Endodontics 01

Endodontics is the branch of dentistry concerned with pulp tissue treatment aiming to save the tooth from extraction. Endodontics in Greek means inside a tooth (endo means inside, and odont means teeth).

The pulp tissue is the heart of the tooth. It occupies the center of the tooth. It contains blood vessels, nerves, and connective tissues necessary to provide nutrition and sensation to the tooth.

A hard enamel shell and resilient dentine protect the pulp from bacterial invasion and temperature fluctuations. Once a trauma or caries extends to the pulp, you will feel pain.

Endodontic pain

 There are three stages of pain related to the pulp of a tooth.

The first stage is when the pain is due to a trigger like a hot or sweet stimulus in a carious tooth. Once the cause is removed, the pulp will remain healthy and vital. It is called reversible pulpitis. It requires caries removal and filing. If the caries is deep and adjacent to the pulp, it may require an indirect pulp capping step. A base of biocompatible material is placed near the pulp to stimulate the formation of a dentine bridge to insulate the pulp.

The second stage is when the pain comes without a stimulus and is continuous. The pulp is already exposed, and pulp death has started. This condition is called irreversible pulpitis. This condition requires a root canal treatment to remove the pulp tissue, clean and disinfect the root canal, and then fill it.

The final stage is the pulp abscess. The pain is distinctive as severe, continuous throbbing pain that does not go away with analgesics. A swelling most commonly exists. This condition is accompanied by pus formation that is compressed in the bone around the tooth root. If left untreated, the pus will find its way out to form a fistula to drain the pus. It requires a root canal treatment and may be combined with endodontic surgery to remove the apex of the tooth (apicectomy) if a cyst exists.

Endodontics 02
Endodontics 03

Conditions that require a visit to our endodontist at Camden High Street Practice

Any disease involving the tooth pulp is handled preferably through an endodontist. These conditions include:

1. Deep caries expose the pulp tissue.

2. Dental abscess.

3. Failed previous root canal treatment.

3. Trauma or crack to the tooth involving the pulp.

Endodontic procedures

In a pursuit to preserve the natural tooth, an endodontist may perform some procedures which include:

Root canal treatment

It is the most common endodontic treatment. It aims to remove the infected or dead pulp, clean and disinfect the root canal, and seal the pulp space with a biocompatible material.

Complete isolation for the operation field is mandatory to avoid bacterial leakage in the treated canal, which may lead to failure and retreatment. A final restoration is placed to close the access opening in the tooth. Often, the endodontic-treated tooth requires full coverage with a crown to protect it from fracture.

The only alternative to root canal treatment is extraction and replacement of the missing tooth with an implant or bridge.

An intentional root canal treatment of a vital tooth may be advised to serve another treatment purpose, such as overdenture construction over remaining natural teeth or during treatment of a cracked or fractured tooth.

Endodontic retreatment

It is essential in case there is a failure in the initial root canal treatment. The filling is removed, and the canal is re-cleaned and refilled.

Pulp capping

This procedure represents a last trial to preserve the vitality of the tooth. It involves the application of a biocompatible material such as MTA or bio-dentine over or near the pulp tissue to stimulate dentine production to cover and insulate the pulp tissue.

Indirect pulp capping is used when there is a deep cavity near the pulp but does not expose it, while direct pulp capping is used when there is an accidental pulp exposure during a dental treatment.

Endodontics surgery

Endodontics surgery is used to expose the root surface through an incision. It involves an apicectomy procedure to remove the tooth apex because of an existing problem, cyst excision, and removal of a stone that blocks the root canal and makes it difficult to perform a root canal treatment. As well as to examine and treat root fractures and cracks.

Endodontic instruments

The main procedure in endodontics is root canal treatment. Even if another endodontic procedure is performed, it may be combined with root canal treatment. These are the instruments an endodontist will need for a root canal treatment.

  • Ni-Ti Rotary system: Nickel-titanium instruments (Ni-Ti) are known for their high flexibility. They offer a better cleaning and shaping of the root canal, especially in the curved roots, which decreases the risk of perforation.
  • Apex locator: A device used to accurately determine the root apex location and the root canal length for an optimum preparation and filling of the root canal without being over or under-filled.
  • Magnification: Endodontists work in a minute structure. Magnification can increase the precision and the success rate of root canal treatment. It may also help in accessory root canal detection. Magnification includes the use of magnifying loops or endodontic microscopes.
  • Digital imaging: X-ray is a valuable diagnostic tool in endodontics. To help to identify the approximation of caries to pulp, any existing root curvature, presence of a cyst, and level of fracture line. Digital imaging provides a clear and detailed image while exposing the patient to minimal radiation. Digital CBCT may also be beneficial to identify the presence of calcification and stones inside the root canal.

Natural tooth preservation is the optimum goal of Camden High Street Practice dental professionals. A natural tooth function appears and feels way better than any artificial substitute. Endodontic treatment is the last resort for saving the natural tooth. If it fails, extraction is inevitable. At Camden, our professional endodontic team is continuously updated with the most pioneering technology to save your tooth.

Frequently Asked Questions

Periodontics is the branch of dentistry that cares for all the structures surrounding the teeth. These structures include cementum, alveolar bone, gums, and periodontal ligaments. The dental professional responsible for periodontal health is called a periodontist. 

A dentist can perform all restorative and preventive dental procedures, such as fillings, crowns, and bridges. A periodontist is concerned with the tissues around the tooth, like the alveolar bone, cementum, gums, and periodontal ligament.

If you have any problem in the tissues around a tooth, you should schedule a visit to a periodontist. These conditions include severe periodontitis, gum recession, bone resorption, removing excess gingival tissues, or freeing a tight frenum. 

It is quite the opposite. Your dentist may refer you to a periodontist to ensure you receive more specialized care for your periodontal tissues.

All our dentists at Camden High Street Dental can treat early periodontits, where there is bleeding gums and minimal bone loss. However we have 2 specialist periodontists at our New Cross Clinic and at our flagship Dulwich Clinic. You do not need a referral. For New Cross Click Here or call 020 7639 3323, or book online 24/7 here. For Dulwich Click here or call 020 8693 3339 or book online 24/7 by clicking here.

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