Endodontic Treatment

What is Endodontic Treatment?

The “Endo” is the Greek word for “inside” and “odont” is Greek for “tooth.” Endodontic treatment treats the inside of the tooth and root canal treatment is a type of endodontic treatment.

Who is an endodontist?

Endodontists are dentists who specialize in saving teeth by performing routine, difficult and complex prodecures, including root canal treatment, root canal retreatment and endodontic microsurgery.

When do I need a Root Canal Treatment?

Root canal treatment (also known as endodontic treatment) is necessary when the pulp, the soft tissue inside the root canal, becomes inflamed or infected. The inflammation or infection can have a variety of causes, namely:

1. Deep decay on the tooth or under a filling/crown
2. Repeated dental procedures on the tooth
3. A crack or chip in the tooth
4. An injury to a tooth may cause pulp damage even if the tooth has no visible chips or cracks

if pulp inflammation or infection is left untreated, it can cause pain or lead to an abscess.

Common signs to look for include:

• 1. Pain
• 2. Prolonged sensitivity to heat or cold
• 3. Tenderness to touch and chewing
• 4. Discoloration of the tooth
• 5. Swelling
• 6. Drainage and tenderness in the lymph nodes as well as nearby bone and gum tissues

Sometimes, however, there are no symptoms.

What are the procedures of root canal treatment?

Firstly, the tooth is anesthesized and a rubber dam placed to prevent saliva contamination during treatment. Your endodontist will then remove any defective restorations and decay and gain access into the root canals. The tooth will also be examined under the dental operating microscope for any cracks, irregularities, calcifications or communications with the external environment.

The inflamed or infected pulp is removed and the root canals are then cleaned and rinsed using sterile instruments called files and disinfecting solution. Once thoroughly cleaned, the canals are sealed with a rubber-like inert material called gutta percha. X-rays are also taken at each stage of treatment. The tooth is then restored with a core or post-core followed by a crown

For the first few days after treatment, the tooth may feel sensitive, especially if there was pain or infection before the procedure. This discomfort can be relieved with over-the-counter or prescription pain medications.

Sometimes, the tooth may require more than 1 visit to complete the root canal treatment such as in the presence of severe infection, calcification, perforation, separated instrument, immature apex and tooth affected by trauma.

Will I feel pain during or after the procedure?

Many endodontic procedures are performed to relieve the pain of toothaches caused by pulp inflammation or infection. With modern techniques and anesthetics, most patients report that they are comfortable during the procedure.

For the first few days after treatment, your tooth may feel sensitive, especially if there was pain or infection before the procedure. This discomfort can be relieved with over-the-counter or prescription medications. Follow your endodontist’s instructions carefully.

Separated instrument retrieval

How do I care for my endodontically treated tooth?

Your endodontically treated tooth is as prone to decay and gum disease as an untreated tooth and it will continue to function as with any other teeth in your mouth and hence, it will need to be properly cared for with good oral hygiene, regular scaling and polishing and reviews with your endodontist to monitor for healing of the tooth.

Bony healing after root canal treatment

What causes my endodontically treated tooth to need additional treatment?

In spite of optimal treatment, some endodontically treated teeth may not heal as expected and require additional treatment.

In such cases, your endodontist will discuss the treatment options available for your tooth: nonsurgical endodontic retreatment or endodontic microsurgery.

The common causes are:

• 1. Complicated canal anatomy eg. narrow, curved or irregular canals that were not treated during the initial procedure.
• 2. A delay in the placement of the proper permanent restoration (eg. crown and bridge).
• 3. Re-contamination of bacteria from the saliva to the inside of the tooth.
• 4. New decay on the tooth allowing entry of bacteria into the root canal treated tooth causing a new infection.
• 5. A loose or broken crown or filling may also result in a new infection.
• 6. Tooth fracture.

In such cases, your endodontist will discuss the treatment options available for your tooth: nonsurgical endodontic retreatment or endodontic microsurgery.