What is Endodontics?

Cross section of a typical tooth

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 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.

Why Would I Need Endodontic treatment?

Endodontic treatment is necessary when the pulp becomes inflamed or infected. The most common reasons for inflammation or infection include deep cavities (caries), repeated dental procedures, cracks or chips, and trauma. Trauma can affect teeth in multiple ways leading to pulp necrosis (death of the pulp), calcification of the pulp, discoloration of the tooth, fracture of the tooth, and internal or external resorption. If pulp inflammation or infection is left untreated, it can cause pain or lead to an abscess.

Signs & Symptoms

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 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. A chronic abscess can sometimes form which is usually a painless infection marked by drainage from a small opening in the gums surrounding the affected tooth.

How Can Endodontic Treatment Help Me?

The Endodontist removes the inflamed or infected pulp, carefully cleans and shapes the canal system, and then seals the prepared space. This procedure is known as endodontic therapy (root canal treatment). Since endodontic therapy is concerned with removing only the pulp from the root canal, the root will continue to function normally because the supporting tissues remain intact. It is advisable to remove the injured pulp because it may become infected or act as an irritant to the tissues surrounding the tooth. 

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.