Endodontics

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If decay progresses to the first stage, a small filling will be required. If decay develops to the third stage depicted, root canal therapy will be required.

Endodontics is a specialty of dentistry, that deals with the tooth pulp and tissues surrounding the root of a tooth. The pulp (containing nerves, arterioles and venules as well as lymphatic tissue and fibrous tissue) can become diseased or injured and thus is unable to repair itself. The pulp then dies and endodontic treatment is required.

Dentists specializing in this field are called endodontists and complete an additional 2-3 years of training following dental school. They specialize and limit their practice to root canal therapy, root canal surgery, and in the case of some endodontists, implant dentistry. Patients requiring root canal therapy are either referred by their general dentists to the endodontist or are self referred. Many general dentists also perform root canal therapy.

The most common procedure done in endodontics is root-canal therapy, which involves the removal of diseased pulp tissue. The aim of treatment is to remove infection caused by bacteria from inside the tooth. If left, the infection would leak out of the tooth's root and make the surrounding bone ill and painful. Once the diseased tissues are removed, the body's defense system can then repair the damage created by disease. Usually, this will require 2-3 visits to your dentist. The dentist will use a local anesthetic to make the procedure pain-free. In most places, it is considered a standard of care to use a rubber dam in order to isolate the tooth and provide a clean environment. An opening is made on the top of the tooth. Then the pulp chamber and root canals are cleaned and shaped for filling and sealing. Often, an intra-pulpal medicament to inhibit bacterial growth is placed and the tooth is filled with a temporary restoration until the second appointment, where the temporary restoration and medicament are removed and the canal(s) are sealed with gutta-percha--thus completing the procedure. Increasingly, however, endodontic treatment is being performed in one appointment as clinicians are finding fewer incidents of infection and pain with one-appointment vs. two appointment treatment.

Other procedures practiced in endodontics include incision for drainage and periradicular surgery. These treatments are needed in cases of abscesses, root fractures, and problematic tooth anatomy.