What does an Endodontist do?
Endodontics is the dental specialty that deals with tissues and structures located inside the tooth. One of the most common endodontic treatments is root canal therapy, a procedure which effectively eases the pain associated with a bacterial infection deep within the pulp of the tooth. Of course, root canal treatment doesn’t just relieve pain — it also stops the infection by removing dead and dying tissue from the tooth’s pulp. Plus, it helps to save the tooth, which is in danger of being lost if left untreated.
Yet root canal therapy isn’t the only treatment endodontics offers. This field also deals with cases of dental trauma, performs microsurgery on the tips of the tooth’s roots, and even helps figure out what’s going on when tooth pain seems to come and go intermittently, or when the pain isn’t localized at one tooth. So when it comes to preserving your natural teeth, endodontics has plenty of ways to help.
The Inside Story
What’s inside your teeth? Behind the tough, shiny enamel of the tooth’s visible crown lies the sturdy inner tissue called dentin. Dentin is also found behind the cementum that forms the outer layer of the tooth’s roots — in fact, it makes up the bulk of the tooth’s structure. Similar in many ways to bone tissue, dentin is composed of many tiny tubules which can transmit sensations to nerve cells when it is stimulated.
At the core of the tooth, inside small, branching chambers called the root canals, we find the soft pulp tissue. This consists of nerves, connective tissues and blood vessels which extend into the center of the tooth and exit through canals near the apex (tip) of the tooth’s roots. When problems (such as infection and inflammation) develop in the pulp tissue, your first indication of trouble may be tooth sensitivity — or intense pain. In time, as the nerves die, the pain may go away… but the problem won’t. In fact, if left untreated, the end result may be tooth loss.
The “Root” of the Problem
What could cause the pulp tissue to become diseased and lead to root canal problems? One potential source of infection is untreated tooth decay, which can allow bacteria from the tooth’s surface to work its way deep inside. A crack or fracture in a tooth could offer another pathway for microorganisms to infect the pulp.
Dental trauma — from a sports injury, for example — may also damage dentin or pulp, or expose it to infection. Extensive dental procedures (such as multiple fillings or restorations on the same tooth) may cause trouble; occasionally, even routine procedures like orthodontics may eventually lead to root canal problems.
The old gag line “I’d rather have a root canal” may still get a laugh — but root canal problems are no joke. It’s important to remember that root canal treatment doesn’t cause pain; it relieves pain. A typical root canal procedure is performed with local anesthetics, and doesn’t cause any more discomfort than having a filling. Here’s what to expect:
First, you will receive anesthesia (usually a numbing shot) — and for many patients, the worst is now over. Next, a small opening is made in the tooth surface to give access to the pulp chamber and root canals. Then, tiny instruments are used — often with the aid of a microscope — to remove dead and dying tissue from inside the narrow passages. These passages are then cleaned, disinfected, and filled with a safe, inert material. Finally, the opening in the tooth is sealed to prevent contamination.
Other endodontic treatments may be recommended for removing sources of infection and preventing future problems. Following an endodontic procedure, a restoration (such as a crown) will be placed on the tooth to restore it to full function and aesthetic appearance. After that, with proper care the restored tooth should last for many years.
The Root Canal Procedure
The first step in root canal treatment is proper diagnosis of the tooth that is affected. Dental examination, X-rays, and tests are performed in to determine if your pain and ailments are accurately identified. Based on the information that is gathered we will be able to make a determination for root canal therapy there are a couple requirements that are met. If it has irreversible inflammation of the pulp or the tooth is dying. Irreversible pulpitis is a condition where the tooth’s pulp is inflamed from injury and will not be able to restore itself or be recovered. A necrotic tooth is a condition where the pulp has lost its blood supply and nerve function and is “dead.”
During root canal therapy, local anesthetics are applied to the affected area. A rubber dam is also placed in the mouth to isolate the tooth that is being treated and to protect other teeth or parts of the mouth during the procedure.
The first step is creating an access hole in the tooth with a dental drill. For molars and premolars, the hole is made on the chewing surface. For the incisors or canines, the hole is made into the tongue surface of the tooth. This access hole enables the dentist to reach the pulp chamber and root canals. Next, the affected pulp is removed with a small instrument. After that, the inside of the tooth is thoroughly cleaned out with an antimicrobial solution that eliminates any infection. Small instruments are used to widen and shape the pulp chamber and canals. Widening and shaping the canals allows for thorough and proper cleansing throughout the tooth. Irrigation is done intermittently throughout the instrumentation of the canals to maintain the cleanliness of the tooth. Finally, the properly cleaned and shaped chamber and root canals are filled with a sealer and a warm soft rubber material called “gutta percha” or percha latex. Once a seal is achieved with the filling materials, the access hole is closed up with a temporary filling or a restorative material such as composite resin.
The occlusion, or bite, is then checked and adjusted to make sure there is no heavy biting from the opposite on to the . For posterior teeth, teeth that have had endodontic treatments require dental crowns. Molars and premolar teeth that have lost vitality are more prone to fracture because of a lack of structural integrity. These teeth are primarily used for chewing and need the protection of a dental crown. In comparison, anterior teeth, the incisors and canines, tend not to bear as much force and usually do not require a crown. This will be determined by the dentist to make sure correct treatment is made for your specific case. Usually, the procedure to place the crown is done during a separate appointment by the general dentist.