Endodontics

Endodontics deals with tissues and structures located inside the tooth, which is a specialized area. The most often heard of endodontic treatments is root canal therapy, a procedure which effectively eases the pain associated with a bacterial infection deep within the pulp of the tooth. Root canal treatment is about stopping the infection by removing dead and dying tissue from the tooth’s pulp. Left untreated, the tooth is in danger of being lost — but with treatment, it can be saved.

There are other treatments offered by endodontics that are not as common. They all help to preserve your natural teeth and there are plenty of ways to do this. Dental trauma, microsurgery performed on the tips of the tooth’s roots and figuring out what is causing intermittent or localized pain all have to do with the specialty area of endodontics.

The Inside of Your Tooth

Beneath the tough, shiny enamel of the tooth's visible crown lies dentin, a sturdy inner tissue. Dentin makes up the bulk of the tooth’s structure and is also found behind the cementum that forms the outer layer of the tooth's roots. Similarly to how bone tissue works, dentin is composed of many tiny tubules which can transmit sensations to nerve cells when it is stimulated.

At the core of the tooth is the soft pulp tissue found inside small, branching chambers called the root canals. This consists of nerves, connective tissues and blood vessels which extend into the center of the tooth and exit through canals near the apex (tip) of the tooth's roots. The first indication of trouble can be tooth sensitivity that range in mild to intense pain. This is usually because of problems such as infection and inflammation that develop in the pulp tissue. When the indication of a problem is ignored and left untreated, this may result in tooth loss. Even though it may seem, in some scenarios, that the pain goes away, the problem has not and is only a sign of the nerves dying, leading to the loss of the tooth in the end.

The “Root” of the Problem

The usual potential source of an infection is untreated tooth decay, which can allow bacteria from the surface of the tooth to work its way deep in. Another source is the tooth having a fracture or a crack that can offer a pathway for microorganisms to infect the pulp.

Other sources are dental trauma whether from a sports injury, extensive dental procedures (an example would be multiple fillings or restorations on the same tooth) or even routine procedures like orthodontics may eventually lead to root canal problems.

Treatment

It’s important to remember that root canal treatment relieves the pain you already in and is not the cause of additional or ongoing pain. Typically, a root canal procedure is performed with local anesthetics, and doesn't cause any more discomfort than having a filling.

First, you will receive local anesthesia, which is a shot to numb the area and for most patients, the worst is then over. Once the area is fully numb, a small opening is made in the tooth surface to give access to the pulp chamber and root canals. These passages are narrow and so tiny instruments are used, often with the aid of a microscope, to remove dead and dying tissue from the inside. Once the cleaning takes place, the passages are then disinfected and filled with a safe, inert material. Finally, the opening in the tooth is sealed to prevent contamination and the procedure is complete.

Preventative endodontic treatments may be recommended for removing sources of infection and preventing future problems. A restoration, such as a crown, can be placed on the tooth to restore it to full function and aesthetic appearance. With proper care, the restored tooth should last for many years to come.