All dentists, including your general dentist, receive basic training in endodontic treatment in dental school. General dentists often refer patients needing endodontic treatment to endodontists.
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An endodontist is a dentist with special training in diagnosing and treating problems associated with the pulp of the tooth. They do only endodontic procedures in their practices because they are specialists. To become specialists, they complete dental school and an additional two or more years of advanced training in endodontics, one of the nine specialties recognized by the American Dental Association. They perform routine as well as difficult and very complex endodontic procedures, including retreatment of previous root canals that have not healed completely, as well as endodontic surgery. Endodontists are also experienced at finding the cause of oral and facial pain that has been difficult to diagnose.
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Signs include throbbing spontaneous pain, prolonged sensitivity to heat or cold, increase in the intensity of pain while lying flat ,tenderness to touch and chewing, discoloration of the tooth, swelling, drainage and tenderness in the lymph nodes as well as nearby bone and gingival tissues. Sometimes, however, there are no symptoms.
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Nothing can replace a natural tooth .So all effort must be made to save a natural tooth .Endodontic treatment eliminates the infected tissue within the canal system of the tooth which is then filled with an inert material . Afterwards, you will return to your dentist, who will place a crown or other restoration on the tooth to protect and restore it to full function. After restoration, the tooth continues to function like any other tooth.
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Many endodontic procedures are performed to relieve toothaches caused by pulp inflammation or infection. With modern techniques and anesthetics, most patients report that they are comfortable during the procedure. For the first few days after treatment, your tooth may feel sensitive and tender, especially if there was pain or infection before the procedure. This discomfort can be relieved with over-the-counter or prescription medications. Follow your endodontist’s instructions carefully. Your tooth may continue to feel slightly different from your other teeth for some time after your endodontic treatment is completed. However, if you have severe pain or pressure or pain that lasts more than a few days, call your endodontist.
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You should not chew or bite on the treated tooth until you have had it restored by your dentist. The unrestored tooth is susceptible to fracture due to decay and instrumentation , so you should see your dentist for a full restoration as soon as possible. Also it is important to practice good oral hygiene, including brushing, flossing, and regular checkups and cleanings in order to prevent recurrent decay .
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Recurrent decay below the crown reinfecting the canal system , missed canals , complex canal anatomy , untreated, narrow calcified canals or non-negotiable curved canals that could not be treated during the initial treatment.
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The cost varies depending on how complex the problem is and which tooth is affected. Molars are more difficult to treat, the fee is usually more. Most dental insurance policies provide some coverage for endodontic treatment. Retreatments and endoodntic surgeries are more expensive since they involve more time and effort .

Generally, endodontic treatment and restoration of the natural tooth are less expensive than the alternative of having the tooth extracted. An extracted tooth must be replaced with a bridge or implant to restore chewing function and prevent adjacent teeth from shifting. These procedures tend to cost more than endodontic treatment and appropriate restoration.
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It is always best to save your natural tooth .As with any dental or medical procedure, there are no guarantees. Your endodontist will discuss your options and the chances of success before beginning retreatment

Advances in technology are constantly changing the way root canal treatment is performed, so your endodontist may use new techniques that were not available when you had your first procedure. Your endodontist may be able to resolve your problem with retreatment.
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If the problem cannot be resolved with retreatment your endodontist may recommend endodontic surgery . It involves reflecting the gingiva near the root end of the involved tooth , examining it, removing infected material, resecting the root tip and sealing the tip with an inert filling to prevent any communication with the surrronding tissues.

If the tooth fails to heal even after endodontic surgery then the only alternative is extraction. The extracted tooth must then be replaced with an implant, bridge, or removable partial denture to restore chewing function and to prevent adjacent teeth from shifting.

No matter how effective tooth replacements are—nothing is as good as your own natural tooth
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Local anesthetics make the procedure comfortable. Of course, you may feel some discomfort or experience slight swelling while the incision heals. This is normal for any surgical procedure. Your tooth may be tender for a few days .Your endodontist will recommend appropriate pain medication to alleviate your discomfort.

Your endodontist will give you specific postoperative instructions to follow. If you have questions after your procedure, or if you have pain that does not respond to medication, call your endodontist.
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Often you can, but you should ask your endodontist before your appointment so that you can make transportation arrangements if necessary.
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Most patients return to work or other routine activities the next day.
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Each insurance plan is different. Check with your employer or insurance company prior to treatment. Our front office staff will be happy to assist you .
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Cracked teeth show a variety of symptoms, including pain when chewing, possibly with release of biting pressure, or pain when your tooth is exposed to temperature extremes. In many cases, the pain may come and go, and your dentist may have difficulty locating which tooth is causing the discomfort. So your dentist may refer you to an endodontist .Endodontists are dentists with at least two additional years of education that include the diagnosis and treatment of unusual dental pain.

Early diagnosis is extremely important. Like cracks in a windshield, cracks in teeth often start small and progress slowly. The sooner a crack is detected and treated, the better the chance of saving your tooth. Failure to do so can result in loss of the tooth The endodontist’s special training and experience can be valuable when a cracked tooth is suspected.
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When the outer hard tissues of the tooth are cracked , chewing can cause movement of the pieces, and the pulp can become irritated. When biting pressure is released, the crack can close quickly, resulting in a momentary, sharp pain. Irritation of the dental pulp can be repeated many times by chewing. Eventually, the pulp will become damaged to the point that it can no longer heal itself. The tooth will not only hurt when chewing but may also become sensitive to temperature extremes. In time, a cracked tooth may begin to hurt all by itself. Extensive cracks can lead to infection of the pulp tissue, which can spread to the bone and gum tissue surrounding the tooth. Timely treatment will help save the tooth

So, it is very important to see your dentist every six months so that cracked teeth can be identified and treated at the early stages .
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Teeth crack due to a variety of reasons: large restorations with compromised cusps which are prone to fracture , bruxism (involuntary grinding of teeth ), loss of a tooth can cause its neighboring teeth to drift and be subjected to abnormal chewing forces causing them to crack ,chewing on ice or unpopped popcorn kernels or contact sports.
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While cracked teeth are not completely preventable, you can take some steps to make your teeth less susceptible to cracks.

• Don't chew on hard objects such as ice, unpopped popcorn kernels or pens.
• Don't clench or grind your teeth. If you clench or grind your teeth while you sleep, talk to your dentist about getting a retainer or other mouthguard to protect your teeth.
• Wear a mouthguard or protective mask when playing contact sports.
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There are many different types of cracked teeth. The treatment and outcome for your tooth depends on the type, location, and extent of the crack

Craze lines - Usually asympotmatic superficial shallow crack lines in enamel . Found in adult teeth and usually need no treatment . Your dentist will observe these teeth for any symptoms.

Fractured Cusp - Sometimes a weakened cusp may fracture. If the fracture does not involve the inner pulp then your dentist may place a crown . But if it involves the pulp a root canal treatment is required followed by a crown.

Cracked tooth - This crack extends from the chewing surface of the tooth vertically towards the root. A cracked tooth is not completely separated into two distinct segments. Because of the position of the crack, damage to the pulp is common. Root canal treatment is frequently needed to treat the injured pulp. Your dentist will then restore your tooth with a crown to hold the pieces together and protect the cracked tooth. At times, the crack may extend below the gingival tissue line, requiring extraction

Split Tooth - A split tooth is often the result of the long term progression of a cracked tooth. The split tooth is identified by a crack with distinct segments that can be separated. A split tooth cannot be saved intact. The position and extent of the crack, however, will determine whether any portion of the tooth can be saved. In rare instances, endodontic treatment and a crown or other restoration by your dentist may be used to save a portion of the tooth.

Vertical Root Fracture - Vertical root fractures are cracks that begin in the root of the tooth and extend toward the chewing surface. They often show minimal signs and symptoms and may therefore go unnoticed for some time. Vertical root fractures are often discovered when the surrounding bone and gum become infected. Treatment may involve extraction of the tooth. However, endodontic surgery is sometimes appropriate if a portion of the tooth can be saved by removal of the fractured root.
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Unlike a broken bone, the fracture in a cracked tooth will not heal. In spite of treatment, some cracks may continue to progress and separate, resulting in loss of the tooth. Placement of a crown on a cracked tooth provides maximum protection by holding the pieces together but does not guarantee success in all cases. The treatment you receive for your cracked tooth is important because it will relieve pain and reduce the likelihood that the crack will worsen. Once treated, most cracked teeth continue to function and provide years of comfortable chewing.
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