Endodontics

Endodontist / Endodontics

Endodontics is the area of dentistry that deals with issues involving the innermost region of each individual tooth.  Within the walls of every tooth, comprising the enamel and dentine, is a space containing the pulp.  This space is called the pulp chamber, which extends into the roots of the tooth, making up the root canals.  The pulp has many tiny blood vessels and nerve endings and it is this that make teeth “sensitive”.

When the pulp of a tooth is irritated, it becomes inflamed in a process called pulpitis.

If the irritation is persistant or severe, then irreversible pulpitis ensues and the symptoms can be severe toothache.  The most common cause of such irritation is dental caries or tooth decay with cavities.  Other causes include trauma (eg accidents) or severe wear and tear leading to attrition and cracks.  Teeth with fillings which are very deep or teeth with crowns and bridges may also subsequently develop pulpitis due to prior damage to the pulp.  In some situations, the pulp may become infected and a dental abscess or gum boil may form even in the absence of pain.  Discolouration or darker coloured teeth can also be indications of root canal problems.

Treatment for irreversible pulpitis or infection of the root canals is called root canal treatment.  This involves cleaning and re-shaping the root canals so that medicaments can be placed in them.  The root canals will subsequently need to be obturated or sealed up to prevent ingress of germs which can cause infection.  Analgesics or pain killers are often prescribed to help to resolve the painful symptoms.  Antibiotic therapy is sometimes necessary to help fight infection.  Root canal treated teeth often require crowning to restore them to function and to prevent further damage to the teeth.

Sometimes, previously root canal treated teeth can become infected if the seal of the root canal filling is breached by bacteria.  Re-treatment of the root canals may become necessary.  Surgical treatment, where the infection around the root tips are treated by a procedure called apicoectomy, is sometimes indicated.

The alternative to root canal treatment is usually extraction of the teeth, which is why Endodontists are often considered specialists in saving teeth.