Endodontic Treatment

"Endo" is the Greek word for "inside" and "odont" is Greek for "tooth."  Endodontic treatment treats the inside of the tooth.

To understand endodontic treatment, it helps to know something about the anatomy of the tooth.  A soft tissue called pulp lies inside the tooth and under the white enamel or hard layer called the dentin.  The pulp contains blood vessels, nerves, and connective tissue and creates the surrounding hard tissues of the tooth during development.

The pulp extends from the crown of the tooth to the tip of the roots where it connects to the tissues surrounding the root.  The pulp is important during a tooth's growth and development.  However, once a tooth is fully mature it can survive without the pulp, because the tooth continues to be nourished by the tissues surrounding it.

When Endodontic Treatment or Root Canal Therapy Is Needed

Endodontic treatment is necessary when the pulp becomes inflamed or infected.  The inflammation or infection can have a variety of causes: deep decay, repeated dental procedures on the tooth, or a crack or chip in the tooth.  In addition, a blow to a tooth may have no visible chips or cracks.  If pulp inflammation or infection is left untreated, it can cause pain or lead to an abscess.

Signs of pulp damage include pain, prolonged sensitivity to heat or cold, discoloration of the tooth, and swelling and tenderness in the nearby gums.  Sometimes, there are no symptoms.


Saving a Tooth with Endodontic Treatment

The endodontist removes the inflamed or infected pulp, carefully cleans and shapes the inside of the tooth, then fills and seals the space.  Afterwards, you will return to your dentist who will place a crown or other restoration on the tooth to protect and restore it to full function.  After restoration, the tooth continues to function like any other tooth.

Endodontic Procedure Described

Endodontic treatment can often be performed in one or two visits and involves the following steps:

1. The endodontist examines and x-rays the tooth, then administers local anesthetic.  After the tooth is numb, the endodontist places a small protective sheet called a " dental dam" over the area to isolate the tooth and keep it clean and free of saliva during the procedure.


2. The endodontist makes an opening in the crown of the tooth.  Very small instruments are used to clean the pulp from the pulp chamber and root canals and to shape the space for filling.


3. After the space is cleaned and shaped, the endodontist fills the root canals with a biocompatible material, usually a rubber-like material called "gutta-percha."  The gutta-percha is placed with an adhesive cement to ensure complete sealing of the root canals.  In most cases, a temporary filling is placed to close the opening.  The temporary filling will be removed by your dentist before the tooth is restored.



4. After the final visit with your endodontist, you must return to your dentist to have a crown or other restoration placed on the tooth to protect and restore it to full function.  If the tooth lacks sufficient structure to hold the restoration in place, your dentist or endodontist may place a post inside the tooth.  Ask your dentist or endodontist for more details about the specific restoration planned for your tooth.


What to Expect for Pain or Discomfort 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.  In most cases, this discomfort can be relieved with over-the-counter or prescription medications.  Follow your endodontist's instructions carefully.

Your tooth will feel sensitive to biting pressure.  This feeling is a result of the nerve endings in the tissue outside the end of the root where it was cleaned, irrigated and a filler or sealer material was placed.

Also, you might feel a rough area where access was made by your Endodontist.  There is a soft, temporary material in that area, which may appear to wear away to some degree before your next dental visit.

What to Do to Relieve Discomfort After the Endodontic Procedure

Taking pain relief medication within one hour of leaving our office is recommended.  Take all medication as prescribed by your doctor.  If none was prescribed, standard over the counter pain relief medication should aid in any discomfort.  Aspirin products are NOT advisable as they tend to increase bleeding from the treated area.  Please take pain medications with soft food unless otherwise advised by your doctor or pharmacist.

Avoid chewing on your treated tooth, especially gum, candies, sticky or crunchy foods until the tooth has been restored with the crown or inlay as this could dislodge the temporary material and fracture the tooth.

Your tooth may continue to feel slightly different from your other teeth for some time after your endodontic treatment is completed.  However, if you have severe pain or pressure or pain that lasts more than a few days, call your Endodontist.

Parts of this content are provided courtesy of the American Association of Endodontics, Copyright 1996.  For more information, please link to their website at http://www.aae.org/

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