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What is an Endodontist?

Michael Pollick
Michael Pollick
Michael Pollick
Michael Pollick

An endodontist is a dentist who specializes in problems with the inside of the tooth: the pulp, which is made up of nerves, blood vessels, and other soft tissues. One of the most common procedures these dental professionals perform is a root canal, which involves removing the infected pulp from a tooth and sealing it up. Also known as endodontic treatment, this procedure can be performed by a general dentist or may require the expertise of a specialist.

Qualifications

Endodontists specialize in conditions concerning the tooth pulp, shown here in red with blood vessels and nerves throughout.
Endodontists specialize in conditions concerning the tooth pulp, shown here in red with blood vessels and nerves throughout.

Like a general dentist, an endodontist must complete dental school, which usually takes about four years. In addition, he or she must also complete an additional two to three years of advanced specialized training, also called a residency. Dentists who complete this training may be awarded a graduate degree or be eligible for board certification, depending on the country in which they studied.

Why Go to an Endodontist?

Endodontist conducting an exam.
Endodontist conducting an exam.

Because basic training in endodontic procedures is provided in dental school, general dentists may — and often do — perform some root canals and other related treatments. A general dentist will usually examine a patient's damaged tooth to determine if the pulp might be infected or inflamed. Many tooth pulp infections may not be accompanied by obvious pain, so a dentist may have to look for other symptoms. Depending on the complexity of the issues involved and the practices of the dentist, a patient may be referred to an endodontist to receive treatment.

A root canal involves the removal of damaged nerves and pulp from a patient's tooth.
A root canal involves the removal of damaged nerves and pulp from a patient's tooth.

For example, a problem in a molar would typically be more difficult to treat than a front tooth, possibly requiring a specialist's care. In a basic root canal procedure, the endodontist will remove the inflamed or infected pulp tissue and nerve, shaping and cleaning the channel inside the root of the tooth. He or she then fills and seals the tooth, and may recommend that the patient return to his or her regular dentist to have the tooth crowned to protect it.

An endodontist specializes in procedures concerning the inside of teeth.
An endodontist specializes in procedures concerning the inside of teeth.

Root canals can be more complicated, however, especially when the pulp is badly infected. It can be extremely difficult to control the pain with local anesthetics if the gums are swollen and filled with pus, and it may be necessary to open the tooth and allow the pus to drain first. In some cases, only some of the pulp may be removed and the tooth temporarily filled to relieve the pain, with the patient coming back to complete the procedure on another day. Medications may also be inserted into the space within pulp space to treat any infection. An endodontist, who has experience treating a wider range of tooth problems, may be better able to recommend the best treatment than a general dentist.

Other Treatments

Antibiotic injections may help prevent infection following a root canal.
Antibiotic injections may help prevent infection following a root canal.

Endodontists may also perform other services besides root canals. They may be called upon to treat cracked and broken teeth, diagnose and treat problems with the roots, and replant or replace teeth have been knocked out or extracted. An endodontist with hospital privileges might be called in to examine patients with dental and facial trauma; opportunistic infections or inflammations of exposed tooth pulp may need immediate treatment before reconstructive work can begin.

Many times, these dental specialists are called on to retreat teeth that have had root canal procedures in the past. Some teeth have multiple, tiny branches off the main canals, and it can be extremely difficult to clean all of them out. In addition, an infection can set in or reoccur. Sometimes, an apicoectomy is required, which is the surgical removal of an infected root tip.

Benefits for the Patient and Dentist

There is financial as well as professional incentive for dentists to pursue this specialty. Being an endodontist allows a dentist to provide more services to his or her patients, and can be a revenue enhancer, since root canals cost considerably more than general dental services, such as filling cavities. Since endodontists have additional training and can perform more complicated treatments, they may be able to charge more generally for their services.

Going to an endodontist can also be of benefit to a patient, however, who may be able to get more advanced treatment of serious dental problems. Many people have a great deal of anxiety about seeing any dentist, and being able to go to someone familiar during a dental emergency can make the experience less stressful. If complex procedures are required, they may also take less time when performed by a specialist.

Michael Pollick
Michael Pollick

A regular TheHealthBoard contributor, Michael enjoys doing research in order to satisfy his wide-ranging curiosity about a variety of arcane topics. Before becoming a professional writer, Michael worked as an English tutor, poet, voice-over artist, and DJ.

Learn more...
Michael Pollick
Michael Pollick

A regular TheHealthBoard contributor, Michael enjoys doing research in order to satisfy his wide-ranging curiosity about a variety of arcane topics. Before becoming a professional writer, Michael worked as an English tutor, poet, voice-over artist, and DJ.

Learn more...

Discussion Comments

anon952443

I have had several molars break before. About a year and half ago, another molar was sensitive in one corner. I thought there was a hairline crack and asked my general dentist. She said there was nothing wrong. One year later, I could detect movement when I chewed as if there was a horizontal plane of space somewhere in my tooth. Recently the tooth broke. I was right.

The receptionist made an appointment for me five days later, even though I asked her to tell the general dentist I had a broken tooth. How soon should I be seen? Should I skip my general dentist and go straight to an endodontist? Is there any diagnosis and treatment for a cracked tooth that can prevent breakage?

anon344305

I might need a root canal on a tooth that has a crown. I am making an appointment with an endodontist. Will I have to pay for a new crown also?

irontoenail

@KoiwiGal - To me, the mark of a professional is when they know their own limits. I have a wonderful dentist who would be the first person to tell me if she wasn't capable of doing something I needed to be done.

Really, you need to have trust with anyone you go to see regularly. Even if they are an endodontist, they might not be the best person to work on your mouth. You should look up the best endodontist in your area and make sure you have someone you can trust.

KoiwiGal

Unfortunately, I've heard many horror stories about people getting treatments like root canals from their dentists and ending up with more damage. It's much better to go to an endodontist if you can. People think of their teeth as being like fingernails, just disposable bits of hard tissue, but they are just as complex as anything any other kind of surgeon would work on.

And general dentists are usually wonderful, highly skilled folk, but they aren't experts in the soft tissues. Always better to trust your health to an expert.

anon172570

I am a nurse for an endodontist and root canals are not completed on kids. Only half the treatment is carried out on baby teeth.

anon161001

Better go to the endodontist! I got two root canals from my regular dentist and now they are infected because she did them wrong! Means I have to spend more money.

anon158994

Root canals aren't that bad. The pain that you will eventually have if you don't get one will be bad. I just had one today. The doctor was great and explained everything. It's a good thing to know a endodondist! I'm sure glad I do.

anon148820

I was recommended by my dentist to see an Endodontist for a complicated root canal (there is a syst). Most probably this will cost me around $2000. An implant will cost $3.500. What would you recommend. I am 65 years of age. Are root canals guarantee? Many thanks.

Snoopy123

I am a former dental office manager hoping to clarify referrals to endodontists. Most general dentists will not perform root canals on adult molar teeth. The primary reason is risk. General dentists have either traditional or digital x-ray equipment they use to detect infection in teeth and gums. The qualities of these x-rays are generally well enough to determine which canal(s) the infection is located, but they are limited in detecting the surrounding nerves and deep tissue. An Endodontist specializes in root canals, so their equipment is much stronger thus safer for the patient. So rather than risk paralysis of the face or loss of the tooth, dentists will refer to endodontists despite the loss of income and larger cost for the patient.

anon35479

please explain about root canal for kids?

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    • Endodontists specialize in conditions concerning the tooth pulp, shown here in red with blood vessels and nerves throughout.
      By: Andrea Danti
      Endodontists specialize in conditions concerning the tooth pulp, shown here in red with blood vessels and nerves throughout.
    • Endodontist conducting an exam.
      By: michaeljung
      Endodontist conducting an exam.
    • A root canal involves the removal of damaged nerves and pulp from a patient's tooth.
      By: Igor Mojzes
      A root canal involves the removal of damaged nerves and pulp from a patient's tooth.
    • An endodontist specializes in procedures concerning the inside of teeth.
      By: Valeriy Velikov
      An endodontist specializes in procedures concerning the inside of teeth.
    • Antibiotic injections may help prevent infection following a root canal.
      By: Sherry Yates
      Antibiotic injections may help prevent infection following a root canal.