An endodontist is a dentist who specializes in the inside of the teeth, particularly the root and the root canal. The root of the tooth is that part which is buried in the gum and jaw. The root canal is the part of the tooth containing the nerves and pulp, which provides nutrients to the tooth. Root canal problems are usually first apparent when a person visits their dentist with a toothache or swelling. A toothache can have a number of causes, so a dentist will perform an examination and x-rays to determine whether this toothache is specifically caused by root canal pain. Root canal treatment can be performed by a general dentist or may require an endodontic specialist.
An endodontist performs treatments designed to help keep natural teeth in a healthy mouth even after the root has died. This helps to avoid having implanted or removable false teeth fitted. In the eventuality of having to have the tooth extracted, your dentist and endodontist can help to choose and make a replacement which has the appearance and functional ability of the lost tooth.
An endodontist will take and assess x-rays of the affected tooth and determine the best course of treatment. A root canal procedure will be performed using a local anaesthetic, an injection into the gum surrounding the tooth which will mean that you don’t feel any pain during the procedure. A rubber dam will be placed around the tooth to keep that tooth dry and clean. This also helps to keep the area of the mouth being worked on feeling quite separate and improving the comfort of the patient. The endodontist may have prescribed a course of antibiotics prior to the root canal procedure, to reduce any infection that may be present.
To access the root canal the endodontist must first drill a small hole in the top of the tooth so that they can remove any remaining infected root and clean out the hole before filling it. The hole will be cleaned out and made a regular shape with a series of small files, which helps to create a good base for the filling. Some teeth have just one root, particularly those towards the front of the mouth; the incisors and canine teeth. The molars and premolars have two or three roots, and so root canal treatment for teeth towards the back of the mouth takes longer than that at the front. Root canal treatment sometimes requires more than one appointment.
After the root canal filling has settled, the endodontist may suggest capping the tooth with a crown to reinforce the tooth, as teeth that have been hollowed out and no longer have a working root can be more brittle and prone to cracking than healthy teeth.
An apicoectomy is an endodontic procedure which involves removing the apex of the root, the innermost tip of it which may still remain and be a focus for infection.