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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. Although all dentists are trained in diagnosis and endodontic therapy,  some teeth can be especially difficult to diagnose and treat and require a referral 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.  They learn, through the use of advanced technology such as the dental operating microscope, to locate and clean the very small root canals and complexities within the tooth. For this reason, many dentists choose to refer their patients to endodontists.

What is Endodontics?

In order to understand endodontic treatment, it helps to know something about the anatomy of a tooth.  Teeth have several layers.  The outside layer of the tooth is composed of a hard layer called enamel.  Enamel is supported by an inner layer called dentin, which has at its center a soft tissue known as the pulp.

The pulp contains blood vessels, nerves, and connective tissue that are responsible for forming the surrounding dentin and enamel during tooth development. The pulp receives its nourishment supply from vessels which enter the end of the root. Although the pulp is important during development of the tooth, it is not necessary for function of the tooth. The tooth continues to be nourished by the tissues surrounding it even after the pulp is removed.

The treatment consists of three or four basic steps and the number of visits will depend on the degree of infection/inflammation and degree of treatment difficulty.  Some treatments take 2 visits but many are just a single visit.  Occasionally, 3 appointments are needed.  We believe it is more important to emphasize the quality of care and attain a succesful outcome than to meet a specific time criteria.  

Why is a Root Canal needed?

Endodontic treatment is necessary when the pulp becomes inflamed or infected. The most common reasons for inflammation or infection are deep cavities (caries), repeated dental procedures, cracks or chips, grinding (bruxing) and/or clenching. Trauma can also cause inflammation and often shows up as discoloration of the tooth. If pulp inflammation or infection is left untreated, it can cause pain or lead to an abscess.

When a tooth becomes inflamed and hypersensitive to a point where it cannot recover or when the pulp dies and abscesses, a root canal in needed in order to retain the natural tooth and eliminate the pain and infection. The only other alternative to having root canal therapy would be to have the tooth removed (extracted/pulled).   Antibiotics are only a short term solution to temporarily control any swelling and pain from the infection.  As there is no blood flow into the abscess or into the root canals where the infection originates, the antibiotics cannot reach the source of the infection and will not "cure" it.  Delaying definitive treatment with either a root canal or extraction of the tooth is not a good option as it will only increase the risk of pain, swelling, loss of tooth structure and bone support. 

Oral pain, such as a toothache or a cracked/fractured tooth, can often be difficult to pinpoint.  Due to the vast network of nerves in the mouth, the pain of a damaged or diseased tooth may be felt in another tooth and/or in the head and neck region.  An Endodontist is a specialist trained in diagnosing and treating this type of pain.

What Happens During Endodontic Treatment?

A local anesthetic will be given for this treatment.  A rubber dam (latex or non-latex) will then be placed around the tooth to isolate it and keep it dry during the treatment.  A small access opening will be made through the biting surface of the tooth and the root canals will be located, cleaned with tiny files and flushed thoroughly with antibacterial rinses.  Once the canals are cleaned and dried, the root canal filling material and a temporary restoration will be placed.

What are some of the risks and complications of having root canal therapy?

Although very rare during endodontic treatment, there is the possibility of instrument separation within the root canals, perforations(extra openings), damage to bridges, existing fillings, crowns or porcelain veneers, canals which are too small to locate or clean entirely, loss of tooth structure in gaining access to canals, and fractures of the tooth or roots over time due to the loss of tooth structure and repeated use/stress on the tooth.  Curved roots and small "calcified" root canals may put you at higher risk for some of these complications.

Success rates of Root Canal Therapy

There are, of course, no guarantees.  Root canal or endodontic therapy has a very high degree of success, up to 90%.   We will discuss with you the prognosis for success before any endodontic procedure is undertaken to help you make an informed decision.  If the endodontic therapy is unsuccessfull, there are other options available.

Are additional visits needed after endodontic therapy?

Once endodontic therapy is completed, your tooth should be examined periodically, usually every 6 - 12 months.  This allows us to make sure the tooth has healed or is healing properly.  Since an abscess may take 2 years to heal, it is important that a reevaluation be done.

Retreatment

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

Endodontic Surgery

Although rare, an infection can be resistant to healing after root canal therapy and may  require a surgical procedure to remove the inflamed and infected tissue at the tip of the roots.  Endodontists are the experts in this type of surgery, using the dental operating microscope, microinstruments and advanced materials to conservatively treat these teeth.  Although the surgery involves making an incision in the gums, it is different than "gum" surgery or periodontal surgery performed by periodontists to treat gum disease.

Treatment of 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. Procedures such as apexification or pulpal regeneration can be utilized in teeth with either incompletely developed roots or fully developed roots to save the tooth. An endodontist is specially trained in procedures for replanting teeth that have been avulsed (knocked out of their sockets).

 
endodontics
Patient Testimonials

Let me get right down to the heart of the matter....My experience with Dr. Layton and her team was quite simply...amazing! Dr. Layton has shown the highest level of professionalism, knowledge and skill during my visit to her office for a root canal. I would stongly recommend her to anyone seeking her level of expertise and performance.

Terry Y.

Having had multiple dental proceedures performed over the years I feel very lucky to have finally been referred to Dr Layton and her team. The two root canals were seamless, and from start to finish, I was treated with kindness, respect and utmost care. As an RN of 35 years my expectations are extremely high, and believe me, Dr Layton and her staff fulfilled each and every one. Also, special thanks to Natasha RDA and Barb at the desk.

Penny G.

My visit to Dr. Layton’s office was one of my best dental experiences! Dr. Layton, along with her wonderful staff, were all so friendly and kind that it made my experience a very pleasant one. Dr. Layton took her time showing me step-by-step procedures and made sure I was comfortable with everything before proceeding with the root canal. The freezing needles were a breeze and the root canal itself went very good! I would highly recommend Dr. Layton to anyone. Going to the dentist isn’t bad when you have great people helping you like themselves!!!

Hope D.

Dr. Layton is truly a professional along with her staff. My root canal procedure was pain free and in fact the best out of all my dental experiences. Dr. Layton was very patient, kind and took her time to explain all my options. She managed to freeze my mouth very well and I didn't feel the freezing needles or the tools that she used. I was amazed at her talent and speed. I had no swelling or pain after the procedure and did not need to take any painkillers. Her staff, in particular RDAs Natasha and Carolynn, were very attentive and caring, and answered all my questions. Overall, the whole experience was like going to the movie - in fact I did watch a movie while Dr. Layton was working on my tooth - except for no popcorn. I would definitely see Dr. Layton again in the future! Many smiles, Oksana B.

Oksana B.

My experience at Dr Laytons practice was excellent. I was in severe pain and looked up the practice to get an urgent appointment. The staff were excellent and I was seen within 24 hours Dr Reza Yasini was excellent and very pleasant. The staff are amazing. Thank you to all at Dr Laytons Practice. I will definitely recommend anyone to the practice.

Shireen


1170, 10665 Jasper Ave
Edmonton, AB T5J 3S9

Phone:
1-780-424-0214
Fax:
1-780-425-5245