What is endodontic treatment?
"Endo” is the Greek word for “inside” and “odont” is Greek for “tooth.” Endodontic treatment treats the inside of the tooth. Root canal treatment is one type of endodontic treatment.
To understand endodontic treatment, it helps to know something about the anatomy of the tooth. Inside the tooth, under the white enamel and a hard layer called the dentine, is a soft fleshy tissue called the dental pulp. The pulp contains the tooth’s blood vessels and nerves. The pulp formed the surrounding hard tissues of the tooth during its development.
The pulp extends from the crown of the tooth visible within the mouth, to the tip of the roots where it connects to the tissues of the jaw surrounding the root. The pulp is important during a tooth’s growth and development. However, once a tooth is fully mature it can if necessary survive without the pulp, because the tooth continues to be nourished by the tissues surrounding it.
Why would I need an endodontic procedure?
Endodontic treatment is necessary when the pulp, the soft tissue inside the tooth, becomes inflamed or infected. The inflammation or infection can have a variety of causes: deep decay, repeated dental procedures, or a crack or chip in the tooth. In addition a traumatic injury to a tooth may cause pulpal damage even if the tooth has no visible chips or cracks. If pulpal inflammation or infection is left untreated it can cause pain and will eventually lead to an abscess.
What are the signs of needing endodontic treatment?
Signs to look for include pain, prolonged sensitivity to heat or cold, tenderness to touch or pressure on chewing, swelling, discharge from the gum, or discolouration of the tooth. Sometimes however there are no symptoms at all.
How does endodontic treatment save the tooth?
The endodontist removes the inflamed or infected pulp by carefully cleaning and shaping the inside of the root canals - the channels inside the root. Once clean the root canal is then filled to seal the space. Afterwards you will return to your general dentist, who will place a crown or other restoration on the tooth to protect and restore it to full function. After restoration, the tooth continues to function like any other tooth.
Will I feel pain during or after the procedure?
Many endodontic procedures are performed to relieve the pain of toothaches caused by pulpal inflammation or infection. With modern techniques and anaesthetics most patients report that they are perfectly comfortable during the procedure.
For the first few days after treatment your tooth may feel uncomfortable, especially if there was pain or infection before the procedure. This discomfort can be relieved with over-the-counter medications such as Ibuprofen or Paracetamol. Your tooth may continue to feel slightly different from your other teeth for some time after your endodontic treatment is completed.
The endodontic procedure
Endodontic treatment can often be performed in one or two visits and involves the following steps:
- The endodontist administers local anaesthetic. After the tooth is numb the endodontist places a small protective sheet called a “rubber dam” over the area to isolate the tooth and keep it clean and free of saliva during the procedure.
- The endodontist makes an opening through the crown of the tooth. Very small instruments are used to remove the pulp from the pulp chamber and root canals, and then to clean & shape the space for filling.
- After the space is cleaned and shaped the endodontist fills the root canals with a biocompatible material, usually a rubber-like material called “gutta-percha.” The gutta-percha is placed with a cement to ensure complete sealing of the root canals. A filling is then placed to close the opening in the crown of the tooth.
- After the final visit with your endodontist you should return to your general dentist to have a crown or other restoration placed on the tooth to protect and restore it to full function.
If the tooth lacks sufficient structure to hold the restoration in place, your endodontist may be able to place a post inside the tooth to help hold the core and crown in place.
Can all teeth be treated endodontically?
Most teeth can be treated endodontically.
Occasionally a tooth can’t be saved because the root canals are not accessible, the root is severely fractured, the tooth does not have adequate bone support, or the tooth cannot be restored. However, advances in endodontics are making it possible to save teeth that even a few years ago would have been lost.
Will the tooth need any special care or additional treatment after endodontic treatment?
In some cases a tooth that has undergone endodontic treatment does not heal or the pain and discomfort continues. Occasionally the tooth may become painful or diseased months or even years after successful treatment. When this occurs re-doing the endodontic procedure can save the tooth.
You should not chew or bite hard on the treated tooth until you have had it restored by your general dentist. The unrestored tooth is susceptible to fracture so you should see your dentist for full restoration as soon as possible. Otherwise, you need only practice good oral hygiene including brushing, flossing, and regular dental checkups. Most endodontically treated teeth last as long as other natural teeth.