ENDODONTOLOGY

Why Choose an Endodontist?

Endodontists are dentists with 3 years additional years of advanced specialty education in diagnosis and root canal treatment.
Because they limit their practices to endodontics, they treat these types of problems every day. They use their special training and experience in treating difficult cases, such as teeth with narrow or blocked canals, or unusual anatomy.
Endodontists use advanced technology, such as operating microscopes, ultrasonics and digital imaging, to perform these special services.

The training, tools and techniques of endodontists have advanced a lot in recent years. Today, getting root canal treatment is often no more uncomfortable than having a filling.

Your Office Visit

A typical visit to an endodontist begins usually with a first consult, this includes completing paperwork, (your medical history and consent forms). It is advisable to bring a list of all the medications (over-the-counter and prescription) that you regularly/have taken within the past month. Once all forms are complete, the endodontist will review and chart your chief complaint, referring dentist’s information and history of the tooth pain before taking x-rays of your teeth.
The endodontist will review your paperwork and evaluate symptoms prior to testing the tooth in question along with adjacent teeth. After the tests are complete, a diagnosis will be given to determine the best treatment care and prognosis. Possible post-treatment decisions such as a crown on the treated tooth will be addressed.

Your endodontist will make you aware of the benefits, options and risks involved in order for you to understand how endodontic treatment is a way of saving your tooth.
If you decide to receive treatment, the procedure may start immediately or a longer appointment will be made. Before treatment begins, you will receive local anesthesia to numb any sensations you may feel during the procedure. If the procedure is unable to be completed within one visit, medicine may be placed inside the tooth between appointments.
Once your procedure is complete, more x-rays are taken to track the success of the treatment. You will be provided with review sheets that include your post-operation instructions and what to expect over the next few days. Be sure to contact your endodontist if you have any questions or concerns regarding your treatment. More detailed information regarding endodontic procedures and post-treatment care is available in this area of the website.

Post-Treatment Care

What should I expect following endodontic treatment? The root canal system inside your tooth has been thoroughly cleaned, and the irritated tissue and bacteria that have caused you to need root canal treatment are gone.
It is normal to feel some tenderness in the area over the next few days as your body undergoes the natural healing process. You may also feel some tenderness in your jaw from keeping it open for an extended period of time. These symptoms are temporary and usually respond very well to over-the-counter pain medications. It is important for you to follow the instructions on how to take these medications. Remember that narcotic medications, if prescribed, may make you drowsy, and caution should be exercised in operating dangerous machinery or driving a car after taking them.
Your tooth may continue to feel slightly different from your other teeth for some time after your root canal treatment has been completed. However, if you have severe pain or pressure that lasts more than a few days, contact your endodontist.

Guidelines for Post-Treatment Care
Do not eat anything until the numbness in your mouth wears off. This will prevent you from biting your cheek or tongue.
Do not chew or bite on the treated tooth until you have had it restored by the dentist.

Be sure to brush and floss your teeth as you normally would. If the opening in your tooth was restored with a temporary filling material, it is not unusual for a thin layer to wear off in-between appointments. However, if you think the entire filling has come out, contact your endodontist.
Contact your endodontist right away if you develop any of the following:a visible swelling inside or outside of your mouth;-an allergic reaction to medication, including rash, hives or itching (nausea is not an allergic reaction);a return of original symptoms; or- your bite feels uneven.

Endodontics

Endodontics: The branch of dentistry concerned with the morphology, physiology and pathology of the human dental pulp and periradicular tissues. Its study and practice encompass the basic and clinical sciences including the biology of the normal pulp and the etiology, diagnosis, prevention and treatment of diseases and injuries of the pulp and associated periradicular conditions.
The scope of endodontics includes, but is not limited to, the differential diagnosis and treatment of oral pains of pulpal and/or periapical origin; vital pulp therapy such as pulp capping and pulpotomy; nonsurgical treatment of root canal systems with or without periradicular pathosis of pulpal origin, and the obturation of these root canal systems; selective surgical removal of pathological tissues resulting from pulpal pathosis; intentional replantation and replantation of avulsed teeth; surgical removal of tooth structure such as in root-end resection, bicuspidization, hemisection and root resection; root-end filling endodontic implants; bleaching of discolored dentin and enamel (teeth); retreatment of teeth previously treated endodontically; and treatment procedures related to coronal restorations by means of post and/or cores involving the root canal space.

Your Teeth

Nothing is as good as your natural tooth!
Saving your natural tooth should always be your first choice when dental care is needed, and is the preferred choice over tooth extraction. Nothing, not even the most advanced bridges and implants, can truly replace your natural tooth.

If your dentist recommends tooth extraction, ask if it an endodontist can help save it with a root canal. This endodontic treatment removes the injured pulp (soft inner tissue) of your tooth and fills and seals the space.

Your tooth is then restored and can function just like any other tooth for the rest of your life, ensuring comfortable chewing and a natural appearance.
Endodontists can often save the most severely injured teeth.
If your tooth cannot be saved — and some cannot — you may consider replacements such as a bridge or dental implant. Your options may depend upon the condition of surrounding teeth and bone structure.
Dental implant procedures can be complex, costly and they often require several visits and several month’s healing time before the procedure can be completed.
Do everything possible to save your teeth before considering tooth extraction. Nothing is as good as your natural tooth!
What's Inside a Tooth? From the outside, a tooth looks like a hard, solid substance. But this cut-away illustration reveals that a tooth is really a complex system of specialized tissues.

Tooth Pain

Symptom: Momentary sensitivity to hot or cold foods.
Possible problem: If this discomfort lasts only moments, sensitivity to hot and cold foods generally does not signal a serious problem. The sensitivity may be caused by a small decay, a loose filling or by minimal gum recession that exposes small areas of the root surface.
What to do: Try using toothpastes made for sensitive teeth. Brush up and down with a soft brush; brushing sideways wears away exposed root surfaces. If this is unsuccessful, see your general dentist. If the sensitivity is coming from a decay you should see your general dentist.
 
Symptom: Sensitivity to hot or cold foods after dental treatment.
Possible problem: Dental work may inflame the pulp inside the tooth causing temporary sensitivity.
What to do: Wait two to four weeks. If the pain persists or worsens, see your general dentist.
 
Symptom: Sharp pain when biting down on food.
Possible problem: There are several possible causes of this type of pain: decay, a loose filling or crack in the tooth. There may also be damage to the pulp tissue inside the tooth.
What to do: See a dentist for evaluation. If the problem is pulp tissue damage, your dentist may send you to an endodontist. Endodontists are dentists who specialize in pulp-related procedures. Your endodontist will perform a procedure that cleans out the damaged pulp and fills and seals the remaining space. This procedure is commonly called a "root canal.”
  
Symptom: Lingering pain after eating hot or cold foods.
Possible problem: This probably means the pulp has been damaged by deep decay or physical trauma.
What to do: See your dentist or endodontist to save the tooth with root canal treatment.

Symptom: Constant and severe pain and pressure, swelling of gum and sensitivity to touch. 
Possible problem: A tooth may have become abscessed, causing an infection in the surrounding gingival tissue and bone.
What to do: See your endodontist for evaluation and treatment to relieve the pain and save the tooth.

Symptom: Dull ache and pressure in upper teeth and jaw.
Possible problem: The pain of a sinus headache is often felt in the face and teeth. Grinding of teeth, a condition known as bruxism, can also cause this type of ache.
What to do: For sinus headache, see your physician. For bruxism, consult your dentist. If pain is severe and chronic, see your endodontist for evaluation.

What the Future Holds

The tooth that has had appropriate endodontic treatment followed by a proper restoration can last as long as your other natural teeth. After the tooth has been restored, you need only practice good oral hygiene, including brushing, flossing, regular checkups and cleanings.
Your dentist or endodontist may periodically x-ray the tooth to ensure that healing has occurred. Occasionally, a tooth that has undergone endodontic treatment does not heal or pain continues. At times, the tooth may become painful or diseased months or even years after successful treatment. Often when this occurs, repeating the endodontic procedure can save the tooth.

Taking Care of Your Tooth

Root canal treatment is only one step in returning your tooth to full function. A proper final restoration of the tooth is extremely important in ensuring long-term success. This final filling might be place in the referral office by a specialist or by your own dentist.

Endodontist

A dentist with 3 years of advanced training in the scope of endodontics who has received a certificate in endodontics from an advanced education program accredited by the NVvE. (Dutch society of endodontology. www.NVvE.com).

The endodontic specialist is responsible for the advancement of endodontic knowledge through research, the transmission of information concerning the most recent advances in biologically acceptable procedures and materials, and the education of the public as to the importance of endodontics in keeping the dentition in a physiologically functional state for the maintenance of oral and systemic health.