“Endo” is the Greek origin for “inside” and “odont” is the Greek origin for “tooth.” Endodontic treatment is what treats the inside of the tooth. Root canal treatment, meanwhile, is a type of endodontic treatment. To understand endodontic treatment, it helps to know a little about the anatomy of the tooth. Inside the tooth, under the white enamel and a hard protective layer called the dentin, is a soft tissue also known as the pulp. The tooth’s pulp contains nerves, blood vessels, and connective tissues. It also creates the hard surrounding tissues of the tooth during development. The pulp extends from the tooth’s crown to the tip of its roots where it connects to the tissues that surround the root. The pulp is important during a tooth’s development and growth. However, once a tooth is fully mature, it is capable of surviving without its pulp because the tooth continues to be nourished by its surrounding tissues.

Endodontic treatment is needed when the tooth’s pulp — also known as the soft tissue within the root canal — becomes infected or inflamed. This infection or inflammation can have a variety of causes. Additionally, an injury or trauma to the tooth may cause damage within the pulp while the tooth shows no visible issues. When left untreated, pulp infection or inflammation can cause a lot of pain and even lead to an abscess.

Signs that you should look out for include pain, extended temperature sensitivity to cold or heat, tenderness to chewing and touch, and tooth discoloration. You may also experience swelling, tenderness, and drainage in your lymph nodes as well as the nearby bone and gingival tissues. Sometimes, however, you may have no symptoms at all.

The endodontist will remove the infected or inflamed pulp, then carefully clean and shape the inside of the tooth’s canal — a channel within the root. After this, the endodontist will fill and seal the space. Later, you will return to your dentist to place a crown or other type of tooth restoration that will protect and restore your tooth to its full function. After this restoration is completed, your tooth will continue to function like any other tooth.

Many endodontic procedures aim to relieve the pain of toothaches caused by pulp infection or inflammation. With modern anesthetics and techniques, most patients report that they’re comfortable during the treatment. For the first several days after your procedure, your tooth may feel sensitive, especially if there was infection or pain before the treatment. Your discomfort can be relieved with over-the-counter or prescription medications. Please follow your endodontist’s instructions carefully. Your tooth might continue to feel slightly different from your other teeth after your endodontic treatment for some time. However, if you have severe pain or pressure, please call your endodontist.

Endodontic treatment can often be performed in one or two visits and involves the following steps:

1. Your endodontist will examine and X-ray the tooth, and then administer you local anesthetic. After the tooth becomes numb, your endodontist will place a small protective sheet called a “dental dam” over the affected area to isolate your tooth and keep it clean and free of saliva during your procedure.

2. Your endodontist will make an opening in the crown of your tooth. Very small instruments are then used to clean the pulp from the pulp chamber and root canals, as well as to shape the space for filling.

3. After the space is cleaned and shaped, your endodontist will fill the root canals with a biocompatible material, which is usually a rubber-like material called “gutta-percha.” This gutta-percha is then placed with an adhesive cement to ensure that the root canals have been completely sealed. In most cases, a temporary filling is placed to close the opening. Your temporary filling will be removed by the dentist before your tooth is restored.

4. After your final visit with the endodontist, you must return to your general dentist to have a crown or other type of restoration placed on your tooth to protect and restore it to full functionality.

5. If your tooth lacks sufficient structure to hold its restoration in place, your general dentist or endodontist may place a post within the tooth. Ask them for more details regarding the specific restoration planned for your tooth.

The cost varies depending on how complex the issue is and what tooth is affected. Molars are often more difficult to treat, and so the fee is usually higher. Most dental insurance providers offer some coverage for endodontic treatment. In general, endodontic treatment and restoration of your natural tooth is less expensive than the alternative of extracting the tooth altogether. An extracted tooth must be replaced with an implant or bridge to restore full chewing function and to prevent the adjacent teeth from shifting. These procedures tend to cost more than general endodontic treatment and appropriate restoration. Root canal treatment will save your natural teeth as well as your hard-earned money.

You should not bite or chew on the treated tooth until it’s been restored by your dentist. An unrestored tooth is susceptible to fracturing, so you should see your dentist for a full restoration as soon as possible. Otherwise, you simply need to practice good oral hygiene, which includes flossing, brushing, and your regular checkups and cleanings. Most endodontically-treated teeth will last as long as other natural teeth. In some cases, a tooth that has undergone endodontic treatment will not heal or the previous pain continues. The tooth may even become painful or diseased months or years after a successful treatment. When this occurs, the tooth can be saved by redoing the endodontic procedure.

Issues such as new trauma, deep tooth decay, or a loose, cracked or broken filling may cause new infection in the tooth. In some cases, your endodontist can discover additional narrow or curved canals that could not be treated during your initial procedure.

Most teeth can be treated endodontically, but sometimes a tooth can’t be saved because:

• Its root canals are not accessible
• Its root is severely fractured
• The tooth doesn’t have the necessary bone support
• Or the tooth can’t be restored

However, there are advances in endodontics that make it possible to save teeth that even a just few years ago would’ve been lost. Furthermore, when endodontic treatment is not effective, endodontic surgery might be able to save the tooth.