An Endodontist is a dentist who has undergone a minimum of 2 years of postgraduate training after dental school. Dr. Davis and Dr. Schwartz have at least 4 years of postgraduate training. An endodontic practice focuses primarily on root canal treatment, related surgery, and treatment of damaged teeth resulting from accidents and injuries. Your general dentist sometimes refers patients to an endodontist for consultation when the diagnosis is complicated or when treatment is more difficult than normal. Aside from providing treatment, our doctors try to act as educators. It is important that patients understand why they require treatment, what treatment involves and what they can do to ensure the best possible outcome. We believe that a properly informed patient has the best chance of achieving the optimal result.
The terms “root canal treatment” and “endodontic treatment” are synonymous. Endodontics is a specialty of Dentistry that deals with diseases of the dental pulp and its supporting structures. Endodontists are dentists with special post-graduate training in this field. Endodontists generally limit their practice to root canal treatment and related surgery. Some endodontists also extract teeth and place dental implants. Endodontists are also experienced at finding the cause of oral and facial pain that has been difficult to diagnose.
Although general dentists can perform endodontic treatment, patients are often referred to an endodontist when treatment is complicated or more difficult than usual.
In order to understand endodontic treatment, it helps to know something about the anatomy of a tooth. Teeth have several layers. The outside layer of the tooth is composed of a hard layer called enamel. Below the enamel is an inner layer, called dentin, which supports the harder, more rigid enamel. At the center is the pulp.
The pulp contains blood vessels, nerves, and connective tissue that are responsible for forming the surrounding dentin and enamel during tooth development. The pulp receives its nourishment supply from vessels, which enter the end of the root and extend deep into the tooth through long, narrow canals (the root canals). Although the pulp is important during development of the tooth, it is not necessary for function of the tooth. The tooth continues to be nourished by the tissues surrounding it even after the pulp is removed. In other words, removal of the pulp does not cause the tooth to “die.”
Endodontic treatment is necessary when the pulp becomes inflamed or infected. The most common reasons for inflammation or infection are deep decay (caries), repeated dental procedures, cracks or fractures. Trauma can also cause inflammation and may result in discoloration of the tooth. If pulp inflammation or infection is left untreated, it can cause pain or lead to an abscess. Occasionally your dentist may recommend endodontic treatment even though your tooth does not bother you, in anticipation of future problems.
There are several typical signs and symptoms that indicate root canal treatment might be necessary. These include prolonged sensitivity to heat or cold, discoloration of the tooth, swelling of the cheek or gums, or tenderness of the tooth or adjacent gums. Sometimes a “pimple” will form on the gums, indicating infection is draining from the tooth. It is not unusual for a tooth to be painful or throbbing one day but then asymptomatic the next. Sometimes there are no symptoms at all if the infection is localized and well controlled by your immune system.
The Endodontist removes the inflamed or infected pulp, carefully cleans and shapes the canal system and then seals the canals to prevent re-infection. Most teeth we treat require two appointments. At the end of first treatment appointment, after the canals have been properly cleaned, we fill them with an antimicrobial medication and a temporary filling. We like to leave the medication in the tooth for several weeks or until all evidence of the infection is gone and the tooth feels the same as the other teeth. At the second appointment, which is usually fairly short, we remove the mediation and complete treatment. Once treatment is completed we will usually place a permanent filling and you may be instructed to return to your regular dentist for a crown. The restoration of the tooth is an important part of treatment because it seals the cleaned canals from contamination by saliva, protects the tooth and restores it to function.
Pain is the main reason patients come to see us for treatment. Fortunately, modern anesthetics can make the procedure pain free in most cases. Don’t wait. Seeking treatment before you are in extreme pain makes the procedure easier and more comfortable. When treated early, root canal treatment should feel no different than a regular filling. For the first few days after treatment, there may be some sensitivity to biting pressure, especially if there was pain or infection before the procedure. Sometimes over-the-counter anti-inflammatory medications (like Advil) are recommended for a day or two. Our doctors can prescribe stronger medications but they are rarely needed.
Our office offers a progressive, proactive approach to resolving your dental problems. This website allows your doctor to send us referral information about you as well as digital x-rays. It allows you to fill out the medical history and other forms ahead of time. All this information is encrypted and automatically entered into your electronic chart. We are, essentially, a “paperless office.” Each treatment room is equipped with the latest technology including operating microscopes. We utilize digital radiography rather than traditional x-ray films, so you are exposed to 80-90% less radiation during radiography procedures. We also utilize 3D imaging with some patients. We monitor all the latest information in our field and utilize the latest technology in the diagnosis and treatment of your root canal problems.