What is endodontic treatment?

What are endodontics and what does this area of dentistry involve? Expert endodontist Dr Michael Sultan is here to explain the ins and outs of endodontic treatment (including root canal procedures).

Endodontics is the diagnosis and treatment of pain relating to teeth. It's a specialist area of dentistry and in general terms, it involves either root canal treatment or apical surgery.

Patients often come in with pain or infections and are either referred to us by their general dentist or find us via other sources. Some patients are very anxious, but the treatment itself is not usually too difficult.

We perform primary treatments, for example:

• Tooth fractures/traumatic damage
• Tooth decay
• Leakage around old crowns

Other times, we redo teeth which have been treated in the past and, using our specialist equipment, we are able to restore these teeth and hopefully prolong their lives for many years.

Often, dentists struggle to do endodontics, even though they should be well trained, and will refer difficult cases on to specialist endodontists directly, so that we can do it right the first time. The whole purpose of this is to save teeth so that people can have them for much longer and can chew comfortably, without the need for extractions and then dentures or implants.

How can endodontic treatment or root canal treatment save a tooth?

When people come to us, they're often apprehensive and they're in pain. They may have broken-down teeth, swellings, or infections. The purpose of endodontics is to resolve the pain and the infection so that people can save their teeth. In the past, the options were to take the teeth out and then replace them with either dentures or bridges or, more recently, with implants.

However, a much more cost-effective kind of treatment is to actually save the teeth themselves. This is done by removing any damaged bits of nerve and pulp in inflamed teeth so that these teeth can become infection-free.

Sometimes, there is infection in the bone which can't be got out by conventional means and by conventional root canal treatment going through the teeth, and in these cases we will perform surgery. We lift up the gum and take a little bit of bone away, ultimately to get that tooth infection-free so that tooth isn't lost. This should prolong the lifetime of a tooth by decades and is a very good, cost-effective way of dealing with problems.

Is endodontic treatment painful?

One of the myths of dentistry is that endodontic treatment is very painful and really it shouldn't be. If done well with great anaesthesia, it should be a very comfortable procedure.

Often, people have heard stories from their friends or well-meaning colleagues that this is a very painful operation, but really it is due to poor anaesthetic techniques. There are some teeth which are very difficult to anaesthetise (e.g. lower molars which are very inflamed), but once anaesthetised, endodontics should be as comfortable as any other dental procedure.

Sometimes, the procedures are quite long and it's not unusual for patients to fall asleep. Also, if people are very apprehensive, they can be offered options such as different sedatives.

However, generally, patients are not in pain during the procedures, as this would be counterproductive to any treatment (as we wouldn't be able to do our jobs!), but also, we don't want the patient to suffer in any way whatsoever. I think a calm technique and explaining everything that goes on with the treatment really does help. We do our best to make sure the patient is comfortable throughout the whole procedure.

Learn more about endodontic treatments or book an appointment with Dr Sultan at his Top Doctors profile!