Endodontics is a dental specialty that focuses on conditions and treatments within the inside of the tooth and the dental pulp, such as restoring chipped or cracked teeth, root canal and apicoectomies. In Greek, "endo" is the word for "inside" and "odont" is the word for "tooth".
Endodontics treats problems of the dental pulp, the soft tissue within the tooth that contains blood vessels, nerves and connective tissue and helps create the surrounding hard tissues that make up the outside of the tooth. The pulp stretches from the crown of the tooth all the way to the tips of the roots and into the surrounding tissue. Dental pulp is vital to the growth and development of healthy teeth, but is not necessarily needed once the tooth has fully matured.
Endodontic treatment is needed when the pulp becomes infected or inflamed. This may occur as a result of decay, repeated dental procedures, a crack or chip in the tooth or injury with no visible signs of damage. When the pulp is affected, it can lead to pain or the development of an abscess, as well as increased sensitivity, tenderness and discoloration.
Problems within the dental pulp can often be identified through X-ray images that identify the damage. Occasionally, this damage does not show up on an X-ray despite the patient's complaints of related symptoms. In these cases, a root canal may be performed as a diagnostic procedure to help identify tiny holes or cracks in the tooth that may be the cause of dental pulp damage.
Although sometimes referred to as the practice of root canal therapy, endodontics actually encompasses a wide range of surgical and nonsurgical procedures that help keep the teeth free from diseases and injuries of the pulp and surrounding tissue. Like other dental specialties, the goal of endodontics is to maintain good oral health.
A root canal is the most common endodontic procedure, and one of the most common dental procedures overall. There are over 15 million root canals performed in the US every year. A root canal can help both diagnose and treat damage within the dental pulp. The pulp can become damaged from a cracked tooth or dental infection and should be removed to prevent further damage to the tooth such as a toothache, bone loss, discoloration and swelling.
A root canal is performed by drilling a hole in the tooth to reach the inside. The inside of the tooth is thoroughly cleaned and the hole is then filled to seal the tooth and prevent any dirt or bacteria from entering the tooth again. A temporary filling is placed as well. This procedure is performed under a local anesthetic in your doctor's office. Follow-up appointments are then needed to restore the appearance of the tooth with a permanent filling or crown that will help prevent further damage. The success rates for root canal procedures are reported as high as 95 percent.
Also known as root-end resection, an apicoectomy is a surgical procedure performed to remove damaged pulp that is located in the bony area at the end of the tooth. This damage may have been persistent after a root canal procedure because of its tricky location. During an apicoectomy, the surrounding tissue is opened and the infected tissue, as well as the end of the root, is removed. A small filling is placed in the root to seal the area and prevent future damage and the area is stitched to help it heal.
Other types of endodontic surgery are available that may be performed for more severe cases.
After endodontic treatment, patients may experience some discomfort, swelling and increased sensitivity in the treated area for the next 24 to 48 hours. After recovery, most patients report that their treated tooth feels the same as their natural teeth and have no problems eating, speaking or smiling.