Endodontics

“Endodontics” means “inside the tooth”: the pulp, tissues, nerves and tiny blood vessels. A tooth with a diseased nerve used to be pulled. Now, in most cases, it can be saved by removing the damaged inner tissue and sealing the tooth, usually under a crown. Most dentists agree there’s no substitute for a healthy natural tooth.

Signs of a problem inside the tooth

What causes inner-tooth damage

• Bacterial infection: the most common cause. Bacteria enter the pulp through tiny cracks from decay or injury, causing inflammation and sometimes an abscess.
• Fractures and chips: when a large piece of the tooth breaks off, the pulp can be exposed, which is very painful.
• Injuries: a blow to the mouth can loosen or dislodge a tooth. Root canal therapy often follows once it’s stabilized.
• Knocked-out teeth: rinse the tooth and put it back in the socket as fast as you can. If you can’t, keep it in milk or a tooth-saving solution from the pharmacy and get emergency care. We splint the tooth in place, then a root canal can save it. See Dental Emergencies.

What treatment involves

Root canal therapy usually takes one to three visits, after complete x-rays.

1. You’re numbed, and a dental dam (protective sheet) keeps the area dry.
2. A small opening is made and the pulp is removed with tiny instruments.
3. The canals are shaped, cleaned and filled with gutta-percha, a biocompatible rubber-like material, then sealed with cement.
4. A temporary filling protects the tooth until a permanent filling or crown is placed at the final visit.