Endodontics Explained

Microscopic Endodontics   Computed Digitial Radiography   Endodontics Explained


Advanced microscopes have increased the performance and predictability of endodontic procedures.

After 10 years of development and in-office use, the microscope has finally become an integral part of endodontic care. The most obvious benefits of the microscope are the higher levels of magnification and superior illumination. Magnification of 4 to 10 is ideal and the fiber optic light adds brightness in a concentrated area.

Microscopic endodontics has enhanced our capabilities to perform clinical procedures that previously were unpredictable, and frequently impossible to accomplish.


Increased capability to find canals in teeth with difficult anatomy.

Internal and external tooth structure can be visualized without shadows that could block a 'fine' diagnosis, or impede treatment.

Tooth fractures (coronal/root) can be more readily identified, allowing for early diagnosis.

Less of the apex needs to be removed during surgical endodontics because of better visualization.

Complex treatments of perforations, and the removal of separated files , posts and other obstructions, are now done more sucessfully in a conventional manner, thus avoiding surgery.

Improved ergonomics for patients, staff and doctors.

Through the use of the microscope, we are seeing what was not previously readily available for examination. Overall, the microscope is a technologically advanced method for patient care, for educating the patients, staff and referring doctors, and for building confidence in endodontic therapy.


Digital radiography is one of the most significant dental changes. New developments in computers and sensor design have greatly improved image quality, thus improving diagnostics.

A sensor is used to "look at the tooth" much the same way a conventional dental x-ray does, but with 90% less radiation exposure. CDR x-rays are accurate, fast and easier to interpret than standard x-rays.

The CDR can be magnified to 300x its normal size and color adjusted to reveal hidden problems. More time can be spent on patient care and less on development and processing. The results are instantaneous, can be downloaded or sent via the computer to the referring dentist, and the original files are stored on the computer in the patients' files for easy reference and future access.


Safer, Smarter, Better, and Faster.

Reduced radiation (70-90% less than 'D' speed film).

No more chemicals (eliminates environmental contamination).

Image appears within 3 seconds.

Image can be adjusted for contrast brightness and zoomed in or out.

Radiographs can be stored in digitial indefinitely and can be transferred by electronic communications.

Each of our three offices is equipped with digitial radiography (CDR) units.


More than 14 million teeth per year receive endodontic therapy. By choosing endodontic treatments, you are choosing to save your natural teeth as a healthy foundation for biting and chewing. The only alternative to endodontic therapy, root canals, is extraction. If it has been a long time since your last root canal or if you have never had the opportunity to experience a root canal, you will be pleasantly surprised by the advancements made in this specialty. We hope this information will answer some of your questions and concerns about this treatment.


DIAGRAM OF TOOTHEndodontic therapy treats the inside of the tooth area containing soft tissue, or the pulp. The pulp itself contains blood vessels, nerves, and connective tissue and creates the surrounding hard tissues of the tooth during development. The pulp extends from the crown of the tooth to the tip of the roots where it connects to the tissue surrounding the root. Once the tooth is fully mature, it can survive without the pulp since the surrounding tissues nourish the tooth. If the pulp becomes inflamed or infected, endodontic treatment may be indicated. Some of the causes for infection or inflammation can be associated with trauma, deep decay, repeated dental procedures on the tooth, or a crack in the tooth.

Signs of pulp damage can include, but are not limited to:

  • Lingering sensitivity to hot or cold.
  • Swelling and tenderness in the gum area or pain.
  • At times there are no symptoms.
Your general dentist will discuss with you the findings of your examination and may determine by exam and diagnostic procedures your need for endodontic treatment.


General dentists can perform endodontic procedures, but often refer these specialty procedures to an Endodontist. Endodontists, are dentists with specialty training, in this specific area. To become a specialist, completion of dental school plus two or more years of advanced training in endodontics are required. Routine to very complex endodontic procedures are included in the specialty along with endodontic surgical procedures.


ImageThe Endodontist will review your x-ray and discuss the findings as it relates to the type of procedure to be done. A local anesthetic will be administered and after the area is numb, the endodontist will place a protective device (rubber dam) over the area to isolate the tooth and to keep the area clean and free of saliva during the procedure. This barrier is essential for this type of procedure.

The endodontist will then make an opening in the crown of the tooth. The pulp will be removed from the pulp chamber and the root canals will be cleaned and shaped in preparation for the space to be filled with a biocompatible rubber like material called gutta percha. The access opening is then sealed with an adhesive cement to ensure a complete sealing of the root canals. In most of the patient cases, a temporary filling is placed and will be removed by your general dentist as the restorations process proceeds. The root canal is often completed in one visit.

For a few days after treatment, your tooth may feel sensitive, especially if there was infection or pain prior to treatment. It is possible for your tooth to continue to feel slightly different from your other teeth for some time after treatment is completed, however, if you have severe pain or pain that lasts more than a few days, call your endodontist for advice.

After completion of your endodontic treatment, you must return to your general dentist for the final step in your tooth restoration as the unrestored tooth is susceptible to fracture. This will usually involve the placing of a post or crown on the tooth. Your general dentist will discuss your treatment plan.


ImageThe most common endodontic surgical procedure is an apicoectomy or root-end resection. When inflammation or infection persists in the bony area around the end of the tooth an apicoectomy may be performed. During this procedure, the endodontist will open the gum area near the tooth and expose the underlying bone and infected tissue. The infection and the very end of the root will be removed and a small filling placed to seal the root canal. Local anesthetic is used for this procedure. Most patients "take the day off" and return to normal activity the following day. The endodontist will instruct the patient on pain control and when to return for suture removal.


Most teeth can be endodontically treated but there are some dental situations where extraction is the only alternative. If the root canals are not accessible, severely fractured root(s) or inadequate bone support is present, the endodontist will evaluate the situation and assist the patient in making an informed decision. With the use of advanced technology, the patient has a increased chance of saving the tooth with endodontic therapy or endodontic surgery.


When the pulp of the tooth is damaged, the only alternative to root canal therapy is extraction. To
prevent shifting of the teeth and to restore chewing function, the extracted tooth must be replaced with
an implant or bridge. This requires dental procedures
on the adjacent and healthy teeth and may be more costly than endodontic treatment.

No matter how effective modern endodontic techniques are, your own healthy teeth are your best gift to yourself. For links to other endodontic information, please see Continuing Education.