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's Greek. All dentists are trained in diagnosis and endodontic therapy, however, some teeth can be especially difficult to diagnose and treat. That’s 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. Endodontists are specialized in saving teeth with deep decay or cracks, narrow or blocked canals, or unusual anatomy, abscessed teeth, and even teeth that have been traumatized. They can also diagnose oral and facial pain and perform surgical procedures when necessary.

Simply put, endodontists are specialists in saving teeth. Retaining the tooth prevents the loss of function (chewing ability), movement of adjacent teeth and unwanted cosmetic changes. Root canal treatment can be very predictable and enjoys over a 90% success rate. Shoreline Endodontics specializes in this area of dentistry exclusively and our practice is designed to optimize the likelihood of success.

Inside the tooth, beneath the hard enamel and dentin, is a soft tissue called the pulp. The pulp contains blood vessels, nerves and connective tissue, and creates the surrounding hard tissues during tooth development. Endodontic therapy is necessary when the pulp of a tooth becomes inflamed or infected. The inflammation or infection can have a variety of causes: deep decay, repeated dental procedures on the tooth, a crack or a chip in the tooth. In addition, trauma to a tooth may cause pulp damage even if the tooth has no visible chips or cracks. If an inflamed or infected pulp is left untreated it can cause pain or lead to an abscess. During treatment, we will remove the diseased pulp from inside the tooth, carefully clean and shape the root canal spaces and then seal the prepared canals with special filling materials.

Signs of pulp damage include pain, prolonged sensitivity to heat or cold, swelling, gum tenderness, and/or discoloration of the tooth. Sometimes, however, there are no symptoms when a pulp degenerates, and it may only be detected by a dental examination and x-rays.

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 often is 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.

First, please visit the Patient Info section of this website for detailed instructions. Our doctors will also verbally communicate these instructions at your appointment and answer any questions you may have. We would like to highlight the following important point: 

If a temporary filling was placed you will need to return to your general dentist for a permanent restoration, usually a crown. We like to see this happen within 30 days of your root canal therapy to avoid loss of the temporary filling, bacterial leakage, reinfection or tooth fracture. An unrestored tooth can fracture easily, so you should see your dentist as soon as possible to complete the treatment of your tooth following the root canal therapy. A complete report of your treatment and digital x-rays will be sent to your restorative dentist.

Once endodontic therapy is completed, your tooth should be examined periodically - usually every 6 to 12 months.  This allows us to make sure the tooth has healed or is healing properly.  You will be contacted by our office when we feel it is appropriate to reevaluate the area.  Please note that an abscess may take 2 years to heal; in this case, our office will reevaluate the tooth for at least 2 years.

Although the pulp has been removed from your tooth, the tooth continues to be vital because it is nourished by the surrounding tissues. With routine preventative care (regular brushing and flossing, proper diet and periodic dental checkups) your tooth should last a lifetime. While this cannot be guaranteed, the success rate of endodontic procedures is very high. Occasionally, an endodontically treated tooth may need an additional surgical procedure or have to be removed.

Often the only alternative to endodontic treatment is removal of the tooth. The extracted tooth must then be replaced with an implant, bridge or removable partial denture to restore chewing function and to prevent adjacent teeth from shifting. Because these options require extensive surgery or dental procedures on adjacent healthy teeth, they can be far more costly and time consuming than the endodontic procedure and restoration of the natural tooth. No matter how effective tooth replacements are, nothing is as good as your own natural tooth. You’ve probably already made an investment in saving your tooth. The payoff for choosing endodontic treatment could be a healthy, functioning natural tooth for many years to come.

The inflamed pulp tissue inside the tooth will eventually break down and die. Once this happens, bacteria have access to the jaw bone and to your blood system. This leads to bone destruction, swelling or drainage from the gum. Once enough bone is destroyed the only treatment option would be to remove your tooth (see alternatives to endodontic treatment above). An untreated infection has the potential for facial swelling, which can lead to life threatening situations of obstructed airway or brain abscess. Untreated chronic jaw infections have also been linked to systemic health problems such as heart disease, stroke and diabetes.
 

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 often can be maintained with a second endodontic treatment called a retreatment.

During endodontic retreatment, we will reopen your tooth to gain access to the root canal filling material. In many cases, complex restorative materials (crown, post and core material) must be disassembled and removed to permit access to the root canals. After removing the canal filling, we will clean the canals and carefully examine the inside of your tooth using magnification and illumination, searching for any additional canals or unusual anatomy that requires treatment. After cleaning the canals, they will be filled and sealed and a temporary filling placed in the tooth. If the canals are unusually narrow or blocked, endodontic surgery may be recommended.

If your endodontically treated tooth has not healed or has developed new problems, you have the option of another procedure called endodontic surgery or apicoectomy. If endodontic retreatment is not an option due to a canal obstruction or a post being present in the canal, then endodontic surgery should be considered. In this procedure, we will open the gingival tissue near the tooth to examine the underlying bone and to remove any inflamed or infected tissue. The removal of the very end of the root is called an apicoectomy. After cleaning the root end, a small biocompatible filling called MTA is placed to seal the canal. A few stitches or sutures are placed in the gingiva to help stabilize the tissue for proper healing. Over a period of months, the bone heals around the end of the root. Most patients return to work or other routine activities the next day.