Recognized by the American Dental Association, Endodontics is a specialized branch of dentistry focused on the treatment of the pulp and surrounding tissues of a tooth. The visible part of your tooth is the crown, and the portion hidden beneath the gum line is the root. The root’s hard outer tissue is called cementum, and the inside channel, or root canal, contains your tooth’s pulp, a soft tissue composed of blood vessels and nerves. When tooth decay, periodontal disease or a fracture introduce bacteria into the pulp, discomfort and severe damage ensue.

 

 

Endodontics is a specialty of Dentistry that deals with diseases of the dental pulp and its supporting structures. Endodontists are Dentists with special post-graduate training in this field. Endodontists are also experienced at finding the cause of oral and facial pain that has been difficult to diagnose.

Although General Dentists can perform Endodontic treatment, patients are often referred to an Endodontist when the case is complicated or more difficult than usual.

In order to understand Endodontic treatment, it helps to know something about the anatomy of a tooth. Teeth have several layers. The outside layer of the tooth is composed of a hard layer called Enamel. Enamel is supported by an inner layer called Dentin, which has at its center a soft tissue known as the Pulp.

The pulp contains blood vessels, nerves, and connective tissue that are responsible for forming the surrounding Dentin and Enamel during tooth development. The pulp receives its nourishment supply from vessels which enter the end of the root. Although the pulp is important during development of the tooth, it is not necessary for function of the tooth. The tooth continues to be nourished by the tissues surrounding it even after the pulp is removed.

 

 

 

 

 

Endodontic treatment is necessary when the pulp becomes inflamed or infected. The most common reasons for inflammation or infection are deep cavities (caries), repeated dental procedures, cracks or chips. Trauma can also cause inflammation and often shows up as discoloration of the tooth. If pulp inflammation or infection is left untreated, it can cause pain or lead to an abscess.

Indications for treatment include prolonged sensitivity to heat or cold, discoloration of the tooth, swelling or tenderness of the tooth or adjacent gums. Sometimes there are no symptoms.

 

 

 

 

Occasionally a tooth that has undergone endodontic treatment fails to heal or pain continues despite therapy. 
Although rare, sometimes a tooth initially responds to root canal therapy but becomes painful or diseased months or years later. 

When either of these situations occur, the tooth often can be maintained with a second endodontic treatment.  
Dr. Ardalan performs a comprehensive evlauation before a root canal is reatreated.

 

 

 

 

 

Why would I need Endodontic Surgery?

Generally, a root canal is all that is needed to save teeth with injured pulp from extraction. Occasionally, this non-surgical procedure will not be sufficient to heal the tooth and your endodontist will recommend surgery. Endodontic surgery can be used to locate fractures or hidden canals that do not appear on x-rays but still manifest pain in the tooth. Damaged root surfaces or the surrounding bone may also be treated with this procedure. The most common surgery used to save damaged teeth is an apicoectomy or root-end resection.

 

 

What is an Apicoectomy?

The above diagram illustrates this simple procedure. An incision is made in the gum tissue to expose the bone and surrounding inflamed tissue. The damaged tissue is removed along with the end of the root tip. 
A root-end filling is placed to prevent reinfection of the root and the gum is sutured. The bone naturally heals around the root over a period of months restoring full function.

 

Following the procedure, there may be some discomfort or slight swelling while the incision heals. 
This is normal for any surgical procedure. To alleviate any discomfort, an appropriate pain medication will be recommended. If you have pain that does not respond to medication, please call our office.