Most of us are familiar with non-surgical endodontics: root canal therapy. Root canal treatment is necessary if the inner tissue of the tooth, called the pulp, becomes infected or injured. This may happen because of advanced decay or injury to the tooth. An endodontist performs root canal therapy to clean out the tooth's canals and fill them in order to preserve the tooth structure.
Endodontic Surgery Options
However, sometimes non-surgical endodontics can't save the tooth, and endodontic surgery is the answer. “Surgical endodontics are required if an infection has spread beyond the confines of the root canal system, and has now spread to the bone and the soft tissue around the tooth,” says Dr. Sinanan, an endodontist and HealthChoicesFirst.com partner. “This patient presents with a severe swelling and is in quite a bit of distress.”
Endodontists are dentists who go on to take advanced training in endodontics. Some general dentists may perform root canals, but many will refer patients to an endodontist, and will always refer difficult cases, such as a patient whose teeth have a complex root structure or narrow canals.
Reasons for Endodontic Surgery
There are a number of reasons why a patient might need endodontic surgery. The endodontist may want to surgically examine your tooth if you have pain or symptoms but an X-ray is inconclusive. An endodontist might see a hidden canal or fracture in the tooth that can't be detected by non-surgical means.
If your endodontist tries to perform root canal therapy but finds that a certain canal is too narrow to effectively clean out with normal instruments, or that the root canal has calcified, he or she may have to do endodontic surgery.
Occasionally, a patient may find that the tooth will not heal after root canal therapy, or it may cause pain months or years after successful treatment. A common type of endodontic surgery used in some cases is called apicoectomy (sometimes referred to as root-end resection). The endodontist performs this procedure if infection or inflammation occurs in the bony area around the tooth following a root canal procedure.
During endodontic surgery, your endodontist will fully numb your jaw with a local anesthetic, so you won't feel any root canal pain. “We make sure the patient is completely anesthetized in every way, the root area especially,” says Dr. Sinanan. “Then, an incision is made in the gum tissue, this tissue is reflected, and the necrotic or dead tissue of the bone in the end of the root itself is removed, cleaned, and filled.”
Do You Need Endodontic Surgery?
You should be comfortable during endodontic surgery and experience only minor discomfort afterwards as your incision heals. Your endodontist will provide you with detailed post-surgical instructions, as well as a contact phone number in case there are any complications.
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