Endodontics

Endodontics is a branch of dentistry dealing with the cause, diagnosis, prevention, and treatment of diseases of the dental pulp, by removal of the nerve and other tissue and its replacement – more commonly known as root canal therapy.

Nerves enter at the tip of the tooth’s roots and run through the center of the tooth in small, thin root canals, which join up in the pulp chamber. Each tooth has at least one root canal but may contain more.  Injury or trauma to a tooth may cause the pulp to become inflamed or infected; eventually, the pulp may die. Damaged or dead pulp leads to increased blood flow and cellular activity, creating pressure inside the tooth that cannot be relieved. This may result in pain when biting down or chewing with the affected tooth, or when consuming hot or cold drinks. Without treatment, the infection may spread, the bone around the tooth may degenerate, and the tooth may fall out.  With a root canal, extraction is not necessary. Instead, a dentist can remove the dying pulp, clean the remaining canal, and seal it up. The pulp chamber will be filled afterwards to keep the tooth strong, and the dentist will put in a temporary filling. This will eventually be replaced with a permanent filling.

Treatment usually involves one to three appointments. After cleaning and reshaping, the dentist may seal the tooth with a temporary crown, leave it open to drain, or fill the canals, depending on the tooth’s condition.  Temporary fillings will be removed on subsequent visits. If the tooth is still weak after the pulp chamber and canal are filled, a metal or fiber-reinforced resin post may be used to reinforce the tooth. Finally, the area is permanently sealed, and a gold, porcelain-fused-to-metal, or ceramic crown usually is placed over the tooth to reinforce its structure and improve its appearance.  The only alternative to root canal therapy is extraction. This can eventually cause the surrounding teeth to move, which may result in a bad bite that ultimately requires an implant or bridge. It’s always best to keep your original tooth if possible.