General Information

An Endodontist is a dentist who has undergone a minimum of 2 years of extra postgraduate training.

Endodontists are specifically trained to:

• Diagnose facial and dental pain
• Treat diseases of the dental pulp and supporting structures
• Treatment can be accomplished nonsurgically (a conventional root canal) or through Microsurgery, when indicated.
  
  Your general dentist sometimes refers patients for consultation when the diagnosis is complicated or when treatment is more difficult than normal.  We will work with your dentist to achieve the best possible outcome.

Endodontics is the science of treating problems with the dental pulp (the tissue inside the tooth).  When this tissue or the tissue surrounding the tooth root is diseased or damaged due to decay or trauma, endodontic treatment typically can save the tooth.

Although General Dentists can perform Endodontic treatment, patients are often referred to an Endodontist when the case 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. Enamel is supported by an inner layer called Dentin, which has at its center a soft tissue known as 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. Although the pulp is important during development of the tooth, it is not necessary for function of the tooth.

Example: Mandibular (Lower) Molar

Endodontic treatment is necessary when the pulp becomes inflamed or infected.

The most common reasons for inflammation or infection are:

• Deep cavities (caries)
• Repeated dental procedures
• Cracks or chips
• Trauma can also cause inflammation and often shows up as discoloration of the tooth. If pulp inflammation or infection is left untreated, it can cause pain or lead to an abscess.

Indications for treatment include prolonged sensitivity to heat or cold, discoloration of the tooth, and swelling or tenderness of the tooth or adjacent gums.  The affected tooth will sometimes be sensitive to chewing pressure.  It is not uncommon for a pulp to become necrotic (die) without any noticeable symptoms.  This is sometimes identified on x-rays by a loss of bone around the ends of the roots.

The Endodontist removes the inflamed or infected pulp, carefully cleans and shapes the canal system and then seals the prepared space. Once treatment is completed, you may be instructed to return to your dentist for permanent reconstruction. The restoration of the tooth is an important part of treatment because it seals the cleaned canals from the oral environment, protects the tooth and restores it to function.

Toothache pain is the main reason for patients seeking treatment. The purpose of a root canal procedure is to eliminate the cause of this pain.  Fortunately, modern anesthetics can make the procedure pain free in most cases. Seeking treatment early makes the procedure more comfortable. When caught early, treatment should feel no different than having 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. Quite often over-the-counter anti-inflammatory medications (like Ibuprofen) are the best medication to manage the post-op sensitivity. Dr. Starley can prescribe other medications but they are rarely required.