How An Endodontist Performs Root Canals: An Introduction

Root Canal Rendering

Their primary and family dentists often direct them to a recommended endodontist to perform a root canal procedure for many patients. Root canal procedures can be perceived as terrifying because of how these procedures handle the root of the problem by directly interacting with the root’s channels, nerve endings, and pulp tissue to correct the problem. However, for an endodontist, root canals are our specialty. Root canals both describe a procedure and a part of the tooth, and here’s a fully-fleshed, detailed guide for how endodontists treat tooth problems with root canal therapy.

Root Canal vs. Root Canal Therapy: Which is Which?

To best understand how root canals are performed, it’s essential to understand how root canals can be interpreted. Root canals are both treatments and an anatomical part of the tooth. While many general dentists and even family dentists can perform root canals, endodontists specialize in diseases of the dental pulp and focus exclusively on treatments related to tooth pain caused by an internal disruption of the tooth’s inner anatomy.

  • Root Canal: The root canal in its anatomical term is the hollow tunnel inside the root of the tooth. The root of the tooth contains the dental pulp, the living part of the tooth containing connective tissues and cells called odontoblasts. The dental pulp root, root canals, and dentin make up the dentin-pulp complex called the endodontium. Root canals within this framework provide the channels and passageways for the pulp to extend and reach out into the tooth’s roots, giving the tooth its ability to sense pain, infection and maintain its internal stability by generating dentin. When the tooth’s pulp is infected or trauma to the tooth’s root canals disrupts the pulp, root canal therapy is then needed to correct the issue.
  • Root Canal Treatment: When dentists often state that they’re performing a root canal, they refer to the treatment procedure that eliminates the infection and returns the tooth to a stable state. Root canals refer to removing that pulp to eliminate the infection. Once removed, the endodontist cleans out the root canals to irrigate the internal system and then cements it to prevent bacteria from infecting the inside of the tooth. By this point, the tooth became dead because of the removed nerve tissue and eliminated infection, but the result of the procedure leaves the external structure of the tooth intact.

When Are Root Canals Recommended?

To begin even considering qualifying for a root canal, an endodontist must first determine where the source of the pain or infection is coming from. For a root canal to be performed, the source of the pain has to be of endodontic origin, meaning that the pain is resulting from the endodontium and not from other conditions such as tooth grinding, atypical facial pain, sinus-related tooth pain, and neuromuscular pain. No matter the cause of the damage, if the endodontium is affected, then we, as endodontists, can perform root canals.

But what conditions technically qualify for a root canal? The root canal and pulp inside the tooth will often require the removal of the pulp and irrigation of the root canal channels due to conditions such as:

  • Irreversible Pulpitis – Also called inflammation of the inner pulp, the pulp becomes so inflamed that the damage caused is irreversible because the pulp cannot heal itself.
  • Pulp Necrosis – This condition is when the pulp inside the tooth dies, often resulting from chronic stages of pulpitis.
  • Apical Periodontitis – When the inflammation of the periodontium, or gums, occurs around the tooth’s root, that infection could cause the root canals to deteriorate and infect the root’s pulp.
  • Pulp Exposure – General pulp exposure of any kind will often require a root canal due to its high vulnerability to bacteria within the mouth, making it a great risk for the pulp to become inflamed and die off.

Cavities, tooth trauma, improper crown preparations, and other invasive procedures can often cause these conditions. The next part of determining whether or not you would need a root canal is to determine whether the tooth is worth saving. For endodontists, if there is little to no tooth left, there are vertical fractures in the tooth that cannot be fully repaired, and there are less expensive options for treatment, then a root canal cannot save the tooth. However, if the tooth is sufficient, has no irreparable cracks, and will become a less expensive option, then a root canal should be performed.

However, as the patient, root canal procedures should be performed if you’re experiencing intensive, chronic pain that radiates throughout the tooth and surrounding areas. The risk of infection spreads even more significantly to the root canal system if ignored and can cause the surrounding tissues to form abscesses and decay at much faster rates, losing the remaining integrity of the tooth.

Are Root Canals Painful?

No procedure should ever be painful, and many of the depictions of tooth extractions and root canals often result from perceived notions that aren’t based on reality. Under the American Association of Endodontists, our education and years of specialized training in treating dental pulp require us to work under highly strict and sanitized conditions. Our specialization requires us to use either general or local anesthesia to perform the treatment. Even after the procedure, good endodontists will prescribe pain medication to alleviate the symptoms and prescribe antibiotics to prevent future infections.

How Endodontists Perform a Root Canal

While different techniques are often used depending on the dentist’s preference, a root canal is performed under the following steps:

  • Your endodontist will first get a radiograph of the tooth using x-rays and then administer a local anesthetic to make it numb. A dental dam is then placed over the area to isolate the tooth and keep it clean during the procedure.
  • Once prepared, the endodontist will make an opening in the crown of the tooth using small instruments. These small instruments are also used to clean the pulp and shape the inside for filling.
  • Once cleaned and shaped, the root canal area will then be filled with a biocompatible material and an adhesive cement to ensure a complete seal. In most cases, however, a temporary filling is placed until the tooth is healed.
  • Once the tooth has been restored, a follow-up appointment will be made to complete the root canal treatment restoration process.

To prevent any further complications, choose an endodontist for a root canal treatment.

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