Endodontics is a specialist area of dentistry that focuses on the pulp as well as other tissues that surround the roots of the tooth.

What is endodontics?

Endodontics is the dental speciality that deals with the pulp of the tooth and the tissues surrounding the roots of the teeth. The word comes from the Greek words endo meaning ‘inside’ and odont meaning ‘tooth.’ The term Endodontics literally means the study of what is inside the tooth.

An Endodontist is a dentist who has completed further training so they can specialise in diagnosing and treating endodontic diseases. This most commonly involves performing root canal therapy.

 

What is root canal therapy?

Inside your teeth, there are canals which contain soft tissue including nerves and blood vessels known as the dental pulp. This pulp tissue supplies nutrients to the tooth to keep it healthy and is responsible for tooth growth. The pulp can become infected and has a limited ability to heal itself. This means that infection can develop in the tooth and the method of removing this infection is known as root canal therapy. The tooth can still function without its pulp as it is nourished by the tissues on the outside of the roots and usually the tooth is fully grown.

What does the procedure involve?

You will be given a local anaesthetic to numb the tooth and the surrounding tissues.

A sheet of rubber, known as rubber dam is placed over the tooth and held in place with a small metal clip. It isolates the tooth, preventing contamination of the canals. You will still be able to breathe normally, however, it may feel a little strange for the first few minutes.

The Australian Society of Endodontology mandates that a rubber dam be used for all root canal procedures.

The Endodontist then creates a small opening into the tooth and the damaged pulp tissue is removed. The canals in the tooth are cleaned, shaped and disinfected. There will be between one and four canals depending on the tooth. All canals in the tooth need to be treated. An antibacterial and anti-inflammatory paste is then placed inside the tooth to help with healing and the tooth is sealed with a temporary filling. A metal band may need to be placed around the tooth to protect the tooth and the filling whilst under treatment. This band will remain in place until the root canal therapy is finished and the tooth is permanently restored by your own dentist. A healing period of a few weeks or months will be allowed for the infection to resolve.

The final treatment session involves filling the canal space left when the pulp was removed from the tooth. This is done to prevent re-infection. A semisolid material called gutta percha is packed inside the tooth with sealant using heat and pressure. A restorative material is then placed to seal the tooth.

A radiograph (x-ray) will be taken to check the position of the root canal filling inside the tooth, and to observe the surrounding tissues.

What can I expect during treatment?

You should feel no pain during the treatment. We can give you additional local anaesthetic if the tooth is very sensitive. If you are particularly anxious you may be able to take some sedative medication to relax you before the treatment session begins.

How many treatments will I need?

In most cases, root canal treatment requires two sessions for completion. Depending on the complexity of your tooth and the severity of infection, you may need additional treatment sessions. Teeth can vary in shape depending on the number, length and curvature of roots. If you have ongoing infection, the tooth may require multiple treatment sessions in order to resolve this.

What can I expect following treatment?

It is normal to experience some mild discomfort in the few days following your procedure. You may need to take some pain medication such as paracetamol or ibuprofen during this period. The soreness should gradually subside. If you have severe or ongoing pain or swelling please contact our rooms. You may need to take oral antibiotics if the condition is severe. It is important that the tooth remains sealed between treatment stages to prevent re-infection. Please contact us immediately if your provisional filling breaks or dislodges so we can repair this. Once the root canal treatment is completed, you will need to have the tooth restored with a permanent filling, onlay or crown. This is done to protect the tooth and to prevent it from fracturing. The type of restoration you require will be discussed with you. We usually refer you to your general dentist for this or you can consult a prosthodontist (crown specialist).

How successful is endodontic treatment?

People have varied healing responses and some infections may respond differently, therefore no guarantee can be given that endodontic treatment will be successful. However, studies have shown that the majority of endodontic treatments are successful and uneventful. If your case is considered less favourable, this will be discussed with you. It may take several months for the tissues surrounding the tooth to return to normal, and for the pain to completely disappear.

It is important that your tooth is reviewed regularly to assess healing and evaluate the success of the root canal treatment. You will be recalled for a short consultation and x-ray check 6-12 months following your final treatment.