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A Practice Limited to Endodontics, San Francisco, CA


General Information

Who is an Endodontist?

Endodontists are specialists who limit their practice to endodontics - a branch of dentistry dealing with the soft inner tissue of teeth (called the pulp) and their surrounding structures.  The word "endodontic" comes from "endo" meaning inside and "odont" meaning tooth.  Like many medical terms, it's Greek.  All dentists are trained in diagnosis and endodontic therapy, however, some teeth can be especially difficult to diagnose and treat.  We perform the routine as well as highly complex root canal treatments such as retreatments, removing previously broken instruments or posts, treatment of the medically complex patients and surgical procedures.

In addition to dental school, endodontists undergo two or more years of postgraduate education in this kind of treatment. As this is all they do, their equipment and office design is specialized for just root canal treatment.  For this reason, many dentists choose to refer their patients to us.  

What is Endodontics?

Endodontics is commonly known as root canal treatment.  When bacteria enter into the pulp (via decay, cracks, repeated fillings or trauma) they cause irreversible damage.  Then, the pulp has to be removed and the canals cleaned and filled to eliminate any infection.  The whole process can often be completed in one visit, but a second visit is necessary if the canals are heavily infected or the difficult to negotiate (e.g. if severely curved or narrow). We prefer to complete the root canal treatment well so that it lasts, rather than meet a time deadline, although certain situations may require it. 

Diagnosing 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, the opposite jaw or even in the head, neck, or ear. An endodontist is a specialist in diagnosing and treating this type of pain.

Root Canal Treatment

After a local anesthetic is given, a sheet of latex called the "rubber dam" (we've got nonlatex too) is placed around the tooth to keep it clean and dry from the rest of the mouth.  A cavity is made through the top of the tooth to find all the canals which can then be cleaned.  This is a critical step as the canals can be very tiny and buried deep below.  Unfound or improperly cleaned canals are the main reason root canal treatment fails later on.  Finally, the canals are filled with a rubber and a filling placed on the surface of the tooth.  Your general dentist will then place the final crown which protects the tooth, if necessary.  For more information:  endodontic (root canal) treatment

Retreatment and Endodontic Surgery

Occasionally a tooth that has undergone endodontic treatment fails to heal or starts to fail after several years.  Quite often, these situations are not painful and the patient can be unaware of any problem.  When either of these situations occur, the tooth usually can be maintained with a second endodontic treatment.  This is a little more complicated as the previous material has to be removed and any blockages bypassed and defects repaired.  However, the treatment is still painless.  For more information: retreatment

Even more rarely, surgery may be required to treat a previously treated tooth.   When the end of the canal can not be reached through the top of the tooth due to blockages or defects, it is accessed directly via a surgical approach.  We know, it doesn't sound like fun, but this procedure also is still painless and not worth worrying about if needed.  For more information: endodontic surgery

Cracked Teeth

One of the subconcious effects of stress is to clench or grind our teeth.  Although our teeth can take large forces directly vertically, they start to crack once we grind side to side (horzontally).  As these cracks propogate and extend into the pulp space, symptoms develop and root canal treatment may be required.  These cases are sometimes notoriously difficult to diagnose and treat predictably.  This is a common reason patients are referred to us.  For more information:  cracked teeth

Traumatic Dental Injuries

Our front teeth often take the brunt of any traumatic event due to their exposed position.  They can become chipped, split, displaced or even completely knocked out.  Endodontists are trained to treat such situations to maximize the longevity of the teeth and to minimize adverse affects later.  For more information:  traumatic dental injuries