Endodontics Wiki FAQ – All You Need To Know!

Endodontics

When we think about our teeth, what usually comes to mind are the pearly whites we can see when we smile. However, there’s more to our teeth than that. The extent of our teeth goes below the gums, to the roots. Inside our teeth are canals which contain the soft tissue or pulp- the nerves and blood vessels. These are the parts that can bleed or cause a jolt of pain during dental treatment.

Endodontists are primarily concerned with the treatment of this soft tissue. Controlling infections, inflammation, and pain in a tooth’s pulp through a procedure such as a root canal therapy is performed by an endodontist.

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Endodontist vs. Dentist

When you need a root canal treatment done, you can choose your regular dentist for the job or a specialist. Root canal specialists are called endodontists.

The major difference between the two is their level of expertise.

  • Expertise

An endodontist goes through exactly the same schooling as your regular dentist. However, in addition to this, is two to three years of graduate school training where they focus on endodontic therapy. After this training, an endodontist must be board certified.

 

  • More advanced equipment

An endodontist level of specialty usually requires that he or she usually have equipment that your regular dentist won’t. Some examples of these are surgical microscopes and cone beam computed tomography (CBCT). CBCT is a method of taking x-rays that gives a 3D representation of teeth.

 

Root Canal Therapy

Dental problems like deep cavities, cracks or chips and teeth can cause the pulp of your teeth to become infected or inflamed. When this happens, you may need root canal therapy to treat it.

Root canal therapy is one of the main dental procedures performed by an endodontist. Here are the main steps involved in a root canal treatment:

  1. To access the pulp of the tooth, an opening is made.
  2. The endodontist then removes the pulp from the roots of the tooth. Tiny files are used to clean and shape the root canals so that they can be properly sealed.
  3. The prepared spaces (root canals) are then filled and sealed to keep any food particles and other materials and bacteria from entering. A temporary filling is then used to seal the opening of the crown of the tooth.
  4. Within 4 weeks of the root canal treatment, the temporary filling is replaced with permanent filling, then a crown (permanent restoration).
  5. Your dentist/ endodontist will then schedule you for recall appointments to evaluate how the treated tooth is healing.

 

** Tooth Pulp

The “pulp” refers to the soft tissues that you can find in the roots or canals of your teeth. This includes blood vessels and nerves. During a root canal, the pulp is removed because it is infected or inflamed. Don’t worry about this though, the tooth can actually function without the pulp. Instead of receiving nourishment from the pulp in the roots, a tooth is nourished by the surrounding tissues.

 

After a Root Canal

  • Pain after a root canal

You can take over-the-counter analgesics like acetaminophen, ibuprofen, or aspirin in order to manage any pain that you might experience after a having a root canal treatment. However, if the pain lasts for longer than just a few days, if the pain becomes severe or if you notice swelling, consult your Endodontist.

 

  • Root canal failure

This is not a very common occurrence, and root canals fail only 5% of the time. A root canal can fail when some infected tissue may be left behind, causing an abscess or ongoing pain. Other causes can be fractured tooth roots or hypersensitivity to the materials used to fill and seal the roots or canals. Root canal failure can lead to either retreatment, an apicoectomy, or extraction of the tooth.

 

Swelling/ Dental Abscesses

Swelling can also come with pain and discomfort. One of the first things to do is to schedule a visit to your dentist. They will assess the swelling and diagnose the cause (gum irritations, cavities, cracked teeth, failed root canals, etc). Minor swellings can be treated with warm salt water rinses. Abscesses usually call for the prescription of antibiotics or a root canal.

 

Consequences of an untreated dental abscess

Dental abscesses are serious infections that should be treated as soon as they can be. If they are ignored and left untreated, they can cause severe pain and other consequences like tooth loss, the spreading of infection to the blood vessels, sinuses, bone marrow, and bone. These infections can lead to even more deadly complications like Ludwig’s angina- a serious infection that can grow to block a person’s airways, causing suffocation and even death.

 

Apicoectomy

Our teeth are held in place by their roots. These roots extend down into the bone. Soft tissue composed of nerves and blood vessels enter the tooth through the end of each root called the apex.

When the pulp of a tooth becomes inflamed or infected, it is removed through root canal therapy. However, there are cases when pain and infection are still present or develop after treatment. These can be caused by infected tissue or debris that might still be left in the branches of a tooth’s roots. In this case, a second root canal or retreatment is considered. If the problem is not solved with a second treatment, you may need an apicoectomy.

An apicoectomy is required when the problem or cause of infection is close to the apex of the root. This procedure is also called an endodontic microsurgery and involves the removal of the root tip or apex along with any infected tissue. So that the end of the root is sealed, a filling is placed.

This dental procedure is only available as an option if the tooth has undergone at least one root canal treatment and retreatment has not been successful or is no longer an option.

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