People may not realize that there are multiple forms of care within the field of dentistry. The teeth are more complex than some people realize, with layers of protection, nerves and blood vessels, while also connecting to the gums and jawbone. If something happens to any of the layers of the tooth, the body can feel repercussions from the damage.
A professional endodontist is a dentist who completes the extra training to specialize in maintaining teeth through procedures that involve the soft tissue of the teeth. The soft tissue of the teeth is also known as the pulp, which contains the nerves and blood vessels of the tooth. When a patient seriously damages his or her teeth, it is important to seek professional care from a specialist. A general dentist will not have the expertise or tools to treat serious damage, where an endodontist does.
The type of issues an endodontist treats
While minor issues such as plaque buildup or even a minor chip in the tooth may only need the services of a general dentist, there are many other issues that require specialist services. An endodontist provides treatment for:
- Chipped teeth
- Broken teeth
- Infected teeth
- Cracked teeth
- Inflamed/infected dental pulp
- Dental abscess
These are only some of the potential conditions that endodontists provide a more detailed level of care. Endodontists have the expertise to accomplish more than simply cleaning a tooth. If a patient is struggling with a broken or cracked tooth, the damage can spread to the pulp. Once the damage reaches the pulp of the tooth, the pain will intensify and eventually cause an infection.
An endodontist will be able to identify the source of the infection, remove the infected or inflamed pulp, and then cover the tooth back up. This way, the patient will be able to continue using the natural tooth and not feel much or any pain. Contrary to popular stigma, an endodontist does not want to immediately extract teeth. In fact, an endodontist will do everything possible to protect the tooth in question.
An endodontist values natural teeth over artificial ones. Having a tooth is better than not having a tooth, since the process of resorption will leech calcium from the jawbone and alter the appearance of one's face. While we live in a world where there are multiple options for artificial teeth replacements, the natural teeth will always be the preferred teeth of professionals.
By removing the infected root in a root canal procedure, an endodontist can save the shell of the tooth and relieve the patient of all pain. The endodontist will then cover the tooth up with a crown that protects the empty space of the root and allows the individual to continue eating whatever he or she likes.
If the patient needs endodontic surgery, then the endodontist will use anesthesia so the patient does not feel any pain during the procedure. If the patient is going through surgery, then the endodontist will put the patient to sleep. When the surgery is complete, the patient will wake up and be sent home with specific directions about proper care. Depending on the procedure, the patient may need to schedule a ride home and avoid driving for a few hours.
An endodontist will mainly use endodontic surgery when non-surgical procedure are not enough or when the fracture is small enough that they are not visible on X-rays. In other cases, endodontic surgery may also be necessary to remove calcium deposits in root canals. While the tooth can seem fairly normal on the surface, there can be an infection or other health issue underneath that is causing more problems.
Various reasons for endodontic surgery
A few possible scenarios in which endodontic surgery is a necessary treatment option:
- Treating persistent symptoms that do not go away with regular dental procedures
- Treating a canal that calcium deposits make too narrow for traditional root canal tools
- Treating a tooth that already underwent a root canal but is now infected
- Treating serious damage to the root surfaces or surrounding bone
There are cases in which an individual has a small fracture or canal that a dentist cannot notice on the X-ray. With endodontic surgery, the endodontist will be able to examine the entire root of the tooth and treat the problem.
There is also a process known as calcification, in which calcium deposits form around the root and make the canal too narrow for a non-surgical root canal. In these cases, an endodontist will need to use surgery to clean the tooth and then re-seal it. Since each part of the tooth affects each other and the other components of the mouth, it is crucial to seek professional care.
In some patients who receive a non-surgical root canal from a general dentist, there is a chance that the root will not heal properly and cause an infection to form. When this happens, it is crucial to seek endodontic surgery from a professional endodontist. If you do not treat the tooth soon, you will feel intense pain that makes daily tasks nearly impossible. People may go months or years after a root canal without any problems and suddenly have the pain strike.
It is also recommended that you take at least the rest of the day off to heal and maybe even the next day. It may take a few days before the teeth are fully functional and ready to eat food. An endodontist will go over all of this with you prior to the surgery so that you can prepare ahead of time.
What you need to know
A common procedure that endodontists perform on a regular basis is known as the apicoectomy. During this procedure, the endodontist opens the gum tissue by the tooth and examines the underlying bone. If necessary, the endodontist will remove any inflamed or infected tissue along with the end of the root. The endodontist may need to then place a small filling at the end of the root canal along with a few stitches or sutures to help the tissue heal properly.
After completing this procedure, the bone will naturally heal around the end of the root over the next few months following the procedure. Since this is only one type of endodontic surgery, it is important to ask all questions during the consultation in order to fully understand your specific situation. The other procedures are all designed to help save the tooth and prevent having to extract it entirely.
If you have any concerns about feeling pain during the surgery, do not worry. While you may feel some swelling and soreness following the procedure, there will not be much of any pain. In fact, the anesthesia will wear off and you will most likely be able to drive yourself home from the appointment.
However, be sure to clarify with the endodontist if it is alright for you to drive yourself or if you need to have someone else drive you. In most cases, it is best to take the remainder of the day to relax. While many people return to normal routines the next day, your endodontist will be able to go over the best course of action during the appointment.
If you are in pain following general dental procedures and are unsure of why, see an endodontist as soon as possible. An endodontist can ensure the pain goes away and the teeth remain in good health.
Types of Dental Root Fractures
Contrary to what some people may assume, there are multiple types of fractures for the roots of teeth. The part of the teeth that people brush and use to chew food or speak is known as the crown. The crown consists of the outer shell known as the enamel and is what most people refer to when they mention anything about the teeth. However, the teeth have roots that actually go deeper into the gums and jawbone.
Understanding the Layers of Teeth
Within the tooth, there are layers that people may not be aware of. Underneath the enamel is the dentin. The dentin is the second layer of the tooth and contains the dental pulp. The dental pulp is the center of a tooth and contains the nerves and blood vessels. Any damage to the tooth that effects the position of these layers or reaches the dental pulp will cause the patient serious pain.
Even a minor crack that one decides to leave untreated can lead to catastrophic results the longer the patient waits to seek professional treatment. While a general dentist is certainly effective in preventing infection and keeping teeth healthy, there are issues that only a specialist will be able to treat. An endodontist can provide the necessary treatment for a variety of infections, cracks, chips or breaks in the teeth.
Several different types of tooth fractures
When a tooth fracture goes deep enough, it can jeopardize the entire tooth and the health of the surrounding teeth. The fracture can also allow plaque to breach the layers of the tooth and cause an infection. While the enamel is a shield that protects teeth against infection, a fracture can cause enough damage for the infection to break through.
There are several different types of fractures that an endodontist will treat:
- Oblique supragingival fracture: An oblique supragingival fracture consists of a crack in the upper portion of the tooth that is above the gum line. This type of fracture may not cause immediate pain, but can lead to infection or pain in the future without treatment. While this type of fracture can be fairly small, it usually affects the surface of the tooth. The surface of the tooth is the most-used section for chewing food. Using a tooth with this type of fracture will only cause more issues. With various forms of treatment available, an endodontist will need to examine the fracture in order to determine the most effective form of treatment.
- Oblique subgingival fracture: An oblique subgingival fracture consists of a fracture that covers more of the tooth and can even reach down the root to the jawbone below the gum line. This type of fracture can cause intense pain and make simple tasks such as chewing, speaking, or even just sitting still, difficult. This type of fracture can also affect the nerves within the tooth.
- Oblique root fracture: While having a similar title to the other fractures listed above, an oblique root fracture takes place below the gum line and can extend all the way into the jaw. Unlike more minor fractures, this fracture will be extremely painful and will require professional endodontic treatment.
- Vertical furcation fracture: A vertical furcation fracture involves the tooth splitting and becoming two or more roots. This fracture will cause the patient pain and make it impossible to effectively use the tooth for basic functions.
- Vertical apical root fracture: A vertical apical root fracture is a fracture directly down the middle of the tooth and root. This type of fracture can be painful and will require professional treatment. In some cases, the treatment may involve a root canal therapy to help the patient heal.
- Vertical root fracture: If part of the tooth root breaks off, it is known as a vertical root fracture. The cause will often involve brittle roots due to nerve death in the tooth. In other cases, a previous root canal procedure that went wrong can also cause this type of fracture.
Do not wait to seek treatment
If you are struggling with any of these issues or pain in your mouth for no known reason, then seek professional care as soon as possible. The longer you wait, the worse the condition will get. If you are unsure about how to find an endodontist in your area, visit a general dentist and ask for advice or recommendations.
Signs That You Need Endodontic Surgery
If the root of the tooth has an infection, it is most likely due to an abscess or other condition that is below the root spreading up through the tooth. This is why it is crucial to seek professional treatment from an endodontist who has the expertise and tools to perform the necessary endodontic surgery. Do not hesitate to schedule an examination to determine the extent and cause of the pain. If endodontic surgery is necessary, there will be specific signs to look out for. Here are seven signs that you need endodontic surgery.
#1. Continuous pain after a professional cleaning
While it is common to experience pain from having food sticking between the teeth, the pain one will feel that requires endodontic surgery will be much more severe. A general dentist may be able to treat a minor infection with non-surgical means, but if the infection is too great, then an endodontist will be necessary.
#2. Increased sensitivity to hot and cold
When you consume anything hot or cold, you may have a slight reaction on your teeth or in your mouth, which is completely natural. However, if the reaction is solely from the teeth and is much greater than normal, then you may need an endodontic procedure. If you have the reaction to any drink or food item, then you definitely need an examination. The pain can be due to the enamel on the teeth being weaker or the inside of the tooth having an infection.
#3. Pain and tenderness to touching the teeth or chewing
While it is possible to hurt the teeth by applying too much pressure, an endodontic surgery is only necessary when the teeth feel intense pain from hardly any pressure. If you feel pain when chewing on any type of food or from the slightest touch of a tooth brush, then you need to schedule an examination as soon as possible. People may assume that this pain is only temporary or bearable, but the pain will only get worse and interrupt one's daily routine.
#4. Swelling and drainage of gums around the tooth
If you notice any odd drainage or swelling around a specific tooth, then a root canal may be the most efficient method to treat and save that tooth. When the pulp of the tooth is infected, it can slowly spread to the gums and even jawbone surrounding the tooth. When this occurs, it is even more crucial to seek professional services such as endodontic surgery.
#5. Abnormal discoloration of a specific tooth
While teeth gradually discolor from consuming wine, coffee, tea, tobacco and other products, it is not common to see a drastic discoloration. Even if one is forgetful with brushing twice a day, a sudden discoloration in the teeth is unnatural. The discoloration is the result of an infection spreading through the tooth to the gums and jawbone. Major discoloration of a tooth is a sign of an infection that will most likely require endodontic surgery to treat.
#6. You have a dental abscess at the bottom of the tooth root
A dental abscess forms from an infection in the tooth and starts at the bottom of the tooth root. A traditional dentist cannot treat a dental abscess without a form of surgery. Thus, it is crucial to seek professional treatment since a dental abscess causes incredible pain in and around the specific tooth.
#7. You notice and feel a tiny bump near the tooth
This bump will appear to be a pimple on the gums near or around the infected tooth that is causing pain. If you notice this and other symptoms, then you will most likely need professional treatment. By visiting an endodontist, you will be able to find the cause for this bump and receive the most effective solution.
If you live in the Staten Island area, call (347) 802-8371 to schedule your dental exam so that you can remain in good health or receive treatment for a current condition.