An Endodontist is a dentist who has undergone at least 2 years of additional advanced speciality training focusing on:

1. Diseases of the dental pulp and supporting structures know as apical periodontitis.
2. Diagnosis of oral and facial pain and related problems.

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Momentary sensitivity to hot or cold foods.

• If this discomfort lasts only moments, sensitivity to hot and cold foods generally does not signal a serious problem.
• Try using toothpastes made for sensitive teeth. Brush up and down with a soft brush; brushing sideways wears away exposed root surfaces. 

Sensitivity to hot or cold foods after dental treatment.

• Dental work may inflame the pulp inside the tooth causing temporary sensitivity.
• Wait two to four weeks. If the pain persists or worsens, see your endodontist or dentist.

Sharp pain when biting down on food.

• There are several possible causes of this type of pain: decay, a loose filling or crack in the tooth.
• See a Endodontist or dentist for evaluation.

Lingering pain after eating hot or cold foods.

• This probably means the pulp has been damaged by deep decay or physical trauma.
• See your endodontist to save the tooth with root canal treatment.

Constant and severe pain and pressure, swelling of gum and sensitivity to touch.

• A tooth may have become abscessed, causing an infection in the surrounding gingival tissue and bone.
• See your endodontist for evaluation and treatment to relieve the pain and save the tooth.

Dull ache and pressure in the upper teeth and jaw.

• The pain of a sinus headache is often felt in the face and teeth. Grinding of teeth, a condition known as bruxism can also cause this type of ache.
• For sinus headache, see your physician. For bruxism, consult your dentist. If pain is severe and chronic, see your endodontist for evaluation.

Your general dentist sometimes refers patients for consultation when the diagnosis is complicated, treament plans need to be validated, or when treatment is more difficult than normal.

Root canal  treatment is necessary when the pulp becomes inflamed or infected. The most common reasons for inflammation or infection are deep cavities (caries), repeated dental procedures, cracks or chips. Trauma can also cause inflammation and often shows up as discoloration of the tooth. If pulp inflammation or infection is left untreated, it can cause pain or lead to serious infections.

Root canal treatment involves making a small opening in the top of the tooth and/or removing the bottom of the tooth to eliminate the inflamed or infected soft tissue (commonly called a pulp or nerve) found inside the tooth and/or necrotic tissue/bone found outside the tooth.  The space that the pulp tissue or nerve occupied is then cleansed and obturated (filled) to help prevent future infections.

When root canal treatment is completed, the tooth will require a permanent restoration, which can be a filling, a crown, or both.   The permanent restoration is mandatory for the preservation and healing of the treatment and will normally be rendered by your dentist.

Toothache pain is the main reason for patients seeking treatment. Fortunately, modern anesthetics can make the procedure pain free in most cases. Seeking treatment early makes the procedure more comfortable, so don't wait. When caught early, treatment should feel no different than having a regular filling. For the first few days after treatment, there may be some sensitivity to biting pressure, especially if there was pain or infection before the procedure.

As with any branch of medicine or dentistry, no guarantee of treatment success can be given or implied. However, with proper care, 90% of teeth that have had root canal treatment can last as long as natural teeth. 

Possiblilites may be due to:

• Narrow or curved canals were not treated during the initial procedure.
• Complicated canal anatomy went undetected in the first procedure.
• The placement of the crown or other restoration was delayed following the endodontic treatment.
• The restoration did not prevent salivary contamination to the inside of the tooth.
• New decay can expose the root canal filling material to bacteria, causing a new infection in the tooth.
• A loose, cracked or broken crown or filling can expose the tooth to new infection.
• A tooth sustains a fracture.

Surgery can help save your tooth in a variety of situations.

• Diagnosis: If you have persistent symptoms but no problems appear on your radiograph, your tooth may have a tiny fracture or canal that could not be detected during nonsurgical treatment. In such a case, surgery allows your endodontist to examine the entire root of your tooth, find the problem, and provide treatment.
• Calcifications:  Sometimes calcium deposits make a canal too narrow for the instruments used in nonsurgical root canal treatment to reach the end of the root. If your tooth has this “calcification,” your endodontist may perform endodontic surgery to clean and seal the remainder of the canal.
• Damaged bone and or the end of the tooth:  Surgery may also be performed to treat damaged root surfaces or surrounding bone.