Endodontists – A Specialty Within Dentistry

Most people are familiar with dentists, oral surgeons, and orthodontists; however, endodontists remain lesser-known dental specialists. With all the education requirements necessary to become a certified endodontist and subsequent board certification processes necessary to become one, becoming an endodontist is certainly one of the more challenging yet rewarding fields in dentistry.

Although many may fear receiving root canal treatments due to COVID-19 pandemic concerns, receiving professional treatment from an endodontist remains safe and necessary in order to preserve long-term oral health. Failure to seek endodontic assistance could result in future issues with untreated teeth causing more significant health concerns than anticipated.

Root Canal Therapy

Root canal therapy, also known as endodontic treatment, involves extracting inflamed or infected tooth pulp before cleaning and disinfecting its interior surface. Any remaining spaces in between then filled and sealed using gutta-percha rubber-like filler. Finally, restoration with crown or filling to protect and allow normal function is undertaken to return it back into function.

Root canal therapy may become necessary when the dental pulp infected by deep decay, repeated dental procedures on one tooth, cracked tooth enamel or injury to it becomes inflamed and infected with bacteria from gingivitis or periodontitis infection spreads through to bone tissue nearby causing bone necrosis and eventually necessitating its removal as the tooth dies off and must be extracted.

Root canal success depends on several factors, including how much healthy natural tooth structure remains after treatment, the health of supporting bones and gingiva surrounding your tooth, as well as prompt restoration by your dentist. When cared for correctly, a tooth treated with root canal therapy can last a lifetime!

At the dental office, you will receive numbing medication to alleviate pain during root canal treatments. Once it has taken effect, an endodontist will create an opening in your affected tooth and extract infected or damaged pulp from within it before cleaning, disinfecting, shaping and filling it with medicated dental materials for permanent restoration by your general dentist. A temporary filling may then be placed temporarily seal off this space until permanent restoration can occur by their general dentist.

Endodontic Retreatment

Root canal therapy may result in mishealing that necessitates additional treatment, and in such instances a secondary endodontic procedure may be required. This could occur for various reasons such as an initial endodontic procedure that failed to achieve chemical mechanical debridement due to undetected curvilinear canal anatomy or crowning too soon post procedure; additionally cracks or breaks during treatment allow saliva into the tooth and into its root canal system which leads to infection and necessitates additional care treatments.

Retreatment may be necessary in such instances. Your endodontist will use advanced technologies like CBCT scan to identify the cause of original root canal failure and then reopen your tooth and remove original filling material and any infected tissue before reshaping, cleaning and disinfecting canals before sealing them off again.

Through this approach, your endodontist may be able to save the tooth. The success rate is comparable to dental implants but significantly superior than extraction; replacing an artificial tooth requires additional dental work which can result in increased pain and discomfort.

No artificial tooth can replicate the look and functionality of natural ones, so it is always advisable to seek an endodontic solution before considering tooth extraction. This is particularly relevant in cases with only one remaining arch tooth remaining; loss can lead to bone loss that compromises surrounding ones as well as aesthetic concerns in later years.

Surgery

When soft inner tissues of a tooth become inflamed or infected due to deep decay, dental procedures, trauma or another reason, a nonsurgical endodontic procedure known as root canal may help save it. In certain instances, however, soft tissues cannot be saved and surgery will need to be performed in order to remove and seal off remaining spaces in the tooth.

Root canal treatment does not always guarantee healing or infection-free results; in these instances, endodontic surgery allows an endodontist to examine and treat any damaged areas on the tooth. When this occurs, if persistent pain exists but no issues appear on X-rays then this could indicate missing fractures or canals during original therapy that need attention.

An apicoectomy is the most frequent surgical endodontic procedure, used to treat inflammation and infection that remains after a root canal treatment. An endodontist will make a small incision in gum tissue to access and extract any infected tissue or root-tip ends, placing a root end filling to protect against reinfection of root, stitching or suturing incision as necessary to aid bone healing in this area over time.

Endodontic surgery is generally quick and comfortable. Local anesthetics make the procedure pain-free; patients only experience minimal discomfort or swelling following incision healing. Prescribed medication can help ease any post-surgery discomfort.

Treating Cracked Teeth

As we live longer, we often engage in harmful dental habits that expose our teeth to damage such as clenching, grinding and chewing on hard objects or ice that can result in cracking. Most general dentists are equipped to recognize and treat cracked teeth; if the crack extends into the root system an endodontic treatment must be sought.

Craze lines, which appear as tiny hairline fractures in the enamel that appear as faint vertical lines and usually affect front teeth, do not cause pain and may even go symptom-free; they could be due to grinding, ice chewing or an uneven bite and are considered cosmetic defects that should be covered with veneers.

Cracked cusps refer to cracks that extend deep into the root, usually more seriously than craze lines and often cause severe pain when chewing or exposed to hot or cold food. Root canal treatment may be necessary in these instances as well as crown protection to restore and protect the tooth.

Split teeth occur when an existing cracked tooth advances to an untreatable stage and becomes intractable; when its crack spreads below the gum line into its roots and separates into two loose segments. Early diagnosis is key as prognosis for split tooth is typically poor; to prevent one, patients must be counseled on eliminating damaging habits (like bruxism), covering cusps as well as attending regular dental visits to detect any signs or symptoms of cracked teeth; early diagnosis could have long-term benefits.

Treating Dental Trauma

Dental trauma often results from accidents or sports injuries and is usually quite serious, often involving cracked or knocked-out teeth and often leading to significant dental and facial damage that delays in treatment can exacerbate further. Delay increases the severity of damage.

Endodontists have extensive training beyond dental school to take care of injuries to the inner areas of injured teeth, so should an accident occur, contact them as soon as possible for emergency treatment.

An unstable tooth can be stabilized by placing it back into its socket if you can locate it, while an endodontist repositions and ensures its stability before beginning root canal therapy for prevention of infection. Over time, they may even place a crown to further safeguard it.

People who sustain traumatic injuries to their teeth often worry about how the damaged tooth will look once it has healed, hoping that it can return to its pre-injury appearance; unfortunately this is often impossible with front teeth.

Though it can be tempting to retain damaged teeth for too long, doing so can lead to root resorption – when your body rejects an injured tooth as foreign and starts eating away at it – something which cannot be reversed and should only be prevented through regular visits with an endodontist for monitoring purposes. Therefore, when playing contact sports it is wise to wear a mouthguard, while children should use chew toys with care in their mouths.