I always go to my family dentist for cleanings and fillings and other basic dental work. Some of my friends have gone to an endodontist—but I’m not sure for what. What is an endodontist, and when, if ever, would I need to see one myself?
Consider yourself lucky—and somewhat of a rarity after a certain age—if you’ve never had to go to an endodontist. Endodontists are one of a number of specialists in the field of dentistry (others include periodontists, orthodontists, oral and maxillofacial surgeons, and pediatric dentists). With an additional two years or more of training beyond four years of dental school, they are experts at evaluating and treating problems related to the innermost layer of the tooth: the pulp. And the procedure they are perhaps best known for is the root canal.
Actually, all general dentists receive training in endodontic procedures—and many are comfortable performing them themselves. Others prefer to refer patients who might need an endodontic procedure to these specialists.
Our teeth are composed of three layers: the visible and very hard enamel; a thick layer of slightly softer dentin just under the enamel; and the pulp, which consists of nerves, blood vessels, and connective tissues. When there is damage to the pulp—whether due to an advanced cavity or traumatic injury from, say, breaking a tooth by biting into a popcorn kernel or a hard tortilla chip—it can cause inflammation, even infection, if left untreated.
One main reason why you would see an endodontist is that you need a root canal to address damaged pulp and save a tooth that might otherwise need to be extracted. You may be experiencing pain, although sometimes a problem in the pulp arises gradually. In that case, the pulp dies over time and the tooth discolors—and you may not experience pain, but your dentist can tell something is wrong.
For a root canal, endodontists make a small hole in the tooth and use very small instruments to clean the pulp from the inside of the tooth’s root canals and the pulp chamber, and to shape the interior tooth for a filling. They then fill that space with a biocompatible material and usually place a temporary filling to be later replaced by the patient’s regular dentist. After a root canal, an endodontist might want to see you again for a follow-up visit, but otherwise you would resume care with your regular dentist.
But endodontists are more than experts in performing root canals. They do a variety of other procedures, such as endodontic surgery, treating abscesses at the root of the tooth, and managing broken teeth. They are also skilled at local anesthesia (making sure patients are numb and comfortable throughout a procedure) and at imaging (which helps them with precision, accuracy, and efficiency). What an endodontist does not do is perform basic dental procedures—so you wouldn’t see an endodontist for your twice-a-year checkups, for instance.
The cost of an endodontic procedure will vary according to which tooth is treated and how complex the treatment is. Most dental insurance covers endodontic procedures, but patients may be responsible for a copay, deductible, or some portion of the cost (sometimes a sizable amount). These procedures are more expensive than a simple filling, but usually less expensive than extracting the tooth and replacing it with an implant or bridge.
