Everything that happens at an endodontist’s office is related to what’s going on inside your tooth, including the pulp (the soft connective tissue) and the root. Most likely, if you are visiting an endodontist, you’ve been referred by your general dentist, either for a root canal or for endodontic surgery.
Root Canal Therapy
A root canal is an endodontic procedure, but it may be performed by your general dentist as well (especially if you have a straight-forward case). A root canal is the best way to save a tooth with infected pulp (sometimes called a dying nerve). A mature tooth can survive just fine without the pulp — but diseased pulp can erode the bone away. Therefore, during a root canal, the dentist or endodontist removes the pulp from the inside of the canal, and then fills it with a substance similar to the pulp (gutta percha or resin), and then seals the root.
After your root canal, you’ll go back to your regular dentist to get a crown (or other restorative procedure) to keep the tooth strong and protected. Once you have your crown, the tooth is as good as new. Root canals have a very high success rate (about 90 percent). It’s normal for your mouth to be a bit tender in the area of the root canal (over-the-counter medications usually help with the discomfort). However, if you have serious issues after your root canal, like visible swelling or a reoccurrence of the original symptoms, definitely contact your dentist or endodontist.
If you’re having problems after your root canal — such as inflammation in the bony area around the root — saving the tooth might require surgery. The most common is an apicoectomy (or root end resection). In an apicoectomy, the endodontist opens the gum tissue to be able to see the underlying bone and get rid of the inflamed or infected tissue. The very end of the root is also removed. The endodontist seals the end of the root canal with a small filling. Eventually, the bone heals around the root.
Cracked teeth can cause a lot of pain, and endodontists are experts at fixing them (and saving the tooth, if it’s possible to be saved). If the crack doesn’t extend into the gingival tissue, an endodontist will most likely try a root canal. If the cracked tooth isn’t treated and becomes a split tooth, the endodontist won’t be able to save it. If you suspect you have a cracked tooth, see your dentist immediately.
Other Endodontic Surgeries
Endodontists sometimes perform a surgery called intentional replantation. The endodontist removes your tooth, treats it while out of your mouth, and then puts it back in the socket — which actually helps save the tooth. Endodontists also perform surgeries that divide a tooth in half or repair injured roots.
With all endodontic procedures, follow-up care is crucial. Your endodontist will want to check to see how the tooth is healing. It’s also important to take good care of the tooth and practice good oral hygiene, such as regular brushing and flossing.