Endodontists are dentists who specialize in maintaining teeth through endodontic therapy - procedures involving the soft inner tissue of the tooth, called the pulp.  The word "endodontic" comes from the Greek words "endo," meaning inside, and "odont," meaning tooth.  All dentists are trained in diagnosis and endodontic therapy; however, some teeth can be especially difficult to diagnose and treat.  This is why you may have been referred to an endodontic specialist.

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 the purpose of diagnosis and treatment of more difficult cases. For this reason, many dentists choose to refer their patients to endodontists.

Some endodontists choose to become Board Certified, which is the highest level of endodontic education.  Board certification is a several year process during which an endodontist has to demonstrate the highest level of theoretical and practical knowledge of endodontics.  He or she does this by passing written and oral exams as well as submitting a case portfolio that demonstrates his or her ability to treat the most complicated cases.  Upon completion of this process, the practitioner is awarded the status of a Diplomate of the American Board of Endodontics.

American Association of Endodontists

Endodontic treatment usually feels similar to a cavity filling procedure, except it takes a longer time, usually 1 to 2 hours.

A local anesthetic will be given.  A sheet of latex called the "rubber dam" (we have non-latex as well) will be placed around the tooth to isolate it, thereby keeping it clean and dry during treatment.  The treatment consists of accessing the pulpal space, cleansing the canal system of all diseased tissues, shaping the canals so they can be properly filled, filling the canal space with specially designed materials, and placing temporary or permanent restoration to seal the access space. 

The number of visits you make will depend on the degree of infection/inflammation and the degree of difficulty of treatment.  Some treatments require two visits, and occasionally, three appointments are needed.  But most of the time, only one visit is necessary.  To us, it is more important to do the very best possible job than meet a specific time restriction.

After completion of treatment, you will be instructed to return to your dentist for permanent restoration of the tooth. This is a vital component of treatment because it protects the tooth from breaking and prevents reinfection by the process of sealing the canal space from the oral environment.  As a general rule, you will have to see your dentist within a couple of weeks after root canal treatment is finished.

There are, of course, no guarantees.  Root canal therapy has a very high success rate - up to 95%. This pertains to teeth which can be treated near ideal. If endodontic therapy is unsuccessful, you still have options. These usually include retreatment or surgical treatment. The success rate for those procedures is approximately 85%. We will discuss with you the probability of success before any endodontic procedure to help you make an informed decision.

Oral pain can often be difficult to pinpoint.  Because of the vast network of nerves in the mouth, the pain of a damaged or diseased tooth is often felt in another tooth and/or in the head, neck, or ear. An endodontist is a specialist in diagnosing and treating this type of pain.

Pulp damage is sometimes caused by traumatic injuries, such as a blow to the mouth.  An endodontist specializes in treating such 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 and treating teeth that have been knocked out.

Occasionally, a tooth that has undergone endodontic treatment fails to heal, or pain continues despite therapy. Although rare, sometimes a tooth responds to root canal therapy initially but becomes painful or diseased months or years later. When either of these situations occur, the tooth can often be maintained with a second endodontic treatment. 

Sometimes, surgical treatment is indicated to save a previously treated tooth.  Surgery usually involves accessing the diseased area through the side of the jaw, removing the diseased tissues, and retrograde (from the tip) filling of the roots.