What is Endodontics?

Endodontics is a specialty of Dentistry that deals with diseases of the dental pulp and its supporting structures. Endodontists are Dentists with a minimum of two years special post-graduate training.  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 the case is anatomically complicated, 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 centre 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. The tooth continues to be nourished by the tissues surrounding it even after the pulp is removed.  There is no reason why the tooth cannot be retained indefinitely following root canal therapy provided it is correctly restored and it remains periodontally sound. i.e. the surrounding supporting structures remain sound.

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 are deep cavities (caries), repeated dental procedures, cracks or chips. Trauma can also cause inflammation and often shows up clinically as discoloration of the tooth. If pulp inflammation or infection is left untreated, it can cause pain or lead to an abscess and loss of bone.

Signs and Symptoms

Indications for treatment include prolonged sensitivity to heat or cold, discoloration of the tooth, swelling or tenderness of the tooth or adjacent gums. Sometimes there are no symptoms but that does not preclude treatment. Clinical tests or X rays may establish the need for endodontic treatment based upon certain findings.  Also, it may be carried out electively, in the absence of symptoms, if treatment now would lead to more predictable treatment outcome at a later date.  For example before the crowning of a tooth.

Signs and Symptoms

Indications for treatment include prolonged sensitivity to heat or cold, discoloration of the tooth, swelling or tenderness of the tooth or adjacent gums. Sometimes there are no symptoms.

The Healthy Tooth