Endodontics: Your Complete Guide
Endodontics is the dental specialty focused on the inside of your teeth. The word comes from Greek: "endo" means inside and "odont" means tooth. Endodontists diagnose and treat problems with the dental pulp, which is the soft tissue inside each tooth that contains nerves, blood vessels, and connective tissue. When this tissue becomes infected or damaged, an endodontist can often save the tooth instead of having it pulled.
What Does a Endodontist Do?
A endodontist is a dentist with advanced training in endodontics. Here is what they handle:
- Perform root canal therapy to remove infected or inflamed pulp tissue and save natural teeth.
- Diagnose the source of tooth pain, which can be tricky because pain from one tooth sometimes feels like it is coming from another.
- Treat cracked teeth and dental injuries caused by accidents or sports impacts.
- Perform apicoectomies (root-end surgery) when a standard root canal is not enough to clear an infection.
- Provide pulp therapy, including pulp capping, to preserve living pulp tissue when possible.
- Use advanced imaging like cone-beam CT scans and dental microscopes to find tiny canals and fractures that might be missed otherwise.
- Retreat previously root-canaled teeth that have developed new infections.
When to See a Endodontist
Your general dentist may refer you to an endodontist, or you might seek one out yourself. Here are common reasons to see an endodontist:
- You have a severe, lingering toothache that does not go away, especially one that wakes you up at night.
- Your tooth is very sensitive to hot or cold temperatures long after the food or drink is gone.
- You notice swelling or a small bump on your gums near a tooth.
- A tooth has darkened in color compared to the teeth around it.
- You cracked or broke a tooth and are feeling sharp pain.
- You suffered a blow to the mouth or face that affected your teeth.
- A previous root canal is causing problems again.
- Your dentist found signs of infection at the root tip on an X-ray.
Endodontist vs. General Dentist
Both general dentists and endodontists can perform root canals. The difference lies in training, experience, and the complexity of cases they handle.
General Dentist
- Routine cleanings, fillings, and preventive care.
- Simple, straightforward root canals on front teeth.
- Initial diagnosis and referrals to specialists.
- Crowns, bridges, and other restorations.
Endodontist
- Complex root canals on molars with multiple or curved canals.
- Retreatment of failed root canals.
- Apicoectomies and other root-end surgeries.
- Difficult-to-diagnose tooth pain.
- Treatment of traumatic dental injuries.
- Cases requiring dental microscopes or cone-beam CT imaging.
Endodontists complete 2 to 3 additional years of specialty training beyond dental school, focused entirely on treating the inside of teeth. They typically perform 25 or more root canals per week, compared to about 2 per week for a general dentist. This extra training and volume of experience means they are especially well-suited for difficult or unusual cases.
Common Endodontics Procedures
Root Canal Therapy
The most common endodontic procedure. The endodontist removes the infected pulp, cleans and shapes the inside of the root canal, then fills and seals the space. Most root canals take one or two visits and are done with local anesthesia. Afterward, your general dentist usually places a crown to protect the treated tooth.
Apicoectomy
Also called root-end surgery. When infection persists after a root canal, the endodontist makes a small opening in the gum to access the tip of the root. They remove the infected tissue and the very end of the root, then place a small filling to seal the root. Recovery typically takes a few days.
Dental Trauma Treatment
Endodontists treat teeth that have been knocked out, pushed into the jaw, or cracked due to an accident. Treatment depends on the type and severity of the injury. A tooth that has been completely knocked out can sometimes be replanted if you get to an endodontist quickly, ideally within 30 minutes.
Pulp Therapy
Also called vital pulp therapy. When the pulp is exposed or irritated but not yet fully infected, the endodontist may be able to save the living tissue. Procedures like direct pulp capping or partial pulpotomy place a protective material over the pulp to encourage healing. This approach is especially useful in younger patients whose teeth are still developing.
Conditions Treated by Endodontists
Endodontists diagnose and treat a range of conditions. Here are some of the most common:
Endodontist Education and Training
Endodontists complete 4 years of dental school followed by 2 to 3 years of advanced specialty training in an accredited endodontic residency program. During residency, they gain extensive experience in root canal therapy, surgical endodontics, and pain management. Many endodontists are also board-certified by the American Board of Endodontics, which requires passing both written and oral examinations.
Frequently Asked Questions About Endodontics
Is a root canal painful?
Modern root canals are performed with effective local anesthesia and are typically no more uncomfortable than getting a filling. Most patients report that the procedure itself is painless, though you may have mild soreness for a few days afterward. The pain you feel before the procedure, caused by the infection, is usually far worse than the treatment itself.
How much does a root canal cost?
Root canal costs vary based on which tooth is treated. Front teeth typically cost $700 to $1,000, premolars $800 to $1,100, and molars $1,000 to $1,400. Dental insurance usually covers a significant portion. An apicoectomy may cost $900 to $1,300. These are averages and prices vary by location and individual case.
Can I drive home after a root canal?
Yes. Root canals are almost always done with local anesthesia (numbing), so you can drive yourself home. If you choose sedation, you will need someone to drive you.
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