Endodontists specialize in performing root canals and relieving oral pain

With all the candy and sweets consumed around the holidays, many people may also find themselves treated to a toothache. If you have a toothache, have a tooth that is painful to hot or cold foods, or you have facial pain or swelling, you may need a root canal. It is not the end of the world! An endodontist can help. A what-o-dontist?

An endodontist is a dental specialist dedicated to root canal treatment, relieving oral and facial pain, and saving natural teeth. If that’s news to you, you’re in good company. A survey conducted by the American Association of Endodontists (AAE) found that 95% of Americans are unfamiliar with who endodontists are and what they do.

Endodontics is one of nine specialties recognized by the American Dental Association. The following is a list of the five most common:

Endodontist: specializes in treating the space inside teeth (root canals).
Oral and Maxillofacial Surgeon: specializes in the removal of teeth, placement of dental implants and facial surgery.
Orthodontist: specializes in straightening teeth.
Pediatric Dentist: (formerly pedodontist) specializes in children’s teeth.
Periodontist: specializes in the gums and tissue around the teeth, and dental implants.

Currently, there are more than 4,000 practicing endodontists in the United States. In my experience the mere mention of my job description of "root canal specialist" sends people into a series of facial spasms that would make you think they were in the process of pulling their own tooth! However, it seems as though misinformation, dental lore, and antiquated dental techniques have established a fear of root canals. Modern techniques provide for a safe, and much more comfortable experience for the patient. Every day I see people in my office who are terrified of the root canal procedure they are about to receive, yet they leave feeling relieved at how relatively simple and painless it was. In fact, studies show that most patients who have had a root canal performed by an endodontist describe the procedure as feeling similar to getting a filling.

The root canal procedure can be intricate and complicated; proper equipment and technique are essential for a successful outcome. Many endodontists use a microscope that allows them to see the space within the tooth with great magnification and clarity. This permits them to more thoroughly clean and locate tough-to-find canals, and to see cracks that would otherwise go undiagnosed. The microscope is an advanced piece of equipment that far exceeds the capability of dental loupes (binocular-like magnifiers worn by many dentists).

Another piece of essential equipment is the rubber dam (a latex or non-latex barrier used to isolate the tooth). The mouth is home to billions of bacteria, and the rubber dam keeps them out of your tooth during treatment. This simple barrier also prevents ingestion or aspiration of dental instruments. It is unethical not to use one, and if a practitioner attempts a root canal on you without a rubber dam, it is best to get up and walk away because your root canal will most likely fail.

The following are a few common questions about root canals that people often ask:

Why do I need a root canal?
Root canal treatment is needed when the pulp (soft tissue inside the tooth) becomes inflamed or infected as a result of injury, deep decay, repeated dental procedures on the tooth, or a cracked tooth. The affected tissue is not capable of healing itself and must be removed by way of a root canal procedure.

What is a root canal?
It is a procedure where the endodontist removes inflamed or infected pulp, carefully cleans and shapes the inside of the canal (a channel inside the root) using a series of stainless steel and nickle-titanium files (sometimes called reamers in lay terms). The roots of the tooth remain while the space within them gets treated. The space is then filled and sealed with a root canal filling material called gutta-percha. The procedure may take an hour to an hour and a half and can often be done in one visit.

What can be expected after the root canal?
After a root canal, the tooth is no longer sensitive to hot, cold, or sweets, but may be tender for a short period until the inflammation heals. The endodontist refers the patient to their general dentist to have a crown placed or other restorative work performed to protect and seal the tooth. After restoration, the tooth continues to function like any other tooth.

Do endodontists do regular dental work like crowns and fillings?
No, endodontists dedicate their treatment time to performing root canals and anything associated with the inside of your tooth.

Would a dental implant be better?
Retention of your natural tooth is better than an implant as long as the tooth has a favorable prognosis. In the event that root canal treatment cannot save your tooth, a dental implant is an acceptable, though more costly, alternative.

If you think you need a root canal, stop chattering your teeth and call an endodontist directly or ask your dentist for a referral. The sooner you get treatment, the more likely you are to have a favorable outcome.

Peter Shelley, DDS, MS
Dr. Shelley is an endodontist (root canal specialist) and owner of Elm Endodontics in Thornton, Colorado (Serving Thornton, Northglenn, Broomfield, Westminster, Brighton, Arvada, Denver, Erie, and surrounding areas). More information can be found at his site www.elmendo.com or his office can be reached at 303-427-2769. More information about endodontics in general can be found at the American Association of Endodontists at www.aae.org.

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