What is an Endodontist and what do they do?


What is an Endodontist and what do they do?

Endodontists are dentists who specialize in maintaining teeth through endodontic therapy — procedures, involving the soft inner tissue of the teeth, called the pulp.  The word “endodontic” comes from “endo” meaning inside and “odont” meaning tooth.  Like many medical terms, it’s Greek.  All dentists are trained in the diagnosis and endodontic therapy, however, some teeth can be especially difficult to diagnose and treat.  That’s why you may have been referred to an endodontic specialist.

In addition to dental school, endodontists receive two or more years of advanced education in this kind of treatment. They study root canal techniques and procedures in greater depth, for diagnosis and treatment of more difficult cases. For this reason, many dentists choose to refer their patients to endodontists.

How does endodontic treatment save the tooth?

The endodontist removes the inflamed or infected pulp, carefully cleans and shapes the inside of the tooth, then fills and seals the space. Afterward, 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.

What is a Root Canal?

A root canal is a common dental procedure performed to save a tooth that may otherwise need to be extracted.  In order to understand the root canal procedure, it helps to review the anatomy of the tooth.  Teeth have several layers.  The outer surface of the tooth is composed of a hard enamel layer.  Supporting this layer is an inner dentin layer, which has at its center a soft tissue referred to as pulp.

The pulp contains blood vessels, nerves, and other supporting tissues that are primarily responsible for forming the hard outer layers of the tooth during development.  After the development of the tooth, the pulp is no longer necessary for the function of the tooth.

Endodontic treatment becomes necessary when the pulp becomes inflamed or the canals containing the pulp become infected.  The most common reasons for inflammation or infection inside the tooth are deep decay, trauma, cracks, and fractures, or multiple/repeated dental procedures.  Symptoms associated with endodontic inflammation or infection include an abnormal or prolonged sensitivity to cold or hot, biting sensitivity, tenderness deep in the bone, spontaneous throbbing pain, discoloration of the tooth, or swelling.  Sometimes there are no symptoms and the results of the inflammation or infection are visualized on diagnostic X-rays.  Left untreated, inflammation of the pulp or infection of the canals can lead to pain, abscess, and eventual loss of the tooth.  If you experience any of these symptoms, your dentist will likely recommend root canal treatment to save your tooth, relieve pain, and eliminate the infection.

What Happens During Endodontic Treatment?

 (What is a Root Canal?)

A local anesthetic will be given.  A sheet of latex called the “rubber dam” (we’ve got nonlatex ones too) will be placed around the tooth to isolate it, hence keeping it clean and dry during treatment.  The treatment consists of three or four basic steps, but the number of visits will depend on your particular case.  Some treatments take 2 visits but many are just a single visit.  Occasionally 3 appointments are needed.

In any case, it depends on the degree of infection/inflammation and the degree of treatment difficulty.  To me, it’s more important to do it the very best we can than to meet specific time criteria.  Let’s look at the basic steps for nonsurgical endodontic therapy.

There are, of course, no guarantees.  Root canal or endodontic therapy has a very high degree of success, up to 90%.  Teeth that can be treated near ideal have a success rate of up to ninety percent!  We will discuss with you the chances of success before any endodontic procedure to help you make an informed decision.  If a root canal or endodontic therapy is unsuccessful or fails you still have options


Diagnoses and Treats Pain

Oral pain such as toothaches or cracked/fractured teeth can often be difficult to pinpoint.  Because of the vast network of nerves in the mouth, the pain of a damaged or diseased tooth often is felt in another tooth and/or in the head, neck, or ear. An endodontist is a specialist in diagnosing and treating this type of pain.

Treats Traumatic Injuries

Pulp damage is sometimes caused by a blow to the mouth, and the endodontist specializes in treating these traumatic injuries. For example, a blow to a child’s permanent tooth that is not fully developed can cause the root to stop growing. A procedure called apexification stimulates bone to be deposited at the end of the root which makes it possible to then save the tooth through a root canal procedure. An endodontist is specially trained in procedures for replanting teeth that have been knocked out of their sockets.

Will I need to return to your office for Additional Visits?

Once endodontic therapy is completed your tooth should be examined periodically, usually every 6 – 12 months.  This allows us to make sure the tooth has healed or is healing properly.  You will be sent a notice in the mail when we feel it is appropriate to reevaluate the area.  Since an abscess may take 2 years to heal, our office will reevaluate the tooth for at least 2 years.


Occasionally a tooth that has undergone periodontics treatment fails to heal or pain continues despite therapy.  Although rare, sometimes a tooth initially responds to endodontic therapy but becomes painful or infected months or years later.  When either of these situations occurs, the tooth often can be maintained with a second endodontic treatment.   Root canal retreatment is typically completed in two appointments in our office, but the number of visits depends on your particular case.  Retreating a tooth that has already had endodontic treatment is frequently more difficult than initial root canal treatments.  Root canal filling materials need to be removed as well as any material placed in the canals for support such as posts.  Previously root canal treated teeth often have obstructions that may need to be overcome to completely clean the root canal system.  These obstructions include ledges, calcifications, separated instruments, or difficult to remove filling materials.  Spreading the treatment over two appointments gives Dr. Baur additional time to properly treat the tooth while keeping the patient comfortable.  Equally important, at the first appointment Dr. Baur places a medicated paste in the roots of the tooth that actively disinfects the tooth even when the patient is not in the chair.  Occasionally this medication may need to be replaced over multiple visits to adequately control the infection or inflammation associated with a tooth.