What 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 tissues surrounding hard tissues of the tooth during development.
The pulp extends from the crown of the tooth to the tip 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.
How does endodontic treatment save the tooth?
The endodontist removes the inflamed or infected pulp, carefully cleans and shapes the inside of the tooth, then fills and seals the space. Afterwards, you will return to your dentist, who will place a crown or other restoration on the tooth to protect and restore it to full function like any other tooth.
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, you 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. Follow your endodontist´s instructions carefully.
Endodontic treatment can often be performed in one or two visits an involves the following steps:
1. 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.
2. The endodontist makes and opening in the crown of the tooth. Very small instruments are used to clean the pulp form the pulp chamber and roots canals, and to shape the space for filling.
3. After the space is cleaned and shaped, the endodontist fills the root canals with 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.
If the tooth lacks sufficient structure to hold the restoration in place, your dentist or endodontist may place a post inside the tooth. Ask your dentist or endodontist for more details about the specific restoration planned for your tooth.
4. 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.
How much will the procedure cost?
Generally, endodontic treatment restorations of the natural tooth are less expensive than the alternative of having the tooth extracted. An extracted tooth must be replaced with a bridge or implant to restore chewing function and prevent adjacent teeth from shifting. These procedures tend to cost more than endodontic treatment and appropiate restoration.
No matter how effective modern tooth replacements are and they can be very effective nothing is as good as a natural tooth.
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. Other wise, you need only practice good oral hygiene, including brushing, flossing and regular checkups and cleanings.
Most endodontically treated teeth last as long as other natural teeth. In a few cases, a tooth that has undergone endodontic treatment fails to heal or the pain continues. Occasionally, the tooth may become painful or diseased moths or even years after successful treatment. Often when this happens, another endodontic procedure can save the tooth.
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 of 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.
Who performs endodontic treatment?
Endodontist are dentist with special training in endodontic procedures. They provide only endodontic services in their practices because they are specialists. To become specialists, they complete dental school and 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.
What is endodontic surgery?
The most common endodontic surgical procedure is called an apicoectomy or root- end resection. When inflammation or infection persist in the bony area around the end of your perform an apicoectomy. In this procedure, the endodontist opens the gum tissue near the tooth to expose the underlying bone and the infected tissue is removed.
The very end of the root is also removed and a small filling may be placed to seal the root canal. Local anesthetics make the procedure comfortable and most patients return to their normal activities the next day.