The term endodontics is derived from two Greek words - "endo" meaning inside and "odons" meaning tooth. Taken together, these words mean study of the inner part of the tooth or the dental pulp. Endodontics specialists are familiar with a number of diseases that involve the dental pulp and the procedures to treat them.
The dental pulp is the innermost part of the tooth. The pulp is protected by the outermost part of the tooth, the enamel, as well as by the dentin that lies underneath the enamel. This hard casing of the pulp protects it from becoming infected by microbes present in the mouth. In cases of tooth decay, this outer cover erodes away to form holes or cavities that expose the dental pulp to these microbes as well as to hot and cold temperatures. Since the pulp is rich with nerves and blood vessels, infection of the pulp can lead to sensitivity and toothache.
Some of the procedures used in endodontics include:
A local anesthetic will be given. A sheet of latex called the "rubber dam" (we've got nonlatex ones too) will be placed around the tooth to isolate it, hence keeping it clean and dry during treatment. The treatment consists of three or four basic steps, but the number of visits will depend on your particular case. Some treatments take 2 visits but many are just a single visit. Occasionally 3 appointments are needed.
In any case, it depends on the degree of infection/inflammation and degree of treatment difficulty. To me, it's more important to do it the very best we can then to meet a specific time criteria. Let's look at the basic steps for nonsurgical endodontic therapy.
There are, of course, no guarantees. Root canal or endodontic therapy has a very high degree of success, up to 90%. Teeth which can be treated near ideal have a success rate up to ninety percent! We will discuss with you the chances of success before any endodontic procedure to help you make an informed decision. If a root canal or endodontic therapy is unsuccessful or fails you still have options.
Oral pain such as toothaches or cracked / fractured teeth can often be difficult to pinpoint. Because of the vast network of nerves in the mouth, the pain of a damaged or diseased tooth often is felt in another tooth and/or in the head, neck, or ear. An endodontist is a specialist in diagnosing and treating this type of pain.
Pulp damage is sometimes caused by a blow to the mouth, and the endodontist specializes in treating these traumatic injuries. For example, a blow to a child's permanent tooth that is not fully developed can cause the root to stop growing. A procedure called apexification stimulates bone to be deposited at the end of the root which makes it possible to then save the tooth through a root canal procedure. An endodontist is specially trained in procedures for replanting teeth that have been knocked out of their sockets.
The first goal of an endodontic treatment is to eliminate the causative agents. Normally, all dental pulp infections are a secondary development of tooth decays that penetrate through the enamel and dentin to reach the pulp.
However, in some cases, the pulp tissue can be injured as result of trauma, such as thermal insult from repeated dental procedures.
Regardless of the nature of the agent, dental pulp tissue (like all human tissues) will try to respond to these insults. The biological response of natural tissues to harmful stimuli is called inflammation.
There is a distinctive difference between inflammation and infection and the therapeutic approach will largely depend on that.
Inflammation is a complex biological response of various tissues to harmful stimuli, such as pathogens (bacteria, viruses, fungus and others), damaged cells, or irritants (toxins produced by infection agents, very hot agents, harmful chemical agents etc.)
The classical signs of acute inflammation are pain, heat, redness, swelling, and loss of function. Basically, inflammation is a protective attempt by the organism to remove the injurious stimuli and to initiate the healing process.
When the dental pulp becomes inflamed, pressure begins to build up in the pulp cavity. Unlike other parts of the body where pressure can dissipate through the surrounding soft tissues, the pulp cavity is surrounded by hard tissues that do not allow for pressure dissipation.
For these reasons, pulp inflammations create intense pressure on the tooth nerve (located inside the dental pulp) which can sometimes cause a severe toothache.
Infection is the invasion of host tissues by disease-causing organisms such as: bacteria, viruses, fungus and others. Dental pulp infections are caused by bacteria from dental caries that penetrate through the enamel and dentin to reach the pulp.
Once endodontic therapy is completed your tooth should be examined periodically, usually every 6 - 12 months. This allows us to make sure the tooth has healed or is healing properly. You will be sent a notice in the mail when we feel it is appropriate to reevaluate the area. Since an abscess may take 2 years to heal, our office will reevaluate the tooth for at least 2 years.
Occasionally a tooth that has undergone endodontic, treatment fails to heal or pain continues despite therapy. Although rare, sometimes a tooth initially responds to root canal therapy but becomes painful or diseased months or years later. When either of these situations occur, the tooth often can be maintained with a second endodontic treatment
Crystal Hospital Building, Near Rama Krishna Hotel, Maratha Colony, Wamanrao Sawant Road,
Dahisar (East), Mumbai-400068, India.