Frequently Asked Questions
Endodontics is the branch of dentistry concerned with the morphology,
physiology and pathology of the human dental pulp and periradicular tissues.
Its study and practice encompass the basic and clinical sciences including the
biology of the normal pulp, and the etiology, diagnosis, prevention, and treatment
of diseases and injuries of the pulp and associated periradicular conditions.
Root canal treatment involves the use of biologically acceptable chemical and
mechanical treatment of the root canal system to eliminate pulpal and periradicular
disease(s) and to promote healing and repair of the periradicular tissues. First,
the endodontist will administer local anesthetic to make the procedure comfortable.
Next, an access will be made through the crown or tooth. Once all of the canals are
located, the lengths of the roots will be determined. The debridement and shaping
of the canal system with the use of hand files and engine driven rotary files
facilitates the chemical cleaning and disinfecting of the canal system. Once the
canal system is as clean as possible, it is dried and sealed with a biologically
acceptable nonresorbable semi-solid or solid root canal obturating material. Your
endodontist will typically place a temporary filling in the access opening. After
root canal treatment, a permanent filling or crown will be necessary to restore
the tooth back to function.
Endodontists perform a wide range of treatments for the goal of retaining
natural teeth. These procedures include, but are not limited to: differential
diagnosis of oral pains of pulpal and/or periradicular origin, vital pulp therapy
to prolong long-term vitality of teeth, apexification to fix non-vital immature
roots, apexogenesis to promote complete root-end formation in vital teeth, standard
root canal therapy (as described above), revisions of existing root canal
treatments, repair of teeth with perforations, bleaching of discolored enamel and
dentin, management of traumatic tooth injuries, surgical root procedures,
intentional replantation and tooth transplantation from other sites within the
patient's mouth.
The goals are the same as for the profession of dentistry as a whole; for the
public to maintain a healthy and natural dentition for life. Although many routine
root canal procedures can be managed by a general dentist, any case that is beyond
the level of training, expertise and experience of the individual practitioner
should be referred to a practitioner/specialist with the appropriate training,
experience and expertise. Ultimately, endodontic procedures are aimed at saving
natural teeth.
Most endodontic specialty training programs are 2 to 3 years in duration.
During specialty residency, endodontists learn to treat complex and difficult
cases. Management of medically compromised patients is also an important part of
the curriculum as well as detailed analysis of the endodontic literature.
Endodontist strive to base their treatment in evidence-based dentistry. In other
words, endodontists seek scientific justification for the procedures and
methodology they employ rather than using a treatment modality because "it works
for Fred down the street."
Success rates for standard root canal therapy are reported as high as 95%. It
is essential that the tooth that has received a root canal be appropriately
restored with a filling or crown in order to ensure long term success. Many of the
root canals that fail, do so because the teeth were not restored and subsequent
leakage of saliva and bacteria back into the canal spaces resulted in reinfection.