Endodontics specializes in the diagnosis, cause, prevention, and treatment of diseases related to the dental pulp which is in the center of a tooth and is made up of connective tissue and cells. The word comes from Greek with “endo” meaning inside, and “odont” meaning tooth, therefore endodontics means “inside the tooth”. While all dentists are trained in the diagnosis and treatment of endodontic disease, particularly difficult cases are referred to a dentist who specializes in endodontics. An endodontic specialist normally completes a further two to three years of study in advanced education relating to treatments such as root canal procedures. Endodontics involves the further practice of treatments and techniques in much greater depth than normal dentistry.
Endodontic treatment involves a range of procedures including root canal or endodontic treatment, repeat endodontic treatment, and endodontic re-treatment, as well as other complicated dental cases. Most people know what a dental filling is, but have little knowledge regarding root canal treatment or endodontic treatment. Root canal treatment becomes necessary when the blood supply and nerves inside the tooth, called the pulp of the tooth become infected.
During the early stages of infection there may be no pain, however, sometimes the tooth may become darkened in color which could indicate that the blood supply to the tooth has been cut off indicating that the nerve has died. There may not be any symptoms during the early stages of infection. When the tooth pulp becomes infected it spreads to the root of the tooth and eventually leads to an abscess which is
extremely painful.
At this point, antibiotics are usually prescribed which sometimes can alleviate the pain temporarily. The continual use of antibiotics can create resistant strains that make them less effective each time they are used, causing more problems in the future. Instead of relying on repeated antibiotic treatments to clear up the infection, it is preferable to treat the root cause.
A dentist will be able to diagnose infection of the pulp and in difficult cases refer you for endodontic therapy. If the problem is left untreated the tooth may deteriorate to such an extent that it would necessitate extraction. Large abscesses are capable of destroying the bone surrounding the affected tooth to such an extent that it limits restorative options.
The purpose of root canal treatment is to remove all infection from the canal of the tooth and to sterilize and fill the space completely with the inert material. After the infected pulp has been removed and the abscess has been drained the endodontist will disinfect the canal space and insert a temporary filling to allow the tooth to settle. When all infection has cleared up the canal will be filled with ‘Gutta-percha’, a rubbery substance, after which a permanent filling will be done.
In some cases, it may be possible to do a root canal treatment in one session depending on the state of the tooth after the completion of the first stage. Teeth that have been subjected to root canal treatment often have missing tooth structure and it may be necessary to insert a crown to support and strengthen the tooth.
Some endodontic treatments may fail and require re-treatment, sometimes after several years. There are a variety of reasons for root canal failure and your dentist will be able to explain the reasons in your particular case.