protective sheet called a "rubber dam" is placed over the area to isolate the tooth and keep it clean and free of saliva during the procedure.

A small opening is made in the crown of the tooth, and very small instruments are used to clean the pulp from the pulp chamber and root canals and to shape the space for filling.

After the space is cleaned and shaped, a biocompatible material called gutta-percha is used to seal the canals. In most cases, a temporary filling is placed to close the opening. The temporary filling will be removed by your dentist before the tooth is restored. You must return to your dentist to have a crown or other restoration placed on the tooth to protect and restore it to full function.

Patients usually have many questions when root canal therapy has been recommended to them. Hopefully yours will be answered here.

Who performs endodontic treatment?
All dentists, including your general dentist, received training in endodontic treatment in dental school. General dentists can perform endodontic procedures along with other dental procedures, but often they refer patients needing endodontic treatment to endodontists.

Endodontists are dentists with special training in endodontic procedures. They only perform endodontic procedures in their practices because they are specialists. To become specialists, they complete dental school and an additional two or more years of advanced training in endodontics. They perform routine as well as difficult and very complex endodontic procedures, including endodontic surgery. Endodontists are also experienced at finding the cause of oral and facial pain that has been difficult to diagnose.

What exactly is endodontic treatment?
"Endo" is the Greek word for "inside" and "odont" is Greek for "tooth." Endodontic treatment treats the inside of the tooth.

To understand endodontic treatment, it helps to know something about the anatomy of the tooth. Inside the tooth, under the white enamel and a hard layer called the dentin, is a soft tissue called the pulp. The pulp contains blood vessels, nerves, and connective tissue and creates the surrounding hard tissues of the tooth during development. The pulp extends from the crown of the tooth to the tip of the roots where it connects to the tissues surrounding the root. The pulp is important during a tooth's growth and development. However, once a tooth is fully mature it can survive without the pulp, because the tooth continues to be nourished by the tissues surrounding it.

Why would I need an endodontic procedure?
Endodontic treatment is necessary when the pulp becomes inflamed or infected. The inflammation or infection can have a variety of causes: deep decay, repeated dental procedures on the tooth, or a crack or chip in the tooth. In addition, a blow to a tooth may cause pulp damage even if the tooth has no visible chips or cracks. If pulp inflammation or infection is left untreated, it can cause pain or lead to an abscess.

Signs of pulp damage include pain, prolonged sensitivity to heat or cold, discoloration of the tooth, and swelling and tenderness in the nearby gums. Sometimes, there are no symptoms.

Will I feel pain during or after the procedure?
Many endodontic procedures are performed to relieve the pain of toothaches caused by pulp inflammation or infection. With modern techniques and anesthetics, most patients report that they are comfortable during the procedure.

For the first few days after treatment, your tooth may feel sensitive, especially if there was pain or infection before the procedure. This discomfort can be relieved with over-the-counter or prescription medications. Your tooth may continue to feel slightly different from your other teeth for some time after your endodontic treatment is completed.

Will the tooth need any special care or additional treatment?
You should not chew or bite on the treated tooth until you have had it restored by your dentist. The unrestored tooth is susceptible to fracture so you should see your dentist for a full restoration as soon as possible. Otherwise, you need only practice good oral hygiene, including brushing, flossing, and regular checkups and cleanings.

Can all teeth be treated endodontically?
Most teeth can be treated. Occasionally, a tooth can't be saved because the root canals are not accessible, the root is severely fractured, the tooth doesn't have adequate bone support, or the tooth cannot be restored. However, advances in endodontics are making it possible to save teeth that even a few years ago would have been lost. And, when endodontic treatment is not effective, endodontic surgery may be able to save the tooth.

What are the alternatives to endodontic treatment?
When the pulp of a tooth is damaged, the only alternative to endodontic treatment is extraction of the tooth. To restore chewing function and to prevent adjacent teeth from shifting, the extracted tooth must be replaced with an implant or bridge. This requires surgery or dental procedures on adjacent healthy teeth and can be far more costly and time-consuming than endodontic treatment and restoration of the natural tooth. No matter how effective modern tooth replacements are - and they can be very effective- nothing is as good as a natural tooth.

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