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Prenard R. Mickens DDS, PA

 

General Information

CBCT (CAT scan technology
What is an Endodontist and what do they do?

Endodontists are dentists who specialize in maintaining teeth through endodontic therapy -- procedures, involving the soft inner tissue of the teeth, called the pulp.  The word "endodontic" comes from "endo" meaning inside and "odont" meaning tooth.  Like many medical terms, it is Greek.  All dentists are trained in diagnosis and endodontic therapy, however, some teeth can be especially difficult to diagnose and treat.  That is why you may have been referred to an endodontic specialist.

In addition to dental school, endodontists receive two or more years of advanced education in this kind of treatment. They study root canal techniques and procedures in greater depth, for diagnosis and treatment of more difficult cases. For this reason, many dentists choose to refer their patients to endodontists.

3D digital xray
What Happens During Endodontic Treatment? or What is a Root Canal?

A local anesthetic will be given.  A sheet of latex called the "rubber dam" (nonlatex are available as well) will be placed around the tooth to isolate it, hence keeping it clean and dry during treatment.  The treatment consists of three or four basic steps, but the number of visits will depend on your particular case.  Some treatments take two visits but many are just a single visit.  Occasionally, three appointments are needed.

In any case, it depends on the degree of infection/inflammation and degree of treatment difficulty.  To me, it is more important to do it the absolute best we can than to meet a specific time criteria.  Let us look at the basic steps for nonsurgical endodontic therapy.

There are, of course, no guarantees.  Root canal or endodontic therapy has a very high degree of success, up to 90%.  Teeth which can be treated near ideal have a success rate up to ninety percent!  We will discuss with you the chances of success before any endodontic procedure to help you make an informed decision.  If a root canal or endodontic therapy is unsuccessful or fails you still have options.

3D dental imaging on computer
Diagnoses and Treats Pain

Oral pain such as toothaches or cracked / fractured teeth can often be difficult to pinpoint.  Because of the vast network of nerves in the mouth, the pain of a damaged or diseased tooth is often felt in another tooth and/or in the head, neck, or ear. An endodontist is a specialist in diagnosing and treating this type of pain.

Treats Traumatic Injuries

Pulp damage is sometimes caused by a blow to the mouth, and the endodontist specializes in treating these traumatic injuries. For example, a blow to a child's permanent tooth that is not fully developed can cause the root to stop growing. A procedure called apexification stimulates bone to be deposited at the end of the root which makes it possible to then save the tooth through a root canal procedure. An endodontist is specially trained in procedures for replanting teeth that have been knocked out of their sockets.

Will I need to return to your office for Additional Visits?

Once endodontic therapy is completed, your tooth should be examined periodically, usually every 3 - 12 months.  This allows us to make sure the tooth has healed or is properly healing.  You will be sent a notice in the mail when we feel it is appropriate to re-evaluate the area.  Since a tooth may take 2 years to heal, our office will re-evaluate the tooth for at least 2 years.

Retreatment and Surgical Treatment

Retreatment:        

Occasionally, a tooth that has undergone endodontic treatment fails to heal or pain continues despite therapy. Although rare, sometimes a tooth initially responds to root canal therapy but becomes painful or diseased months or years later. When either of these situations occur, the tooth can often be maintained with a second endodontic treatment.

Surgical Treatment :      

Sometimes, previous endodontic treatment or retreament to a tooth may fail to heal. The most common surgical endodontic treatment  is called an apicoectomy. This procedure is performed when an endodontist opens the gum tissue to expose the underlying bone and remove any infected or inflamed tissue along with a portion of the root. Then a small filling may be placed to seal the end of the root, and the gum tissue can be sutured back in place. Over a period of time, the bone can heal back around the end of the root. Other surgeries may include treating damaged roots or perforations. Your endodontist will be happy to discuss the specific type of surgery designed to help save your tooth and your chances for success so that you can make an informed decision.