Endodontics

Endodontics: A little-known specialty

Endodontists are dental specialists who deal primarily with root canal inflammation and infection, generally arising inside the tooth (pulp) and surrounding (periradicular) tissues.

Their main goal is to restore the health, viability and function of infected teeth (as demonstrated clinically and by X-ray).

The following terms are commonly used in this specialty:

Pulp chamber: contains most of the tooth’s pulp or nerve. Holds nerve fibers and blood vessels.

Root: portion of tooth anchored in the jaw. The tooth’s pulp canal, lying inside the root, is removed during a root canal procedure. Different teeth contain different numbers of canals.

Apex: tip of the root and end of the canal.

Periradicular tissue: tissue holding the tooth in place (bone and gum).

Endodontic therapy: Also known as “root canal.” Involves removing, treating and sealing the tooth’s internal pulp system (pulp chamber and canals).

Endodontic lesion: In the apical area (end of the tooth), due to deterioration of the pulp for various reasons (pulp exposed by cavity or restoration, crack in the crown extending to the pulp, traumatic injury, etc.).

For a detailed review of definitions and the different types of endodontic treatments, download this PDF document (2.1 MB in French).

After earning a doctorate in dentistry, the endodontist pursues graduate studies leading to a certificate in endodontics (2 years) or a master’s degree in this specialty (3 years). Endodontists work with dental generalists and specialists in other dental fields who refer patients in line with their skills or for complex cases.

Patients see endodontists primarily to obtain diagnosis for oral and dental pain, along with a treatment plan. Specific pulp assessment tests are used to draw up an appropriate diagnosis and plan.

Endodontics is particularly important:

1. In root canal procedures, to eliminate inflammation or infection of the tooth’s internal canal system and maintain tooth function.
2. If prior treatment has not generated healing in the surrounding tissues or such treatment did not meet accepted standards.
3. When there is no other way to negotiate the canal system (due, for example, to blockage by a radicular post, absence of alternate canal treatments or investigation).
4. In traumatic oral and dental injuries requiring prompt response after an accident and where post-traumatic follow-up is needed to optimize the likelihood of maintaining the teeth in place and minimizing circumstances that could result in their loss.

Endodontics has been revolutionized through the introduction of magnifying lenses and surgical microscopy. Such tools permit much more accurate examinations of dental pulp and periradicular structures.

Endodontist working with a dental microscope.