Who performs endodontic treatment?

All dentists, including your general dentist, received some training in endodontics while in dental school. Often general dentists refer patients needing root canal treatment to endodontists.

What is an "endodontist"?

Endodontists are dentists who specialize in treating the soft inner tissue of your tooth's roots. After they complete dental school, they attend another dental school program for two or three more years. This program is called an advanced specialty education program. They study only endodontic treatment and learn advanced techniques so they can give you the very best care.

Why is there a need for endodontic treatment?
Sometimes the pulp inside your tooth becomes inflamed or infected. This can be caused by deep decay, repeated dental procedures on the tooth, a crack or chip in the tooth, or a blow to the tooth.

What are the signs of needing endodontic treatment?
Signs to look for include pain, prolonged sensitivity to heat or cold, discoloration of the tooth, and swelling and tenderness in the nearby gums. But sometimes, there are no symptoms.

How does endodontic treatment save the tooth?
After obtaining good anesthesia, the endodontist removes the inflamed or infected pulp, carefully cleans and shapes the inside of the tooth, then fills and seals the pulp space with the gutta percha root filling material. Afterwards, you return to your general dentist, who will place a crown or other restoration on the tooth to protect it and restore it to full function.

Will I feel pain during or after the procedure?
While many patients may be in great pain before seeing an endodontist, most report that the pain is relieved by the endodontist and that they are comfortable during the procedure. For the first few days after treatment, the 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. The endodontist will tell you how to care for your tooth at home.

How much will the procedure cost?
The cost varies depending on how severe the problem is and which tooth is affected. Many dental insurance policies cover endodontic treatment. Generally, treatment and restoration of your natural tooth is the least expensive option. The only alternative is having the tooth extracted and replaced with a bridge, implant, or removable partial denture to restore chewing function and prevent adjacent teeth from shifting.

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 general dentist because your tooth could fracture. Otherwise, just practice good oral hygiene - brushing, flossing and regular checkups and cleanings. Endodontically treated teeth can last for many years, even a lifetime.

What causes an endodontically treated tooth to need additional treatment?
New trauma, deep decay, or a loose, cracked or broken filling can cause new infection in your tooth. In some cases, your endodontist may discover very narrow or curved canals that could not be treated during the initial procedure. Sometimes a previously root canaled tooth may develop an infection of the external surface of the root and may need endodontic surgery to be saved.

What is endodontic surgery?
The most common endodontic surgical procedure is an apicoectomy or root-end resection. It is used to relieve inflammation or infection in the bony area around the end of your tooth that continues after endodontic treatment. The endodontist lowers the gum tissue and removes the infected tissue and may remove the very end of the root. A small filling may be placed to seal the root canal.

Endodontists use local anesthetics, like those used when you have a cavity filled. Most patients return to their normal activities the next day. For more on surgery, see Endodontic Surgery.