In addition to dental school, endodontists receive two or more years of advanced education in this kind of treatment. They study root canal techniques and procedures in greater depth, for diagnosis and treatment of more difficult cases. To provide the patient with the most successful outcome, many dentists choose to refer their patients to endodontists.
Saving your natural tooth should always be your first choice when dental care is needed. Nothing, not even the most advanced bridges and implants, can truly replace your natural tooth.
Do everything possible to save your teeth before considering extraction. Nothing is as good as your natural tooth!
Root Canal Treatment
To make the appointment as easy as possible, a local anesthetic will be gently given. A sheet of latex called the "rubber dam" (we've got nonlatex ones too) will be placed around the tooth to keep 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 and many are just a single visit. Occasionally 3 appointments are needed.
The number of visits depends on the degree of infection/inflammation and degree of treatment difficulty. It’s most important to gain the very best resolution for your particular dental problem so the condition of your tooth will guide our time requirements. One piece of good news is that we value your time and do our best to begin your treatment promptly at your appointed time.
The endodontist examines and x-rays the tooth, then administers local anesthetic. After the tooth is numb, the endodontist places a small protective sheet called a “dental dam” over the area to isolate the tooth and keep it clean and free of saliva during the procedure.
The endodontist makes an opening in the crown of the tooth. 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, the endodontist fills the root canals with a biocompatible material, usually a rubber-like material called “gutta-percha.” The gutta-percha is placed with an adhesive cement to ensure complete sealing of the root 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.
After the final visit with your endodontist, 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.
There are, of course, no guarantees. Root canal or endodontic therapy has a very high degree of success. Modern research shows success rates as high as 98% when ideal treatment outcomes are obtained! We will discuss with you the chances of success before any endodontic procedure to help you make an informed decision. If a root canal or endodontic therapy is unsuccessful or fails you still have options to preserve a healthy dentition.
Root Canal Retreatment
Occasionally a tooth that has undergone endodontic, treatment continues to be uncomfortable or fails to respond to the therapy. Although rare, sometimes a tooth initially responds to root canal therapy, but months or years later can become diseased. When this unusual circumstance occurs, the tooth often can be managed and saved with a second endodontic treatment, called "Retreatment".
Endodontic Surgery (Apicoectomy)
Under certain conditions a Retreatment will not be the ideal course of treatment. It may be determined that the tooth may be best treated with a surgical approach. An apicoectomy is a procedure in which the endodontist opens the gum tissue near the tooth to see the underlying bone and to remove any inflamed or infected tissue. The tip of the root is removed and a filling is placed into the tip to seal the canal.
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 permanent and pediatric teeth that have been loosened or knocked out of their sockets.