In this article
Endodontists are dental specialists who treat tooth pain, disease, and infection. They are experts in treating dental pulp issues.
They are often called “root canal specialists” because root canal therapy is the most common treatment they provide.
Endodontists have an in-depth understanding of the anatomy of tooth roots, root morphology, dental pulp, and the internal anatomy of teeth. In addition to dental school, these specialists undergo two to three years of advanced education and further training in endodontic care.
The primary difference between a dentist and an endodontist is their level of expertise. Dentists typically treat a wide range of general oral health issues but might not be advanced specialists.
Endodontists are dentists who have completed extra training and specialize in issues relating to dental pulp. An endodontist is a dentist, while a dentist is not always an endodontist.
Dental pulp is a living tissue in teeth that contains sensory nerves and blood vessels. It’s essential for oral health.
Because pulp is a living tissue, it’s easy to irritate it. Pulp irritation can lead to inflammation and tissue damage in more serious cases.
If tooth decay spreads, it can infringe on the pulp, potentially leading to an infection or severe disease. Even small cavities and trauma-related dental issues can release toxins into the dental pulp.
Endodontists spend most of their time diagnosing and treating root canals.
However, they also specialize in endodontic retreatment, endodontic surgery, and trauma-related dental injuries:
Endodontists specialize in root canal treatment, also called endodontic treatment or root canal therapy. A root canal is necessary when the pulp within a tooth is severely infected or damaged.Root canal treatment involves removing the infected pulp within a tooth. It saves the tooth and eliminates the need for extraction.
On average, endodontists complete 25 root canals per week, while general dentists perform about two per week.
When a tooth dies or is determined unsavable, extraction is typically necessary. An endodontist is skilled at complex tooth extractions.
After extracting the infected tooth, the endodontist will place a dental implant where the permanent tooth used to be. A dental implant (artificial tooth root) mirrors the shape of a screw. It is surgically inserted into the jawbone and bonds with the natural bone.
Then, a dental crown goes on top of the implant and becomes the only visible part of the artificial tooth.
Tooth extraction and dental implant treatment are recommended when a root canal isn’t enough to preserve a tooth. Common indicators for implant placement include:
Root canals are usually successful and can last a lifetime with proper care. However, restorations can occasionally fail, which results in the need for “retreatment.”
Endodontic retreatment is necessary if the treated tooth heals improperly, becomes painful, or is infected months or years after treatment. The procedure helps relieve dental pain and discomfort and promotes 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. In these cases, an endodontist will perform microsurgery, also called endodontic surgery.
Endodontic surgery involves finding the fractures or root canals an X-ray didn’t detect. The procedure removes calcium buildup in a root canal, treats damaged root surfaces, and stabilizes the surrounding bone near the tooth.
Microsurgery might be necessary if root canal treatment isn’t enough. The tooth won’t need to be extracted during surgery.
There are four common dental pulp conditions (pulpitis), including:
Reversible pulpitis is caused by tooth decay and exposed dentin (the layer under tooth enamel). It’s typically minor and doesn’t require a tooth extraction or root canal.
Treatment involves removing the cavity and covering the tooth with a filling to protect it from infection. Reversible pulpitis commonly develops after dental procedures and often resolves without treatment.
Symptomatic irreversible pulpitis develops when cavities get very close to or inside the pulp chamber (interior of a tooth). Traumatic dental injuries can also cause irreversible pulpitis if the trauma exposes the pulp.
Teeth with this condition are hypersensitive to cold stimuli and develop lingering pain. Root canal treatment is usually recommended.
Asymptomatic irreversible pulpitis is similar to symptomatic irreversible pulpitis (minus the symptoms). You might notice mild or no discomfort, though the affected tooth will be sensitive to cold.
Despite the lack of symptoms, this form of pulpitis also requires root canal treatment.
Pulpal necrosis is when the tissue inside a tooth dies. When this happens, debris, inflammatory cells, and bacteria replace the healthy dental pulp within the tooth.
A tooth with pulpal necrosis will not respond to cold and may result in bone loss. Treatment involves root canal therapy or removal of the affected tooth.
The need for root canal therapy or a similar endodontic treatment depends on the type and severity of the pulpitis. You’ll need a root canal if you have a severe infection in a tooth or irreversible damage to the pulp.
An endodontist will examine your mouth using radiographic images and pulp testing. They may use thermal and electrical testing to determine the severity of the pulpitis.
Various factors contribute to the need for a root canal, including:
Your dentist may send you to an endodontist if you have symptoms of infected tooth pulp and they believe you might need a root canal.
They might also refer you if you have a previous root canal that needs to be examined, have a cracked tooth, or need an apicoectomy.
General dentists are also qualified to perform root canals. However, endodontists are experts at performing endodontic procedures like root canals and often have higher success rates for saving teeth.
Endodontists also use more advanced technology and might have better pain management protocols. These specialists might be more expensive, though.
Endodontists are dentists with extra training and expertise in oral health issues related to dental pulp. They have an in-depth understanding of tooth anatomy and complex dental problems.
The most common procedure an endodontist performs is a root canal treatment. Root canal therapy removes inflamed or infected tissue, or dental pulp, inside a tooth. Endodontists can also perform microsurgery, tooth extractions, and dental implant placements.
You can see a general dentist for a root canal, though your dentist might refer you to an endodontist for expert treatment.
In this article