You are likely to have heard of the term “root canal treatment/therapy (RCT)” and how it is an alternative to tooth extraction. This treatment option comes under a specialty of dentistry called endodontics, which basically means “inside the tooth”. The inside of a tooth has a chamber (pulp) which continues into the tooth root as the pulp canal. This pulp canal and the chamber houses the soft tissue consisting of nerves and blood vessels within the tooth.
A specialist who deals with the diagnosis and treatment of diseases/injuries (oral pathology) of the pulp and the surrounding areas of the root tip (periapical area) is called an endodontist.
What does an endodontist normally do?
Most common cases that an endodontist handles are related to root canal therapy wherein they remove the pulp of an infected or dead (non-vital) tooth by using special instruments. The root canals are cleaned and shaped by using files that are specially designed for this use. After thorough disinfection, the canal is sealed with inert material and the tooth is filled.
The endodontist then decides whether to place a crown directly on the tooth or after creating a post and core (a specially designed extension to give support and strength to the crown when the loss of tooth structure is extensive). Rarely, endodontics is done on a healthy tooth, when it is being used as a support for replacing many teeth with a permanent, fixed bridge.
The other common procedure that an endodontist does is called an apicoectomy or root end resection. This procedure is done when the infection (periapical pathology) doesn’t subside even after RCT. The gum is exposed to access the root tip. This tip is removed along with the surrounding infected tissue and a filling is placed into the end of the tooth. The gum is sutured back in place and allowed to heal. After a period of few months, the bone around the previous infection heals and the patient should be symptom-free.
The most common causes of a patient needing an endodontist’s services are deep dental decay, teeth broken due to trauma and/or abscessed teeth due to long standing infection. An endodontist will review your medical and dental history, chief complaint, perform diagnostic tests, and study all x-rays before suggesting any treatment required.
For lots more info on their work, see our comprehensive guide to root canal, where we answer all the common questions.
Becoming An Endodontist
After undertaking an undergraduate degree in dentistry, a general dentist can become an endodontist by taking up a postgraduate course in endodontics. At least two to three years full-time post-graduate study is required, followed by examinations to gain entry into this specialism. The requirements vary from country to country. The salary varies in different places depending on experience, skill, popularity, work load and advanced qualifications of the endodontist.
Endodontists are highly trained, and often use extra equipment such as microscopes to make the tricky job of RCT more successful. While most general dentists do endodontics, they are likely to refer you to the specialists for more complicated teeth/procedures.
Next: A look at some other dental specialists