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Endodontists specialize in diagnosing and treating diseases of the dental pulp, which consists of nerves, blood vessels, and other cells inside the tooth's root. Their primary treatment is the root canal. A root canal removes the pulp from within the root canal, followed by filling this same canal.
Often, endodontic treatment is the only way to save a tooth that would otherwise have to be extracted. While root canal treatment is rumored to be painful, it is the diseased pulp that is painful; root canal treatment eliminates the problem and the pain.
Endodontists take X-rays of affected teeth to determine what condition could be causing the pain. They also do tests to learn whether the tooth pulp is still vital, or "alive"; they evaluate the tooth's response to temperature changes, electrical stimulation, and tapping.
When performing a root canal, the endodontist anesthetizes the tooth and drills a hole in it to gain access to the pulp chamber. Using small instruments called files, the endodontist cleans and shapes the root canal, removing the pulpal tissue. After the canal has been disinfected, it is obturated, or filled, with substances such as gutta-percha. Obturation is usually performed at a later appointment. The obturated tooth is then restored to function with a crown.
In some cases, endodontic surgery is required. The endodontist cuts through the gum surgically to expose the diseased root and surrounding bone. A portion of the root may be removed surgically.
While general dentists frequently perform routine root canal treatment, endodontists are better equipped to handle more complex cases. When pain is extreme or persists despite routine root canal procedures performed by their general dentist, patients may be referred to an endodontist. Complicated cases involving extra tooth roots, oddly shaped root canals, or calcification also may require a specialist. Patients who need root canal treatment and have serious medical conditions also may be best treated by an endodontic specialist.
Endodontists also treat patients with dental injuries such as oral trauma, cracked or broken teeth, teeth that have been twisted in the socket, and teeth that have been knocked out. Injured teeth often can be saved only by root canal treatment.
Those who manage their own practices must hire, train, and supervise employees, including office staff and dental hygienists.