Endodontists deal with oral health issues related to the dental pulp and periradicular tissues, which are the blood vessels, tissues, and nerves surrounding a tooth’s root. They are commonly referred to as “root canal specialists” because root canal therapy is the most common treatment they provide. Endodontists are experts in understanding the anatomy of tooth roots, root morphology, dental pulp, and the internal anatomy of teeth.
Dental pulp is a living tissue in teeth that contains sensory nerves and blood vessels. Since it is living tissue, pulp irritation is common and results in inflammation and, in more serious cases, tissue damage. As caries (dental cavities) grow, they get closer to the pulp, which may lead to an infection or a serious pulpal disease. Small caries and trauma-related dental issues are even capable of releasing toxins to the dental pulp.
The need for root canal therapy, or similar endodontic treatment, depends on the classification of the pulpal disease at hand. Endodontists examine a patient’s mouth using radiographic images and pulp testing to assess the infection and determine its classification. There are four common types of pulpal conditions, including:
Endodontists spend most of their time diagnosing and treating root canals. Although, they also specialize in endodontic retreatment, endodontic surgery, and trauma-related dental injuries:
Endodontists specialize in root canals, also known as endodontic treatment. Instead of extracting a tooth, an endodontist removes the infected dental pulp. Patients get root canals for a variety of reasons, including:
On average, endodontists complete 25 root canals per week, while general dentists perform about two per week.
When a tooth dies, decays, or is unsavable, extraction is typically necessary. After the tooth extraction, a dental implant replaces the permanent tooth. A dental implant (artificial tooth root) mirrors the shape of a screw. An endodontist surgically inserts the implant into the patient’s jawbone, which bonds with the natural bone.
A dental crown sits on top of the implant and becomes the only visible part of the artificial tooth. Common reasons patients get implants include:
Root canals are successful most of the time and can last a lifetime with proper care. Although, sometimes the restorations fail, which results in the need for “retreatment.” If the root canal treated tooth heals improperly, becomes painful, or is infected months or years after treatment, retreatment saves the tooth. The procedure helps relieve dental pain, discomfort, and promote healing.
A tooth may not heal after root canal therapy for a few reasons, including:
Nonsurgical root canal therapies may not be enough to save a patient’s tooth. If this is the case, an endodontist will perform microsurgery, also referred to as endodontic surgery. This procedure consists of finding fractures or hidden canals that an x-ray did not detect. The surgery removes calcium deposits in a patient’s root canals, treats damaged root surfaces, and stabilizes the surrounding bone near the tooth.
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“Endodontic Retreatment.” American Association of Endodontists, www.aae.org/patients/root-canal-treatment/endodontic-treatment-options/endodontic-retreatment/.
Hollins, Carole. Basic Guide to Dental Procedures. John Wiley & Sons, Inc., 2015.
Syrbu, John DDS. The Complete Pre-Dental Guide to Modern Dentistry. 2013.