Endodontics is the dental specialty that deals with the dental pulp inside of a tooth. Within the dental pulp are the tooth nerves. When a tooth is compromised, the inside can be susceptible to decay. An endodontist treats the inside of the tooth in order to save the tooth structure.
Diagnosis is completed during the first visit after a thorough examination of the tooth and surrounding tissues that are experiencing pain or discomfort. Diagnosis of an endodontic problem involves testing the tooth for sensitivity to cold and hot, tapping on the tooth, and taking appropriate radiographs. Some tooth pain is not severe enough to require a root canal, in which case you may be asked to return for another evaluation or be referred back to your general dentist with a recommendation for treatment. Occasionally, a patient may have diffuse pain in an area that is not attributed to a tooth (non-odontogenic). In these cases, symptoms may be coming from a nearby structure such as the sinus, muscles of mastication, or temporomandibular joint (TMJ). Your endodontist is able to differentiate between pain from a tooth (odontogenic) versus non-odotogenic pain, and will make the appropriate referral to a pain management specialist if needed.
Root Canal Therapy
Our primary goal is to save your natural teeth whenever possible. Root canals are most often necessary when decay has reached the nerve of the tooth or the tooth has become infected. Often this injury occurs without any symptoms, however, if the tooth remains untreated, pain or sensitivity may occur and an abscess could develop. People can have anywhere from 1 to 4 canals in a tooth. When root canal therapy is performed, the pulp chamber of the tooth is removed and then filled with a suitable filling material.
Occasionally a tooth that was endodontically treated months or even years ago may develop new problems. In some cases, a tooth that has received endodontic treatment fails to heal or continues to have pain. With advanced technology and the latest techniquest, we may be able to provide another chance to save the tooth with a second endodontic procedure.
Apical Surgery (Apicoectomy)
In some cases, it may be necessary to remove the infected root tips or apex and the nearby tissue. This is known as a apical surgery or an apicoectomy. The area around the apex of the tooth that is infected is cleaned, and the tip of the root is resected and sealed. Sutures are placed and an ice pack is applied. Medication is prescribed to help alleviate any pain or discomfort and it is best to plan to rest for the remainder of the day. Most patients will have some minor swelling and occasional bruising with some numbness.
Symptoms of a cracked tooth are varied and may include pain when chewing, temperature sensitivity or pressure sensitivity or a combination of these. Because the pain often comes and goes, it can be very difficult to recognize what is causing the problem. It can sometimes even be difficult to identify exactly which tooth is causing the discomfort. Over time, the tooth pulp will become damaged from the crack in the tooth which can sometimes lead to infections in the pulp tissue and spread to the surrounding gum and bone.
Traumatic injuries can result in the need for dental treatment. Fractured or cracked teeth, a displaced tooth, or even a tooth that has been knocked out (avulsed) are common results of dental trauma. Any dental trauma requires prompt medical evaluation and treatment. Treatment may include a splint, medication, a root canal or other procedures. Once treated, your tooth will be monitored to ensure it is healing as expected and so that any injuries or infections can be quickly resolved.
We understand that receiving endodontic care can create anxiety for some patients, causing them to delay early treatment that might prevent the need for more extensive treatment in the future. We strive to make every patient comfortable in our relaxing environment and will the take the time to address any concerns or anxiety before beginning treatment. While most patients find endodontic treatment to be less stressful than they anticipated, we are equipped to provide sedation dentistry in our office so that our patients can relax and feel at ease during treatment.
Root resorption is defined as the destruction of the root structure of a tooth. This loss can be manifested either internally or externally and is usually caused by trauma, excessive occlusal force, tumors or inflammation in the affected area. We will use 3D cone beam technology to help identify the location and extent of the resorption and then create a customized treatment plan for you.
Regenerative Endodontic Treatment utilizes tissue engineering to restore the root canal to a healthy state, allowing for continued development of the root and surrounding tissue. Endodontists’ knowledge in the fields of pulp biology, dental trauma, and tissue engineering can be applied to deliver biologically based regenerative endodontic treatment of necrotic immature permanent teeth resulting in continued root development, increased thickness in the dentinal walls and apical closure. These developments in the regeneration of a functional pulp-dentin complex have a promising impact on efforts to retain the natural dentition, the ultimate goal of endodontic treatment.***
***Information provided by American Association of Endodontics
3D Cone Beam Computed Tomography
3D imaging provides better quality and more detailed images than traditional x-rays. This new technology is also less invasive and emits less radiation than traditional x-ray machines. We can use this technology to help identify the location and extent of treatment needed and then create a customized plan of action for each patient.
Learn more about our 3D Imaging System