The purpose of endodontic therapy is to clean out the inside of a tooth (the canals as well as the pulp chamber) of both infected and necrotic tissues, and to fill the internal space so that no further infections will occur within the space. For this reason it is VERY important that the proper precautions are used to keep saliva & bacteria out of the tooth while working on it. In our office we always use a "rubber dam", which is a piece of rubber that surrounds the tooth & hangs out of the mouth. This also keeps endodontic instruments and irrigants (normally used to clean out the inside of the tooth) from going down patients' throats.

Endodontic therapy is necessary when the pulp becomes inflamed or infected (often accompanied by pain to chewing or prolonged sensitivity to cold/hot). The most common reasons for this are tooth decay, deep/multiple restorations, or fractures that expose the pulp to bacteria. Trauma, such as a blow to the tooth, will often lead to discoloration of the tooth. If the damaged pulpal inflammation or infection is left untreated, the result is often pain and swelling, and, sometimes, an abscess.

Sometimes you won’t see or feel any of the signs or symptoms described above. Instead your dentist may see something on a radiograph that may indicate an infected pulp, and therefore, refer you to a specialist for treatment.

Endodontic therapy allows you to keep your own tooth and restore it to a point where you can use it, again. If a tooth is too broken down to save (meaning there is not enough tooth structure left to restore it), the tooth can be extracted and a bridge or an implant can replace the empty space where the tooth used to be.

If the gums around the tooth are unhealthy (severe periodontal disease is present), there may be minimal support to hold the tooth in place, and, therefore, extraction may be a better option then endodontic therapy.

The perception that endodontic therapy is painful began decades ago. Today, with advancements in technology and anesthetics, endodontic therapy is, often, no more uncomfortable than having a filling placed.
 

Once endodontic therapy is complete it is very important that you return to the office periodically (usually every 6-12 months) to make sure that your tooth is healing properly. We will notify you when you should come in. Since an abscess may take up to 2 years to heal, we will reevaluate your tooth for at least 2 years.
 

Your tooth is not “dead”, but rather “non-vital”. This means that the tooth can no longer respond to stimuli like hot and cold, but it is still being nourished by the surrounding tissues (even after the pulp is removed). Because it has nerves & ligaments that run around the roots, the tooth will still respond to pressure, biting and tapping. For this reason your tooth may take a little while to feel “normal” again, after treatment.
 

When endodontic therapy is performed it can be a very technically difficult procedure. There are many reasons that endodontic therapy might not heal properly. We call this “failed treatment”. Many of those reasons are preventable, and some, unfortunately, are not. If a rubber dam is not used, failure is almost guaranteed due to contamination. Instrument breakage, perforations, unremoved infected tissues (missed canals), and non-restored, leaking teeth are some of the preventable reasons endodontic therapy fails. If you have a tooth that is failing for any of these reasons, there is the possibility that with a retreatment it may heal.

Cracked and fractured teeth may be a reason that is unpreventable, and is sometimes a reason teeth need to be extracted.

Endodontic therapy can be very predictable when done well; success rates of up to 95% have been shown. Cautious, careful treatment is the key to successful endodontic therapy. During your diagnostic exam an evaluation of your tooth will be done and the chances of success will be explained to the patients for each individual case.
 

Endodontic surgery is done when a tooth can’t be treated from the coronal side (the part that sticks out in your mouth) of the tooth, or when a retreat is failing, and no other reasons for failure can be diagnosed.

In this procedure, the endodontist opens the gum tissue in order to evaluate the supporting bone and tissues, and remove any infected or inflamed tissues. The tip of the root is removed and a small filling is placed in the end of the canal to seal off the root canal space.

Immediately after treatment, the temporary that was placed will be soft for about an hour. Wait an hour or so for this temporary to harden, otherwise it might be displaced by food, allowing leakage into the canals.

After an hour you can use the tooth to chew, but please be careful not to chew anything hard, as this might cause the tooth to chip or break off. The tooth is now weaker because a hole was cut in the center of it, and part of the tooth is missing. It is very important that a crown be put on an endodontically treated tooth, for this exact reason. Once a crown is in place, the tooth may be used to chew, as normal.