Endodontics is the branch of dentistry concerned with the morphology, physiology and pathology of the human dental pulp and periradicular tissues. Its study and practice encompass the basic and clinical sciences including the biology of the normal pulp, and the etiology, diagnosis, prevention, and treatment of diseases and injuries of the pulp and associated periradicular conditions.
Root canal treatment involves the use of biologically acceptable chemical and mechanical treatment of the root canal system to eliminate pulpal and periradicular disease(s) and to promote healing and repair of the periradicular tissues.
First, the endodontist will administer local anesthetic to make the procedure comfortable. Next, an access will be made through the crown or tooth. Once all of the canals are located, the lengths of the roots will be determined. The debridement and shaping of the canal system with the use of hand files and engine driven rotary files facilitates the chemical cleaning and disinfecting of the canal system.
Once the canal system is as clean as possible, it is dried and sealed with a biologically acceptable nonresorbable semi-solid or solid root canal obturating material. Your endodontist will typically place a temporary filling in the access opening.
After root canal treatment, a permanent filling or crown will be necessary to restore the tooth back to function.
Endodontists perform a wide range of treatments for the goal of retaining natural teeth. These procedures include, but are not limited to: differential diagnosis of oral pains of pulpal and/or periradicular origin, vital pulp therapy to prolong long-term vitality of teeth, apexification to fix non-vital immature roots, apexogenesis to promote complete root-end formation in vital teeth, standard root canal therapy (as described above), revisions of existing root canal treatments, repair of teeth with perforations, bleaching of discolored enamel and dentin, management of traumatic tooth injuries, surgical root procedures, intentional replantation and tooth transplantation from other sites within the patient's mouth.
The goals are the same as for the profession of dentistry as a whole; for the public to maintain a healthy and natural dentition for life. Although many routine root canal procedures can be managed by a general dentist, any case that is beyond the level of training, expertise and experience of the individual practitioner should be referred to a practitioner/specialist with the appropriate training, experience and expertise. Ultimately, endodontic procedures are aimed at saving natural teeth.
Most endodontic specialty training programs are 2 to 3 years in duration. During specialty residency, endodontists learn to treat complex and difficult cases. Management of medically compromised patients is also an important part of the curriculum as well as detailed analysis of the endodontic literature.
Endodontists strive to base their treatment in evidence-based dentistry. In other words, endodontists seek scientific justification for the procedures and methodology they employ rather than using a treatment modality because "it works for Fred down the street."
Success rates for standard root canal therapy are reported as high as 95%. It is essential that the tooth that has received a root canal be appropriately restored with a filling or crown in order to ensure long term success. Many of the root canals that fail, do so because the teeth were not restored and subsequent leakage of saliva and bacteria back into the canal spaces resulted in reinfection.