Endodontics

The branch of dentistry known as endodontics deals with the pulp and tissues that surround the tooth roots. The sensitive pulp tissue inside the tooth can be treated using endodontic treatments  or root canal treatments.  An endodontist is a dentist who concentrates in saving teeth. Endodontists carry out common, challenging, and highly complicated endodontic procedures, such as root canal treatment, endodontic surgery, and specialized procedures for saving teeth after severe dental trauma. 

Endodontists are professionals in effectively handling a wide range of difficult endodontic disorders since they concentrate their practice on particular procedures such as root canal treatment, surgery, and trauma. Endodontists use advanced technologies and specialized techniques that offer them a very accurate visualization of the inside of the tooth and enable quick and comfortable treatment. They can help preserve the natural smile by applying the right treatment to save the tooth. (1)

Definition and Overview

Endodontics deals with tooth pulp-related conditions and treatments for them. The interior of the tooth is referred to as dental pulp. Dentin, which is located beneath the enamel and is the component of the tooth that is closest to the teeth, guards the pulp. The pulp is protected from infection by mouth-borne germs by this tough layer. When teeth decay occurs, this outer layer is worn away, leaving holes or cavities that expose the pulp to these microorganisms as well as extreme heat and cold.

A pulp infection can result in sensitivity and toothache due to the pulp's abundance of nerves and blood vessels. For many of these conditions involving tooth pulp, there are numerous procedures for treatment. These are chosen depending on the patient's condition and what the disease is. (2)

Procedures

There are many treatment options available to repair damaged teeth. The patient needs to consider their treatment options and how these will affect their future dental health and lifestyle. Getting proper care is essential to maintaining oral health, being able to eat foods, and limiting the need for ongoing dental treatment. 

With the right treatment, teeth can often last a lifetime. Here are the most common treatment methods:

• Root Canal Treatment

A simple treatment called a root canal is frequently used to save teeth and treat toothaches. When a tooth's roots are inflamed or infected, patients often need a root canal. An endodontist who specializes in this procedure carefully removes the pulp from the tooth, cleans, disinfects, and forms the root canals, and inserts a filling to replace the space left by the pulp removal.

• Endodontic Retreatment

It is possible for teeth that have undergone root canal treatment to heal improperly and become painful or diseased months or even years after treatment. If this occurs to a treated tooth, the retreatment will give the patient a second chance to save the tooth. An additional procedure might lessen discomfort from a toothache and quicken the healing process. If a tooth that has had root canal treatment is suspected to require retreatment, a dentist or endodontist should be consulted for evaluation.

• Endodontic Surgery

The endodontist might recommend surgery if a non-surgical root canal treatment is unable to preserve the tooth. When beginning treatment, endodontic surgery may be performed to locate minor fractures or hidden channels that X-rays had previously missed. Additionally, surgery may be required to treat damaged root surfaces, the bone around the tooth, calcium deposits in root canals, and other conditions. 

There are numerous procedures for surgery that can be used to preserve a tooth. The most typical is an apicectomy, also known as a root tip resection, and may be required when infection or inflammation in the bony region at the tooth's tip continues after a root canal operation.

• Dental Implants

A dental implant is frequently the first option to save the natural tooth when an injury or infection is affecting the tooth. Even the most advanced implants or bridges cannot provide the same level of strength and health as natural teeth. Therefore, if a person experiences any toothache or discomfort, it is essential to meet with a dentist or endodontist as soon as possible to discuss the treatment options.

If an endodontic procedure is unable to save the tooth and it needs to be extracted, the dentist may recommend a dental implant that will enable proper biting and chewing, prevent healthy teeth from slipping, and help maintain a natural appearance. (3)

Candidates

Patients need endodontic treatment when 

• the pulp, 
• or the soft tissue inside the root canal 

becomes inflamed or infected. Inflammation or infection can have a variety of causes, such as repeated dental procedures in the tooth or a crack or chip in the tooth. It may be caused by several factors including

• deep decay or cavities
• cracked or broken teeth
• trauma to the tooth
• gum disease
• repeated dental procedures on the tooth (4)

Risks and Side Effects

There are some main risks and side effects associated with endodontic treatments such as

• one of the delicate instruments breaking off inside the tooth
• curved canals or roots
• impenetrable canals
• perforation of the root canal
• fracture of the root or tooth
• infection
• swelling
• discolouration of the area
• additional unknown problems (5)

Post-Procedure and Follow-up

The tooth may feel sensitive for the first few days after treatment, especially if there is pain or infection before the procedure. In some cases, prescription medications may be required and are available from the endodontist.

After the endodontic treatment is completed, the tooth may continue to feel a little different from other teeth for a while. It is essential to seek medical support when there is an abnormal situation. (6)

Recovery

It's important to take good care of the teeth as they heal from root canal treatment. Biting hard foods should be avoided until the treatment is complete. After the last treatment, the restored tooth may feel sore for a few days during the healing process, but should no longer be painful. In order to relieve any discomfort, painkillers can be taken by consulting the doctor. If there is still pain or swelling after using painkillers, the dentist should be consulted again.

Results

A root canal is regarded as a restorative procedure. The majority of patients who get the operation can benefit from the positive results for the rest of their lives. However, how well the patient takes care of the teeth will determine how long the effects persist. The restored tooth needs to be cleaned and flossed on a regular basis just like the rest of the teeth do.