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What is endodontic treatment?
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“Endo” is the Greek word for “inside” and “odont” is Greek for “tooth.” Endodontic
treatment treats the inside of the tooth. Root canal treatment is one type of endodontic
treatment.
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To understand endodontic treatment, it helps to know something about the anatomy
of the tooth. Inside the tooth, under the white enamel and a hard layer called the
dentin, is a soft tissue called the pulp. The pulp contains blood vessels, nerves,
and connective tissue and creates the surrounding hard tissues of the tooth during
development.
The pulp extends from the crown of the tooth to the tip of the roots where it connects
to the tissues surrounding the root. The pulp is important during a tooth’s growth
and development. However, once a tooth is fully mature it can survive without the
pulp, because the tooth continues to be nourished by the tissues surrounding it.
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Why would I need an endodontic procedure?
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Endodontic treatment is necessary when the pulp, the soft tissue inside the root
canal, becomes inflamed or infected. The inflammation or infection can have a variety
of causes: deep decay, repeated dental procedures on the tooth, or a crack or chip
in the tooth. In addition, an injury to a tooth may cause pulp damage even if the
tooth has no visible chips or cracks. If pulp inflammation or infection is left
untreated, it can cause pain or lead to an abscess.
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What are the signs of needing endodontic treatment?
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Signs to look for include pain, prolonged sensitivity to heat or cold, tenderness
to touch and chewing, discoloration of the tooth, and swelling, drainage and tenderness
in the lymph nodes as well as nearby bone and gingival tissues. Sometimes, however,
there are no symptoms.
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How does endodontic treatment save the tooth?
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The endodontist removes the inflamed or infected pulp, carefully cleans and shapes
the inside of the canal, a channel inside the root, then fills and seals the space.
Afterwards, you will return to your dentist, who will place a crown or other restoration
on the tooth to protect and restore it to full function. After restoration, the
tooth continues to function like any other tooth.
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Will I feel pain during or after the procedure?
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Many endodontic procedures are performed to relieve the pain of toothaches caused
by pulp inflammation or infection. With modern techniques and anesthetics, most
patients report that they are comfortable during the procedure.
For the first few days after treatment, your tooth may feel sensitive, especially
if there was pain or infection before the procedure. This discomfort can be relieved
with over-the-counter or prescription medications. Follow your endodontist’s instructions
carefully.
Your tooth may continue to feel slightly different from your other teeth for some
time after your endodontic treatment is completed. However, if you have severe pain
or pressure or pain that lasts more than a few days, call your endodontist.
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Endodontic Procedure
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Endodontic treatment can often be performed in one or two visits and involves the
following steps:
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1.
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The endodontist examines and x-rays the tooth, then administers local anesthetic.
After the tooth is numb, the endodontist places a small protective sheet called
a “dental dam” over the area to isolate the tooth and keep it clean and free of
saliva during the procedure.
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2.
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The endodontist makes an opening in the crown of the tooth. Very small instruments
are used to clean the pulp from the pulp chamber and root canals and to shape the
space for filling.
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3.
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After the space is cleaned and shaped, the endodontist fills the root canals with
a biocompatible material, usually a rubber-like material called “gutta-percha.”
The gutta-percha is placed with an adhesive cement to ensure complete sealing of
the root canals. In most cases, a temporary filling is placed to close the opening.
The temporary filling will be removed by your dentist before the tooth is restored.
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4.
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After the final visit with your endodontist, you must return to your dentist to
have a crown or other restoration placed on the tooth to protect and restore it
to full function.
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If the tooth lacks sufficient structure to hold the restoration in place, your dentist
or endodontist may place a post inside the tooth. Ask your dentist or endodontist
for more details about the specific restoration planned for your tooth.
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How much will the procedure cost?
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The cost varies depending on how complex the problem is and which tooth is affected.
Molars are more difficult to treat, the fee is usually more. Most dental insurance
policies provide some coverage for endodontic treatment.
Generally, endodontic treatment and restoration of the natural tooth are less expensive
than the alternative of having the tooth extracted. An extracted tooth must be replaced
with a bridge or implant to restore chewing function and prevent adjacent teeth
from shifting. These procedures tend to cost more than endodontic treatment and
appropriate restoration. With root canal treatment you save your natural teeth and
money.
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Will the tooth need any special care or additional treatment after endodontic treatment?
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YYou should not chew or bite on the treated tooth until you have had it restored
by your dentist. The unrestored tooth is susceptible to fracture, so you should
see your dentist for a full restoration as soon as possible. Otherwise, you need
only practice good oral hygiene, including brushing, flossing, and regular checkups
and cleanings.
Most endodontically treated teeth last as long as other natural teeth. In a few
cases, a tooth that has undergone endodontic treatment does not heal or the pain
continues. Occasionally, the tooth may become painful or diseased months or even
years after successful treatment. Often when this occurs, redoing the endodontic
procedure can save the tooth.
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What causes an endodontically treated tooth to need additional treatment?
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New trauma, deep decay, or a loose, cracked or broken filling can cause new infection
in your tooth. In some cases, the endodontist may discover additional very narrow
or curved canals that could not be treated during the initial procedure.
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Can all teeth be treated endodontically?
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Most teeth can be treated. Occasionally, a tooth can’t be saved because the root
canals are not accessible, the root is severely fractured, the tooth doesn’t have
adequate bone support, or the tooth cannot be restored. However, advances in endodontics
are making it possible to save teeth that even a few years ago would have been lost.
When endodontic treatment is not effective, endodontic surgery may be able to save
the tooth.
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