A severe toothache can take over your life. Highly trained endodontists (dental specialists) repair tissues inside the tooth in intricate ways. They diagnose and treat complex causes of tooth pain, such as tooth abscess (infection). Endodontists perform root canal treatments and other procedures to relieve pain. They work to save your natural tooth.

What is tooth pulp?

Tooth “pulp” is what dental providers call the nerves, blood vessels and other tissues deep inside each tooth. (When you look in the mirror, the part of your teeth that you see is an outer layer called enamel.)

The pulp, or connective tissue inside teeth, plays an important role in helping children’s teeth develop as they grow.

Tooth decay (due to poor teeth and gum care) or a cracked tooth can lead to pulpitis (an inflamed or infected tooth pulp).

Pulpitis often causes a painful toothache (tooth pain). It can sometimes lead to a serious health problem that requires urgent medical attention.

How does an endodontist compare to a dentist?

All endodontists are dentists. But less than 3% of dentists have done the extra training to become endodontists.

After dental school, an endodontist completes at least two more years of focused dental training. During this time, endodontists focus on techniques to diagnose and treat tooth pain that affects tissues inside (pulp) or around (roots) your teeth.

What does an endodontist do?

Endodontists are sometimes called root canal dentists. While general dentists and endodontists can both perform root canal treatment, endodontists perform this procedure much more often. This higher volume and additional training translates to endodontists’ higher level of expertise in performing root canal treatment.

Endodontists specialize in diagnosing complex causes of tooth pain. They also perform other dental surgeries, including:

• Endodontic retreatment: Removes and replaces materials used during a previous root canal that did not heal properly.
• Emergency dental surgery: May involve repairing complex dental injuries or treating severe tooth infections.
• Tooth extraction (removal) surgery: Pulling a tooth when its tissues are too severely damaged to be saved.
• Dental implant surgery: Surgical placement of a dental implant which can then be used to support prosthetics, such as bridges, to restore look and function after a tooth must be removed.
• Endodontic surgery: Specialized surgery, such as apicoectomy (removal of the end, or tip, of a tooth’s root).

What do endodontists treat?

Endodontists primarily treat tooth’s pulp (interior tissues) or root tissues that have undergone damage from some of the following causes:

• Tooth decay, such as an untreated cavity from plaque that damages a tooth’s root tissues.
• Tooth abscess,a buildup of pus that forms when bacteria gets inside your tooth or gums).
• Tooth injuries due to trauma (such as a hard fall).
• Cracked tooth, when a crack extends to a tooth’s pulp tissue.

How does an endodontist test a tooth?

Endodontists have specialized training to diagnose many complex causes of tooth, mouth (oral) and facial pain. An endodontist may check your symptoms by performing one or more tests:

• Dental X-rays capture clear details of tooth structures.
• Hot or cold swabs touching the affected tooth test your tooth’s sensitivity.
• Tapping on teeth may provide clues to what tooth is affected and how far inflammation has spread, especially if your teeth are sensitive to the tapping.

What is a root canal?

During root canal treatment, an endodontist removes diseased or injured pulp tissue (inside a tooth). Removing inflamed or infected tissue can relieve tooth pain. It can also get rid of bacteria that could cause further damage (to your tooth and the rest of your body).

How is a root canal performed?

Endodontists use an operating microscope and sophisticated tools to repair tissues inside a tooth. During root canal surgery, you lie on your back in a comfortable chair. You receive local anesthesia to numb the inside of your mouth for your comfort.

During root canal treatment, your endodontist:

1. Places a dental dam (tiny tarp) over your tooth to isolate the affected area and protect your mouth, such as from infection.
2. Accesses the pulp tissue from the top or behind your affected tooth.
3. Removes damaged or diseased pulp tissue.
4. Cleans and disinfects the area inside a tooth.
5. Fills and seals the tooth.

What can I expect after an endodontic procedure?

How you feel after an endodontic treatment will depend on your specific problem and how severe it is. Most endodontic treatments are outpatient procedures (you go home soon after your procedure). You may feel minor discomfort after a root canal treatment. Some people feel well enough to return to work the same day.

Your mouth or tooth may feel sore for a few days after your procedure. More extensive surgery may cause discomfort that’s more severe or lasts longer. Your provider may prescribe medication to ease your pain, fight infection or help your body heal.

After a root canal, you may need to follow up with your regular dentist. Your provider may fit a crown (metal or porcelain covering) on top of your tooth to fully protect and restore your repaired tooth. It’s important to follow your provider’s instructions to ensure your tooth heals the way it should.

When should I call an endodontist?

Call a dental provider you trust to evaluate any tooth pain that doesn’t go away or gets worse. Waiting to get your tooth evaluated may decrease the chances your provider will be able to save your natural tooth.

You may need to call an endodontist if you have:

• Lingering tooth pain.
• Unexplained pain in your mouth or jaw.
• Teeth that are sensitive to heat, cold or sweet foods.
• Inflammation (swelling) near affected teeth or gums.

Some causes of tooth pain (such as a tooth abscess) can pose a serious threat to your health if left untreated long enough. Seek immediate treatment if you injure your mouth in an accident or experience possible signs of infection, such as:

• Fever.
• Difficulty breathing or swallowing.
• Redness or swelling in your mouth that expands to your cheek

A note you should know

A severe or persistent toothache can seem to take over your life until it’s fixed. It can also pose a real threat to your health if left untreated. Endodontists are dental specialists who can diagnose complex causes of tooth pain, such as an infection. Root canal treatment provides many people with lasting tooth pain relief. It also offers the potential of saving your natural tooth. If you have ongoing tooth or mouth pain, reach out to an endodontist to discuss your treatment options.