General Information

The word "endodontic" comes from the Latin "endo" meaning inside and "odont" meaning tooth. Endodontists are dentists who specialize in maintaining teeth by providing endodontic therapy. This treament typically involves the removal of infected or contaminated nerves and blood vessels inside the teeth, collectively called the pulp. 

In addition to attending college and dental school, endodontists undergo an additional two to three years of advanced education in endodontic therapy including the diagnosis, treatment and follow up of more difficult cases.  Endodontists are also specifically trained in the use of the dental operating microscope, which is essential to achieving a successful endodontic outcome. For this reason, many general dentists choose to refer their patients to endodontists.

All images supplied by the American Association of Endodontists. 

A root canal involves the removal of the pulp and the replacement of the tissue with a biocompatible filling material. 

During a root canal, a local anesthetic will be given to ensure the patient is comfortable. Next, a sheet called the "rubber dam" will be placed around the tooth to isolate it and keep it clean during treatment. The root canal procedure itself consists of three or four basic steps, but the number of visits will depend on the degree of infection/inflammation as well as the degree of treatment difficulty and patient's time constraints. 

As with any biologic treatment, there are no guarantees, however endodontic therapy enjoys a very high degree of success, often >90%. Doctors Vettraino Bachstein and staff will discuss with you the chances of success before any endodontic procedure is initiated in order to help you make an informed decision. 

Although rare, occasionally a tooth that has undergone root canal treatment fails to heal or pain continues despite adequate endodontic therapy. Luckily, this tooth can often be maintained with a second endodontic therapy, called retreatment. Again, local anesthetic is applied and rubber dam will be placed to isolate the tooth. Using endodontic solvents and instruments, the pre-existing filling materials are removed, the canals are re-sterilized and a new biocompatible filling material will be placed. Once again, success rates are very high for endodontic retreatment procedures, but Doctor Vettraino Bachstein will be sure to discuss prognosis for each individual case prior to initiating treatment. 

Often during retreatment, an existing crown post and core may need to be disassembled to gain access to the endodontic filling materials. Our office will be sure to communicate with our patients and referring doctors to determine if new restorative materials are indicated after endodontic treatment is completed. 

Occasionally conventional root canal therapy or retreatment is not indicated to treat infection or inflammation. In these cases, Doctor Vettraino Bachstein may recommend endodontic microsurgery. There are several types of microsurgery, which are tailored to the individual patient's needs such as apicoectomy, root amputation, intentional replantation, or exploratory surgery to identify small or hidden fractures or areas of resorption. 

Similar to root canal therapy or retreatment, local anesthetics are used to ensure patient comfort. A small incision will be made to push back the gums in the area of the root, and the infected tissue is removed. The root tip will also be cleaned, resected and sealed with a biocompatible filling material. A few stitches will be placed in the gums to encourage rapid soft tissue healing. In the following months, the bone will heal around the disinfected root tip. 

Most patients return to work/normal daily activites the following day and report only mild post-surgical discomfort and swelling. Doctor Vettraino Bachstein will be sure to work with each patient on an individual basis to tailor post-operative medications and instructions to fit each lifestyle and activity level.

Diagnose Cracks/Vertical Root Fractures

Oral pain such as toothaches or cracked / fractured teeth can often be difficult to pinpoint.  Because of the vast network of nerves in the mouth, the pain of a damaged or diseased tooth often is felt in another tooth and/or in the head, neck, or ear. An endodontist is a specialist in diagnosing and treating this type of pain.

Treat Traumatic Injuries 

Pulp damage is sometimes caused by a blow to the mouth, and the endodontist specializes in treating these traumatic injuries. For example, a blow to a child's permanent tooth that is not fully developed can cause the root to stop growing. A procedure called apexification stimulates bone to be deposited at the end of the root which makes it possible to then save the tooth through a root canal procedure. An endodontist is specially trained in procedures for replanting teeth that have been knocked out of their sockets.