Endodontics

Endodontics is a specialty of dentistry, that deals with the tooth pulp and tissues surrounding the root of a tooth. The pulp (containing nerves, arterioles and venules as well as lymphatic tissue and fibrous tissue) can become diseased or injured and thus is unable to repair itself. The pulp then dies and endodontic treatment is required.

The most common procedure done in endodontics is root-canal therapy, which involves the removal of diseased pulp tissue. The aim of treatment is to remove irreversibly inflamed, or necrotic pulp tissue before infection sets in. If the pulp tissue becomes infected, caused by bacteria from inside the tooth, the infection can leak out of the tooth's root and make the surrounding bone ill and painful or cause an abscess to form. Once the diseased pulp tissues are removed, the body's defense system can then repair the damage created by disease.

The dentist will use a local anaesthetic to make the procedure pain-free. In most places, it is considered a standard of care to use a rubber dam in order to isolate the tooth and provide a clean environment. An opening is made on the top of the tooth. Then the pulp chamber and root canals are cleaned and shaped for filling and sealing. Often, an intra-pulpal medicament to inhibit bacterial growth is placed and the tooth is filled with a temporary restoration until the second appointment, where the temporary restoration and medicament are removed and the canal(s) are sealed with gutta-percha--thus completing the procedure. Increasingly, however, endodontic treatment is being performed in one appointment as clinicians are finding fewer incidents of infection and pain with one-appointment vs. two appointment treatment.

Other procedures practiced in endodontics include incision for drainage and periradicular surgery. These treatments are needed in cases of abscesses, root fractures, and problematic tooth anatomy.

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