Endodontics

What is endodontics?

Endodontics is a specialty of Dentistry that deals with diseases of the dental pulp and its supporting structures.

We are a leading dental centre dedicated to Endodontics, the treatment carried out to save natural teeth, often referred to as root canal therapy. Our specialists offer some of the best endodontic treatments and welcome referrals from dentists all over the UK and abroad. Endodontic Treatment is an economical way to preserve a tooth in function especially when the cost of tooth loss and replacement is so high.

Anatomy of a Tooth

In order to understand what Endodontic Treatment or Root Canal Treatment is, 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.
  • The Dentine layer which is protected by the Enamel layer 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 Dentine 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.

Why would I need Endodontic Treatment?

Endodontic Treatment or Root Canal Treatment is necessary when the Pulp becomes inflamed or infected.

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The most common reasons for inflammation or infection are deep cavities (caries), repeated dental procedures, cracks or chips. 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.

Signs and Symptoms

Indications for treatment include
  • Prolonged sensitivity to heat or cold
  • Swelling of the gum adjacent to the tooth
  • Tenderness of the tooth especially to biting or adjacent gums.
  • Sometimes there are no symptoms and the first sign of a problem maybe radiographic evidence corroborated with additional diagnostic testing by the Endodontist.
  • Discoloration of the tooth

How can Endodontics help me?

  • The Endodontist removes the inflamed or infected pulp, carefully cleans and shapes the canal system and then seals the prepared space.
  • Most treatment is performed within one or two appointments, ranging from 60-120 minutes (depending on the tooth and number of canals).
  • Once treatment is completed, you will be instructed to return to your dentist for a permanent restoration.
  • The restoration of the tooth is an important part of treatment because it seals the cleaned and filled canals from the oral environment, protects the tooth and restores it to function.
  • In addition to conventional endodontic treatment your dentist may have referred you for Endodontic Retreatment, Endodontic Surgery, Cracked Tooth or Traumatic Injury.

Root Canal Treatment

Root canal treatment involves the location, shaping, disinfection and filling of the root canal space, to allow a tooth with an inflamed or infected pulp to be saved.

The procedure is carried out under local anaesthesia (injection in the gum) and we endeavour to provide pain-free treatment.

Following canal location, flexible instruments called root canal files are used to shape the narrow channels in the centre of each root. Shaping allows the disinfectant access to the bacteria located at the end of the tooth.

Disinfection of the root canals is carried out with various disinfectant solutions and often an antibacterial paste may need to be left within the tooth between appointments.

The cleaned space is then filled with a rubber-based material known as gutta percha.

A dental operating microscope / magnification loupes is used during treatment to aid visualisation and assure precision during treatment.

Root canal therapy may be completed in one or two appointments, depending on the tooth and the number of canals present.

Once treatment is completed, you will be instructed to return to your dentist for a permanent restoration.

The restoration of the tooth is an important part of the treatment because it seals the cleaned and filled canals from the bacterial re-entry, protects the tooth and restores it to function.

Root canal Retreatment

Occasionally, teeth that have previously had root canal treatment become infected again. The main reasons for this are:
  • Bacterial infection through leaking fillings or crowns.
  • Missed anatomy such as extra root canals or canal branches. These areas may house bacteria.
  • Blockage of the narrow canal channels.
  • Fracture/separation of root canal files during treatment.

Revision of the treatment can save these teeth.

The procedure involves removal of the existing root-filling material, followed by the stages outlined for root canal treatment.

Retreatment shares a similar success rate to first-time root canal treatment. Maintaining the tooth in this way therefore provides a cost-effective alternative to it's removal and replacement.

Post Removal

Posts are used to restore teeth that have lost a lot of structure. They consist of metal or glass-fibre cylinders that are placed into the canals to retain the filling material and/or crown.

When teeth with posts have an endodontic infection, they can be treated in one of two ways:
  • Removal of the post, followed by root canal retreatment.
  • Leaving the post in place and treatment of the infection by carrying out Endodontic Microsurgery.

The choice of method will depend on the individual tooth and is made following an in-depth discussion regarding the pros and cons of both procedures.

The type of post dictates how we remove it. They can be unscrewed, loosened with ultrasonic vibration or removed by cutting into them. Depending on how well fitting the post is, the procedure can take from 30 to 90 minutes.