Say “root canal” and most people shudder with imagined pain and apprehension. But ask the millions of Americans who have had root canal treatments in recent years and they will often report that they were comfortable during their procedure, with little or no post-operative pain. 

Improvements in anesthesia and technique, as well as better training of dentists, have resulted in less painful and more successful treatments of infected teeth.

The field of root canal therapy has been struggling for a new public image that better matches reality. It has taken on a new name: endodontics, from “endo,” meaning within, and “dontics” referring to teeth. The dental specialists devoted to saving teeth through root canal therapy call themselves endodontists, sometimes endo dentist.

Innovations in Endodontics

Endodontists often utilize state-of-the-art technology, such as digital radiography, operating microscopes, ultrasonic instrumentation, fiber optics and 3D-imaging while performing endodontic treatment. Advanced technologies, together with specialized techniques, give root canal specialists a very accurate view of the tooth, and allow them to treat the tooth quickly and comfortably.

When should I visit an Endodontist?

The best time to undergo root canal therapy is when there is no pain. With regular dental check-ups, your dentist can often detect a problem before it causes symptoms.

The crown portion of the tooth is covered by a hard layer of enamel. Beneath that lies the dentin, another hard tissue. Under the dentin and extending down into the roots is the pulp, a soft tissue that houses nerves, blood vessels and lymph vessels. The pulp’s job is to form the teeth and nourish them.

Normally, the pulp is protected from the many infectious organisms in the mouth. But infection can spread into the pulp when decay moves through the enamel and dentin, or when the hard layers or fillings crack and expose the soft tissue. An infection can also spread when a tooth is dislodged or damaged by trauma. If an infection remains untreated, it can progress through the tooth’s roots and into the supporting bone, causing a painful abscess.

Sometimes endodontic therapy is needed because a tooth’s nerve has been damaged by periodontal disease, trauma or the need to prepare the tooth for a crown. Endodontics may also be used to remove unsightly discoloration by bleaching the tooth from the inside.

The usual purpose of endodontics is to remove the infected pulp (or damaged nerve), sterilize the tooth’s roots and seal the area to protect it from future infections. Even when all of a tooth’s pulp must be removed, the tooth can remain alive indefinitely, nourished by nearby tissues.

Endodontic treatment can allow you to retain your natural tooth for a lifetime.

What happens during the Root Canal Treatment?

The visit starts with an examination, including X-rays, to evaluate the tooth for possible treatment. Electrical impulses may be used to test the tooth for sensitivity to heat, cold and pressure and to measure the pulp chamber and root canal system.

A local anesthetic will be applied and the tooth will be isolated with  a rubber dam.

Treatment consists of the use of ultrasonic instruments and highly-refined files are used to remove the infected pulp and thoroughly cleanse and shape the pulp chamber. Medication may further sterilize the root canals. If there is an abscess, antibiotics may be prescribed.

If more than one treatment is needed, an antibacterial medication and temporary filling will be placed in the pulp chamber. When all signs of infection are gone, the root canal will be lined with cement and filled and sealed with a soft, pliable material called gutta percha, which conforms to the space and prevents bacteria from entering. The patient’s general dentist then completes the permanent restoration of the tooth, usually with a crown.

How many visits are required for root canal treatment?

Typically, endodontic therapy involves two or three visits. Sometimes the treatment can be performed in one visit.

What factors determine the cost of root canal therapy?

The fees for root canal therapy often depend on several factors. These include whether it is an initial root canal treatment or retreatment (redoing of a previously performed root canal), the number of roots involved, and the location and position of the tooth.

Portions of this information were adapted from “Your Guide to Endodontic Treatment” by the American Association of Endodontists.

Cezar Mitrut is one of the best root canal specialist in New York.

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