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Endodontists are dentists that have advanced training in endodontics and specialize in root canal therapy. The endodontic procedures they perform include root canals, root canal retreatments, and endodontic microsurgery. Their expertise also extends to diagnosing the cause of oral and facial pain.

To become an endodontist, a dentist must complete an additional two years of advanced education in root canal treatment and diagnosis. Practicing specialized medicine allows endodontists to perfect their craft because they perform procedures like root canals every day. With their specialized training, they’re also prepared to treat difficult cases where narrow or blocked canals are involved. Endodontists use advanced technology like digital imaging to make treatment even more accurate and efficient.

Endodontic treatment could be needed for several reasons that vary in severity. You could be diagnosed with irreversible pulpitis, which happens when the nerve space is inflamed, or pulp necrosis, which happens when the nerve has died. Some indications that you may need to see an endodontist include:

• Lingering pain to cold
• Spontaneous toothache
• Pain with biting or with pressure
• Swelling
• An area that drains pus on the gum

However, in some cases, root canal problems are asymptomatic and don’t cause any pain. Endodontic treatment may be recommended based on X-ray findings or a clinical visit.

Endodontists treat the inside of the tooth, or the pulp of the tooth. Inside the tooth, underneath the white enamel and a hard layer called dentin, is a soft tissue called pulp. Pulp extends from the crown of the tooth to the tip of the roots where it then connects to the tissue surrounding the root. The pulp of the tooth contains blood vessels, nerves, and connective tissue; all of which help the tooth in its growth and development. Once a tooth is fully mature, it can survive without the pulp because the tooth is then nourished by the tissues surrounding it. Even though a tooth doesn’t need the pulp at that point, an endodontist must treat the pulp if it becomes inflamed or infected.

Any inflammation or infection of the pulp of a tooth, if left unchecked, can cause pain or lead to an abscess. That inflammation or infection of pulp can be caused by a variety of things including deep decay, repeated dental procedures on a tooth, a crack or chip, or trauma to a tooth. In some cases, endodontic treatment may also be required even if no symptoms are present. In those cases, a dentist or endodontist may discover disease only through examination or X-ray.

The first thing patients should know if they are nervous about root canal treatment is that they’re not alone! It’s very common for us to see patients who are apprehensive about treatment, but we can tell you that root canals are very routine and actually not all that uncomfortable. We will talk you through the procedure and many patients find that through anesthesia and the high-tech instruments that we use, a painless experience. If patients feel anxious during their appointment, nitrous oxide or “laughing gas” may be used without a prior consultation. In some cases, oral anxiolysis may be prescribed for moderate anxiety during the procedure. This route will require a consultation prior to scheduling treatment.

Endodontists and dentists alike strongly encourage their patients to schedule treatment in short order. Delaying treatment or deciding against treatment altogether can lead to:

• Increased pain
• Infection
• Swelling
• Bone loss around the tooth

If you are experiencing any of these symptoms, it’s important to seek treatment right away. Not only will the problem get worse, but delaying treatment further can decrease a patient’s ability to heal.

Endodontists deal with the inflamed or infected pulp of the tooth by removing it and then they move on to cleaning and reshaping the inside of the tooth, filling it and then sealing it. After endodontic treatment, a dentist will place a crown or other restoration on the tooth to protect it and restore it. Once both of those steps are completed, a tooth will essentially be saved and able to function properly.

In the majority of cases, teeth can be treated and saved. Some advanced cases make endodontic treatment more complicated or ineffective. Examples include inaccessible root canals, a severely fractured root, inadequate bone support, and the inability to restore a tooth. However, advances in endodontics save more and more teeth, and endodontic surgery can even be used in order to save teeth.

Ultimately, natural teeth are more efficient when it comes to chewing function than implants, and will obviously look more natural aesthetically. From a financial perspective, extracting a tooth costs less money in the short term, but may cost more money in the long term. Dental implants can be costly, especially when it comes to maintenance and preservation. Dental implants are also more prone to causing complications than natural teeth over time.

Most endodontic procedures only cause minor discomfort, not pain. While patients may feel some pressure and vibration during treatment, pain is not normal in endodontics. If you are feeling pain, Dr. Beasley asks that you raise your hand so that it can be addressed immediately. Patients seeking endodontic treatment usually feel nothing but relief during and after treatment considering that they may have been in pain from inflammation or infection prior to their appointment. Modern techniques have made root canal treatment efficient and very routine. Following your procedure, your tooth will feel a bit more sensitive than normal, but the tenderness, especially with biting, will diminish as the tooth and surrounding area begin to heal. Many patients need nothing more than over-the-counter medications to relieve discomfort.

Endodontic procedures tend to vary in cost depending on a couple of factors. The first factor is severity of the tooth inflammation or infection and which tooth is affected. Molars are generally more difficult to treat and may cost more. The second factor is your insurance coverage. Most dental insurance policies provide ample coverage for endodontic treatment, but our team is happy to assist you in getting an estimate if you so choose. Interest-free financing is also available through CareCredit.

Endodontic treatments need to be closely followed by restoration, which can be performed by your dentist. Until the tooth can be treated by your dentist, you should not chew or bite with the treated tooth. Biting something too hard can lead to a fracture and limit the success of the treatment. Once the tooth has been restored, you should continue to practice good oral hygiene like brushing, flossing and regular cleanings. Many treated teeth don’t need any additional care, but occasionally the tooth can become painful or diseased again after time. In that case, another endodontic procedure may be required to save the tooth.

A variety of issues can lead to retreatment including trauma, deep decay or a loose, cracked or broken filling. In other cases, narrow or curved canals may have caused complications during the initial procedure.

The alternative to endodontic treatment is extraction of the tooth. This alternative isn’t recommended as, even with technological advances, no implant or bridge will be a better solution than saving a natural tooth. Not only will extraction and then the addition of an implant, be most costly, it will be more time-consuming and susceptible to problems over time.