Endodontics is the dental specialty that treats problems associated with inner tooth and dental root tissue. When this tissue is diseased or damaged due to either decay or trauma, endodontic treatment typically can save the tooth.

Endodontists are dentists who specialize in maintaining teeth through endodontic (root canal) therapy. All dentists receive some training in diagnosis and root canal 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, our endodontists received three more years of advanced education in this kind of treatment. They study advanced root canal techniques and procedures in greater depth, learn advanced anesthesia techniques to make root canal therapy virtually painless, and treat more difficult cases. Our doctors diagnose and treat oral and facial pain, and are specifically trained to relieve discomfort and save natural teeth. Additionally, our office has the latest technology to augment patient care.  Our advanced training makes what was considered impossible just a few years ago, possible today. For this reason, many dentists choose to refer their patients to endodontists to have a root canal. By choosing to refer you to an endodontist, your dentist is providing you with the highest level of care.

The pain associated with root canal treatment is the stuff of legend. In fact, today it’s merely a myth. Modern root canal treatment is nearly painless for most people. Our doctors and staff are specifically trained to relieve oral and facial pain and save natural teeth.  In most instances the treatment should be similar to a filling appointment. Most patients report that they are comfortable and pain free during the appointment.

Teeth that are painful and troublesome before treatment are likely to take a few days to heal and resolve after treatment. It is not uncommon to have post-treatment mild discomfort and biting soreness, but this is usually relieved by taking over the counter or prescription medications that your endodontist can prescribe. Healing will continue to occur, and most teeth feel back to normal after 1 – 1 ½ weeks.

Endo" is the Greek word for "inside", and "odont" is Greek for tooth. Endodontic treatment specifically treats problems associated with the inside of the tooth. To fully understand this, it helps to know a little about the anatomy of a tooth. Every tooth is covered on the outside by very hard, white, material called enamel. Inside of this is a deeper material called dentin, also hard but less so than enamel. At the center of the dentin is a hollow space than extends from the "crown" of the tooth, or the part that you see in the mouth, all the way down to the tips of the roots within your jaw. In this hollow space is living tissue called the "dental pulp" containing blood vessels and nerves. Once your tooth is fully formed, this tissue does not play as active of a role but remains to give you feedback on when you are biting too hard, and when things are hot or cold etc. Since this tissue is not critical to your tooth during your adult life, the tooth can actually survive almost unchanged without this tissue.

One characteristic of this tissue is that it has a somewhat reduced ability to heal itself when it becomes injured. The injuries that occur to this tissue from cavities, deep fillings, cracks, and trauma tend to add up over a lifetime, and can reach a point when the body can no longer eliminate the swelling or inflammation inside this pulp tissue. This results in pain and discomfort, and if left untreated, usually leads to death of this tissue. Once the tissue dies, an infection usually follows which can spread out the root ends and cause a jaw infection or "abscess". Abscesses are usually related to pain and swelling, but can exist without any symptoms other than showing up on a dental X-ray film.

To solve this problem, the endodontist removes the inflamed or infected tissue and cleans the hollow space in the tooth to remove all remnants and bacteria present. Once this space is emptied, cleansed, and shaped, it can be filled with a biocompatible material to seal this space from any entry of bacteria in the future.

If the internal space does not become contaminated in the future by new decay, leaking fillings, or cracks, the root canal treatment can last a lifetime. Studies show long term success with root canals to be 90% or better.

Besides the structural problems listed above that can recontaminate the internal space, sometimes teeth have internal areas difficult to find and access during treatment. Some roots can also have extra "canals" or hollow spaces that are not expected and not found during the first treatment. For example, the upper first molar has three separate roots; however, this tooth has four distinct canals filled with nerve tissue (an “extra canal”) approximately 80% of the time. Studies show that most offices find that fourth canal very infrequently. Our office conducts an extensive search and finds that “extra-canal” 80% of the time. Some of these problems can cause a recurrence of pain or swelling and a second treatment to re-open and search for causes is necessary. If this is needed, the treatment is often similar to the first root canal, but may require added care and time to get through metal fillings, posts, and the previous root canal filling material.

Once the pulp tissue has been shown to be irreversibly inflamed or infected, there are few alternatives to a root canal procedure. Letting the tooth go untreated involves continued pain and ultimately can lead to destruction of bone from the infection, abscess formation often accompanied by significant swelling, and loss of the tooth. Extraction of the tooth is always an alternative, but although it is less expensive on the short term, the restoration of your complete bite can involve much more expensive options than root canal therapy, such as replacing the tooth with a bridge or an implant. Removing teeth and not replacing them can lead to crowding, shifting, and tipping of teeth and subsequently problems with how your teeth fit together and function.

Although saving teeth is always the goal in dentistry, some problems can exist that cannot be solved with any current treatment. Some teeth have cracks than run through the entire tooth, and even with root canal therapy, problems will persist. Also if periodontal or "gum" disease is too advanced, the support is lost to this tooth and root canal therapy cannot be expected to improve on this situation. Some teeth are decayed or broken beyond a point that they can reasonably be repaired. In all of these cases, extraction and replacement is the only predictable option. Correct diagnosis before treatment is part of making root canal therapy as successful as it is by eliminating the teeth that cannot be expected to respond to treatment.