The DDS (Doctor of Dental Surgery) and DMD (Doctor of Dental Medicine) are the same degrees. The difference is a matter of semantics. The majority of dental schools award the DDS degree; however, some award a DMD degree. The education and degrees are the same.

Approved by the Council on Dental Education and Licensure, American Dental Association

Dental Public Health: Dental public health is the science and art of preventing and controlling dental diseases and promoting dental health through organized community efforts. It is that form of dental practice which serves the community as a patient rather than the individual. It is concerned with the dental health education of the public, with applied dental research, and with the administration of group dental care programs as well as the prevention and control of dental diseases on a community basis. (Adopted May 1976)

Endodontics: Endodontics is the branch of dentistry which is concerned with the morphology, physiology and pathology of the human dental pulp and periradicular tissues. Its study and practice encompass the basic and clinical sciences including biology of the normal pulp, the etiology, diagnosis, prevention and treatment of diseases and injuries of the pulp and associated periradicular conditions. (Adopted December 1983)

Oral and Maxillofacial Pathology: Oral pathology is the specialty of dentistry and discipline of pathology that deals with the nature, identification, and management of diseases affecting the oral and maxillofacial regions. It is a science that investigates the causes, processes, and effects of these diseases. The practice of oral pathology includes research and diagnosis of diseases using clinical, radiographic, microscopic, biochemical, or other examinations. (Adopted May 1991)

Oral and Maxillofacial Radiology: Oral and maxillofacial radiology is the specialty of dentistry and discipline of radiology concerned with the production and interpretation of images and data produced by all modalities of radiant energy that are used for the diagnosis and management of diseases, disorders and conditions of the oral and maxillofacial region. (Adopted April 2001)

Oral and Maxillofacial Surgery: Oral and maxillofacial surgery is the specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. (Adopted October 1990)

Orthodontics and Dentofacial Orthopedics: Orthodontics and dentofacial orthopedics is the dental specialty that includes the diagnosis, prevention, interception, and correction of malocclusion, as well as neuromuscular and skeletal abnormalities of the developing or mature orofacial structures. (Adopted April 2003)

Pediatric Dentistry: Pediatric Dentistry is an age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. (Adopted 1995)

Periodontics: Periodontics is that specialty of dentistry which encompasses the prevention, diagnosis and treatment of diseases of the supporting and surrounding tissues of the teeth or their substitutes and the maintenance of the health, function and esthetics of these structures and tissues. (Adopted December 1992)

Prosthodontics: Prosthodontics is the dental specialty pertaining to the diagnosis, treatment planning, rehabilitation and maintenance of the oral function, comfort, appearance and health of patients with clinical conditions associated with missing or deficient teeth and/or oral and maxillofacial tissues using biocompatible substitutes. (Adopted April 2003)

What Is Fluoridation?

The Idaho State Dental Association (ISDA) strongly supports water fluoridation to prevent dental disease. For more information contact the ADA.

Fluoride is an element, which has been shown to be beneficial to teeth. However, too little or too much fluoride can be detrimental to the teeth. Little or no fluoride will not strengthen the teeth to help them resist cavities. Excessive fluoride ingestion by preschool-aged children can lead to dental fluorosis, which is a chalky white to even brown discoloration of the permanent teeth. Many children often get more fluoride than their parents realize. Being aware of a child’s potential sources of fluoride can help parents prevent the possibility of dental fluorosis.

Some of these sources are:

• Too much fluoridated toothpaste at an early age.
• The inappropriate use of fluoride supplements.
• Hidden sources of fluoride in the child’s diet.

Two and three year olds may not be able to expectorate (spit out) fluoride-containing toothpaste when brushing. As a result, these youngsters may ingest an excessive amount of fluoride during tooth brushing. Toothpaste ingestion during this critical period of permanent tooth development is the greatest risk factor in the development of fluorosis.

Excessive and inappropriate intake of fluoride supplements may also contribute to fluorosis. Fluoride drops and tablets, as well as fluoride fortified vitamins should not be given to infants younger than six months of age. After that time, fluoride supplements should only be given to children after all of the sources of ingested fluoride have been accounted for and upon the recommendation of your pediatrician or pediatric dentist.

Certain foods contain high levels of fluoride, especially powdered concentrate infant formula, soy-based infant formula, infant dry cereals, creamed spinach, and infant chicken products. Please read the label or contact the manufacturer. Some beverages also contain high levels of fluoride, especially decaffeinated teas, white grape juices, and juice drinks manufactured in fluoridated cities.

Parents can take the following steps to decrease the risk of fluorosis in children’s teeth:

• Use baby tooth cleanser on the toothbrush of the very young child.
• Place only a pea sized drop of children’s toothpaste on the brush when brushing.
• Account for all of the sources of ingested fluoride before requesting fluoride supplements from your child’s physician or pediatric dentist.
• Avoid giving any fluoride-containing supplements to infants until they are at least 6 months old.
• Obtain fluoride level test results for your drinking water before giving fluoride supplements to your child (check with local water utilities).

What Is Dental Amalgam?

The Idaho State Dental Association (ISDA) supports the ADA’s official statement on dental amalgam. For more specific information you may go onto the ADA’s website.

Amalgam Fillings (Silver-Colored Fillings) Used by dentists for more than a century, dental amalgam is the most thoroughly researched and tested restorative material among all those in use. It is durable, easy to use, highly resistant to wear and relatively inexpensive in comparison to other materials. For those reasons, it remains a valued treatment option for dentists and their patients.

Dental amalgam is a stable alloy made by combining elemental mercury, silver, tin, copper and possibly other metallic elements. Although dental amalgam continues to be a safe, commonly used restorative material, some concern has been raised because of its mercury content. However, the mercury in amalgam combines with other metals to render it stable and safe for use in filling teeth.

While questions have arisen about the safety of dental amalgam relating to its mercury content, the major U.S. and international scientific and health bodies, including the National Institutes of Health, the U.S. Public Health Service, the Centers for Disease Control and Prevention, the Food and Drug Administration and the World Health Organization, among others have been satisfied that dental amalgam is a safe, reliable and effective restorative material.

Because amalgam fillings can withstand very high chewing loads, they are particularly useful for restoring molars in the back of the mouth where chewing load is greatest. They are also useful in areas where a cavity preparation is difficult to keep dry during the filling replacement, such as in deep fillings below the gum line. Amalgam fillings, like other filling materials, are considered biocompatible—they are well tolerated by patients with only rare occurrences of allergic response.

Disadvantages of amalgam include possible short-term sensitivity to hot or cold after the filling is placed. The silver-colored filling is not as natural looking as one that is tooth-colored, especially when the restoration is near the front of the mouth, and shows when the patient laughs or speaks. And to prepare the tooth, the dentist may need to remove more tooth structure to accommodate an amalgam filling than for other types of fillings.

Amalgam Frequently Asked Questions (FAQ)

If my tooth doesn’t hurt and my filling is still in place, why would the filling need to be replaced?

Constant pressure from chewing, grinding or clenching can cause dental fillings, or restorations, to wear away, chip or crack. Although you may not be able to tell that your filling is wearing down, your dentist can identify weaknesses in your restorations during a regular check-up.

If the seal between the tooth enamel and the restoration breaks down, food particles and decay-causing bacteria can work their way under the restoration. You then run the risk of developing additional decay in that tooth. Decay that is left untreated can progress to infect the dental pulp and may cause an abscess.

If the restoration is large or the recurrent decay is extensive, there may not be enough tooth structure remaining to support a replacement filling. In these cases, your dentist may need to replace the filling with a crown.

Are dental amalgams safe?

Yes. Dental amalgam has been used in tooth restorations worldwide for more than 100 years. Studies have failed to find any link between amalgam restorations and any medical disorder. Amalgam continues to be a safe restorative material for dental patients.

Is it possible to have an allergic reaction to amalgam?

Only a very small number of people are allergic to amalgam fillings. Fewer than 100 cases have ever been reported. In these rare instances, mercury may trigger an allergic response. Symptoms of amalgam allergy are very similar to a typical skin allergy.
Often patients who are truly allergic to amalgam have a medical or family history of allergies to metals. If there is a confirmed allergy, another restorative material will be used.

Is it true that dental amalgams have been banned in other countries?

No. Erroneous news reporting has confused restrictions in a few countries with outright bans. Dentists around the world are using dental amalgams (silver fillings) to restore teeth that have dental decay. Studies have not shown a link between dental amalgam and any medical disorder.

Is there a filling material that matches tooth color?

Yes. Composite resins are tooth-colored, plastic materials (made of glass and resin) that are used both as fillings and to repair defects in the teeth. Because they are tooth-colored, it is difficult to distinguish them from natural teeth. Composites are often used on the front teeth where a natural appearance is important. They can be used on the back teeth as well depending on the location and extent of the tooth decay. Composite resins are usually more costly than amalgam fillings.

What Are Composite Fillings?

Composite fillings are a mixture of glass or quartz filler in a resin medium that produces a tooth-colored filling. They are sometimes referred to as composites or filled resins. Composite fillings provide good durability and resistance to fracture in small-to-mid size restorations that need to withstand moderate chewing pressure. Less tooth structure is removed when the dentist prepares the tooth, and this may result in a smaller filling than that of an amalgam. Composites can also be "bonded" or adhesively held in a cavity, often allowing the dentist to make a more conservative repair to the tooth.

The cost is moderate and depends on the size of the filling and the technique used by the dentist to place it in the prepared tooth. It generally takes longer to place a composite filling than what is required for an amalgam filling. Composite fillings require a cavity that can be kept clean and dry during filling and they are subject to stain and discoloration over time.

What is plaque?

Many of the foods you eat cause the bacteria in your mouth to produce acids. Sugared foods, such as candy and cookies, are not the only culprits. Starches, such as bread, crackers, and cereal, also cause acids to form. If you snack often, you could be having acid attacks all day long. After many acid attacks, your teeth may decay.

Plaque also produces substances that irritate the gums, making them red, tender or bleed easily. After a while, gums may pull away from the teeth. Pockets form and fill with more bacteria and pus. If the gums are not treated, the bone around the teeth can be destroyed. The teeth may become loose or have to be removed. In fact, periodontal (gum) disease is a main cause of tooth loss in adults.

One way to prevent tooth decay and periodontal (gum) disease is by eating a balanced diet and limiting the number of between-meal snacks. If you need a snack, choose nutritious foods such as raw vegetables, plain yogurt, cheese or a piece of fruit.

What are some tips for daily oral care?

The best way to remove decay-causing plaque is by brushing and cleaning between your teeth every day. Brushing removes plaque from the tooth surfaces.

Brush your teeth twice a day, with a soft-bristled brush. The size and shape of your brush should fit your mouth, allowing you to reach all areas easily. Use a toothpaste that contains fluoride, which helps protect your teeth from decay. When choosing any dental product, look for the American Dental Association Seal of Acceptance, an important symbol of a dental product's safety and effectiveness.

Cleaning between the teeth once a day with floss or interdental cleaners removes plaque from between the teeth, areas where the toothbrush can't reach. It is essential in preventing periodontal (gum) disease.

By taking care of your teeth, eating a balanced diet and visiting your dentist regularly, you can have healthy teeth and an attractive smile your entire life. Follow these tips to keep your teeth and mouth clean:

How do I brush my teeth?

• Place your toothbrush at a 45-degree angle against the gums.
  
  
• Move the brush back and forth gently in short (tooth-wide) strokes.
  
  
• Brush the outer tooth surfaces, the inner tooth surfaces, and the chewing surfaces of the teeth.
  
  
• Use the "toe" of the brush to clean the inside surfaces of the front teeth, using a gentle up-and-down stroke.
  
  
• Brush your tongue to remove bacteria and freshen your breath.

How do I floss my teeth?

• Break off about 18 inches of floss and wind most of it around one of your middle fingers. Wind the remaining floss around the same finger of the opposite hand. This finger will take up the floss as it becomes dirty. Hold the floss tightly between your thumbs and forefingers.
  
  
• Guide the floss between your teeth using a gentle rubbing motion. Never snap the floss into the gums.
  
  
• When the floss reaches the gum line, curve it into a C shape against one tooth. Gently slide it into the space between the gum and the tooth.
  
  
• Hold the floss tightly against the tooth. Gently rub the side of the tooth, moving the floss away from the gum with up and down motions.
  
  
• Repeat this method on the rest of your teeth.
  
  
• Don't forget the back side of your last tooth.

People who have difficulty handling dental floss may prefer to use another kind of interdental cleaner. These aids include special brushes, picks or sticks. If you use interdental cleaners, ask your dentist about how to use them properly, to avoid injuring your gums.

What is Tooth Decay?

Decay is the destruction of tooth structure. Decay occurs when plague, the sticky substance that forms on teeth, combines with the sugars and / or starches of the foods that we eat. This combination produces acids that attack tooth enamel. The best way to prevent tooth decay is by brushing twice a day and flossing daily. Eating healthy foods and avoiding snacks and drinks that are high in sugar are also ways to prevent decay.

What Causes Tooth Decay?

Decay occurs when plague, the sticky substance that forms on teeth, combines with the sugars and / or starches of the foods that we eat. This combination produces acids that attack tooth enamel. The best way to prevent tooth decay is by brushing twice a day and flossing daily. Eating healthy foods and avoiding snacks and drinks that are high in sugar are also ways to prevent decay.

What is a Cavity?

A cavity is a hole in the tooth that is caused by decay. Decay occurs when plague, the sticky substance that forms on teeth, combines with the sugars and / or starches of the food we eat. This combination produces acids that attack tooth enamel. The best way to prevent tooth decay is brushing twice a day, flossing daily and going to your regular dental check ups. Eating healthy foods and avoiding snacks and drinks that are high in sugar are also ways to prevent decay.

What is Plaque?

Plaque is the soft and sticky substance that accumulates on the teeth from food debris and bacteria. Plaque can be removed by brushing and flossing thoroughly. If plaque is not removed, it can lead to gum disease and cavities. Regular dental check ups, brushing twice a day, flossing daily and eating nutritional snacks will help to prevent plaque from forming on the teeth.

What is Calculus?

Calculus, also known as tartar, is the hardened residue that forms on your teeth when plaque is not removed. Plaque can be removed by brushing twice a day and flossing daily.

What is a Prosthodontist?

A prosthodontist is a dental specialist who is skilled in the replacement of missing teeth and the restoration of natural teeth. A prosthodontist has graduated from dental school and usually will have three or more years of continuing education after that. This type of dental specialist is trained to deal with complicated and simple restorations of the whole mouth as well as treating facial deformities. Common procedures treated by a prosthodontist may include dentures, partial dentures, fixed bridges, crowns, implants, veneers and more.

What is an Implant?

A dental implant is a metal device designed to replace missing teeth. The device is usually made out of titanium and is surgically placed into the jawbone where the tooth is missing. Unlike a dental bridge, an implant is permanent. A dental implant is designed to act as the tooth root and can anchor an artificial tooth or teeth such as a crown, bridge or denture.

How Often Should I Get a Dental Check Up and Cleaning?

Most children and adults should get a regular dental cleaning and check up every six months. People at a greater risk for oral diseases should have dental check ups more than twice a year. Tobacco and alcohol use, diabetes, pregnancy, periodontal and gum disease, poor oral hygiene and certain medical conditions are some of the many factors that your dentist takes into consideration when deciding how often you need your dental cleaning and check up. Going to your regular check ups will help to keep your gums and teeth healthy as well as detect any early problems such as gum disease, oral cancer and cavities. The best way to maintain good oral health is to visit your dentist on a regular basis.

How Often Should I Brush My Teeth?

According to the American Dental Association, you should brush your teeth twice a day. Brushing your teeth helps to remove plaque which causes tooth decay and can lead to gum disease. Always use a soft bristled toothbrush with a toothpaste that contains fluoride. Make sure that the toothbrush fits inside of your mouth so that you can easily reach all areas. When brushing, use gentle back and forth strokes, brushing all sides of the teeth. Always brush your tongue to remove any bacteria and keep your breath fresh.

How Often Should I Floss My Teeth?

You should floss your teeth at least once a day. Flossing in between your teeth removes food debris and plaque from in between the teeth that a toothbrush can't reach. Plaque causes tooth decay and can lead to gum disease. Another great reason to floss is that recent studies have shown that flossing helps to prevent a heart attack or stroke. When flossing, be sure to gently insert the floss in between the teeth, without snapping, which could damage the gum tissue. Gently move the floss up and down into the spaces between the gum and teeth. Floss the sides of all of your teeth, even if there isn't a tooth next to another one. There are a number of dental products available that are designed to make flossing easier, such as disposable dental flossers.

How Often Should I Change My Toothbrush?

Adults and children should change their toothbrush every 3 months because they become worn out and are not as effective as they once were. Exceptions to this would be if you were using an electric toothbrush, and the manufacturer states otherwise. Some electric rechargable toothbrushes have very good brush heads that only need to be changed every 6 months. If you have gum disease, you should change your toothbrush every 4 - 6 weeks because bacteria can harbor in the bristles. You should always rinse your toothbrush out with hot water after every use and change it after you have been sick.

What Causes Bad Breath?

According to dental studies, about 85% of people with persistent bad breath (also known as halitosis) have a dental condition that is to blame. These conditions could be one or more of the following:

• gum disease
• cavities
• poor oral hygiene
• oral cancer
• bacteria on the tongue

If bad breath is the cause of a dental condition, mouthwash will only mask the odor and not cure it. Regular dental check ups & cleanings, flossing daily, and brushing your teeth & tongue twice a day can greatly reduce and possibly eliminate bad breath.

What is Gingivitis?

Gingivitis is the early stage of gum disease, which can be treated and reversed if diagnosed early. The signs and symptoms are red, swollen and puffy gums that bleed easily. If treatment is not received, gingivitis could progress into periodontitis, an advanced and more serious stage of gum disease which includes bone loss and is not reversible. Gum disease is one of the main causes of tooth loss in adults and has also been linked to heart attacks and strokes. Brushing twice a day, flossing daily, regular dental checkups and dental cleanings are the best preventions against gum disease.

What are Dental Sealants?

Dental sealants are a clear and protective coating that is applied to the biting surfaces of the back teeth. The sealant protects the tooth from getting a cavity by shielding against bacteria and plaque. Sealants are most commonly placed on children's permanent back teeth because they are more prone to cavities. Most insurance companies pay for sealants on children's teeth. They can also be placed on adult's teeth, however, insurance usually won't cover them.

What is Cosmetic Dentistry?

Cosmetic or Aesthetic Dentistry is one of our areas of specialty. We use everything from veneers to laser whitening and bleaching to create your perfect smile.

What is a Veneer?

A veneer is a thin shell made out of porcelain or composite material. They are custom made and cemented to the front side of the tooth. A veneer can be used to treat dental conditions such as a slightly crooked tooth, discolored teeth, chipped teeth or they can even be used to cover spaces in between the teeth. A veneer can be made by the dentist or in a dental laboratory, depending on the materials used and the preference of the dentist.

What Is Teeth Whitening?

Whitening of the teeth is performed for patients who desire a brighter smile. Tooth whitening can be performed to reduce discoloration and staining, or simply to provide the patient with whiter, brighter teeth.

What causes discoloration of the teeth?

Teeth enamel discoloration can be caused by staining, aging, or chemical damage to teeth. Some of the more common causes of teeth discoloration are medications, coffee, tea or cigarettes. People who drink significant amounts of cola soft drinks can experience similar staining.

Aside from staining, there are other factors that can affect the color of an individual's teeth. Genetics can play a role. Some people have naturally brighter enamel than others. Disease can also be a factor and certain medications can cause a discoloration of the teeth. If you suspect that there is an underlying medical cause for your teeth discoloration, be sure to inform your cosmetic dentist.

What Is Laser Teeth Whitening?

Using a laser with a whitening gel, this is an in-office bleaching system. The translucent bleaching gel is applied to the teeth and a laser light is used to activate the crystals to absorb the energy from the light and penetrate the teeth enamel to increase the lightening effect on the teeth. The length of time in the cosmetic dentist's chair depends on the degree of discoloration you have.

What is tooth bonding?

Bonding is a composite resin filling placed in the back teeth as well as the front teeth. Composites are the solution for restoring decayed teeth, making cosmetic improvements and even changing the color of your teeth or the reshaping of teeth. Bonding will lighten any stains you may have, close up minor gaps and can be used to correct crooked teeth. Basically, bonding will cover any natural flaws applying a thin coating of a plastic material on the front surface of your teeth. After this, your cosmetic dentist will apply a bonding material and sculpt, color and shape it to provide a pleasing result. A high-intensity light then hardens the plastic, and the surface is finely polished.

What is tooth contouring and reshaping?

Tooth reshaping, or contouring, is one of few instant treatments now available in cosmetic dentistry. Dental reshaping and contouring is a procedure to correct crooked teeth, chipped teeth, cracked teeth or even overlapping teeth in just one session.

The dental contouring procedure can even be a substitute for braces under certain circumstances. It is also a procedure of subtle changes. A few millimeters of reduction and a few millimeters of tooth-colored laminate can create a beautiful smile when performed by a cosmetic dentist, with no discomfort to you. Tooth reshaping, or dental contouring, is commonly used to alter the length, shape or position of your teeth.

What are dentures?

Dentures are removable replacements for missing teeth typically made out of an acrylic resin which at times incorporate porcelain or metal for additional structural support. There are two main types of dentures. Both Complete Dentures and Partial Dentures are finely crafted, custom-fitted. If you properly maintain your dentures they will appear natural and provide a perfect smile. Additionally, dentures help strengthen muscles controlling your expressions that require the support of your teeth, rid you of pronunciation problems caused by missing teeth and aid with chewing.

What are Tooth Caps?

Grinding of your teeth, an improper bite, age, fillings and tooth decay can all be contributing factors in the wearing down, cracking or breakage of your teeth. Dental caps cover the entire visible surface of your affected tooth and add strength, durability and stability.

What is cosmetic gum surgery?

Your gum tissue is like a frame that provides form and shape to the top of your tooth. A less than attractive smile results when the integrity of the gum is compromised or the actual gum between your teeth becomes weak. Usually due to poor hygiene (gum disease), you actually begin to lose gum tissue. Cosmetic dentistry provides many cosmetic solutions such as composite resin bonding, crowns, and veneers to create a great smile. These solutions are usually part of an overall strategy which may involve cosmetic gum surgery. Used to correct a 'gummy smile' (a significant portion of your gum is exposed when you smile), cosmetic gum surgery is the procedure of lengthening your teeth from the neck of the tooth upwards. Your teeth then appear to be longer and much less gum is seen when you smile.

The "Long in the Tooth" Smile - Cosmetic gum surgery, or periodontal plastic surgery, can correct almost any deformity or gingival problems preventing you from a beautiful smile. As we age, our gums may shrink and recede which makes our teeth look longer. While this is often age-related, it can also occur due to a bad bite. A cosmetic dentist or a periodontist can correct this to such an extent, that you'll have a very youthful appearing smile.

The "Gummy Smile" - This is a problem where your teeth appear to be too short. Gum sculpting is often the solution. To solve this, a dentist uses a laser to remove the excess tissue of your "gummy" smile, which then exposes more of your tooth.

What Is A Root Canal?

FAQs About Root Canal Treatment

Nothing is as good as a natural tooth! And sometimes your natural tooth may need root canal (endodontic) treatment for it to remain a healthy part of your mouth. Most patients report that having root canal (endodontic) treatment today is as unremarkable as having a cavity filled. If you've been told you need root canal (endodontic) treatment, you can find the answers to your questions below.

Who performs endodontic treatment?

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.

Who is an “endodontist?”

An endodontist is a dentist with special training in diagnosing and treating problems associated with the inside 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.

What is endodontic treatment?

“Endo” is the Greek word for “inside” and “odont” is Greek for “tooth.” Endodontic treatment treats the inside of the tooth.

To understand endodontic treatment, it helps to know something about the anatomy of the tooth. Inside the tooth, under the white enamel and a hard layer called the dentin, is a soft tissue called the pulp. The pulp 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 tissues surrounding the root. The pulp is important during a tooth’s growth and development. However, once a tooth is fully mature it can survive without the pulp, because the tooth continues to be nourished by the tissues surrounding it.

Why would I need an endodontic procedure?

Endodontic treatment is necessary when the pulp, the soft tissue inside the root canal, becomes inflamed or infected. The inflammation or infection can have a variety of causes: deep decay, repeated dental procedures on the tooth, or a crack or chip in the tooth. In addition, an injury to a tooth may cause pulp damage even if the tooth has no visible chips or cracks. If pulp inflammation or infection is left untreated, it can cause pain or lead to an abscess.

What are the signs of needing endodontic treatment?

Signs to look for include pain, prolonged sensitivity to heat or cold, tenderness to touch and chewing, discoloration of the tooth, and swelling, drainage and tenderness in the lymph nodes as well as nearby bone and gingival tissues. Sometimes, however, there are no symptoms.

How does endodontic treatment save the tooth?

The endodontist removes the inflamed or infected pulp, carefully cleans and shapes the inside of the canal, a channel inside the root, then fills and seals the space. 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.

Will I feel pain during or after the procedure?

Many endodontic procedures are performed to relieve the pain of 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, 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.

Endodontic Procedure

Endodontic treatment can often be performed in one or two visits and involves the following steps:

1. The endodontist examines and x-rays the tooth, then administers local anesthetic. After the tooth is numb, the endodontist places a small protective sheet called a “dental dam” over the area to isolate the tooth and keep it clean and free of saliva during the procedure.
2. The endodontist makes an opening in the crown of the tooth. Very small instruments are used to clean the pulp from the pulp chamber and root canals and to shape the space for filling.
3. After the space is cleaned and shaped, the endodontist fills the root canals with a biocompatible material, usually a rubber-like material called “gutta-percha.” The gutta-percha is placed with an adhesive cement to ensure complete sealing of the root canals. In most cases, a temporary filling is placed to close the opening. The temporary filling will be removed by your dentist before the tooth is restored.
4. After the final visit with your endodontist, you must return to your dentist to have a crown or other restoration placed on the tooth to protect and restore it to full function.

If the tooth lacks sufficient structure to hold the restoration in place, your dentist or endodontist may place a post inside the tooth. Ask your dentist or endodontist for more details about the specific restoration planned for your tooth.

How much will the procedure cost?

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.

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. With root canal treatment you save your natural teeth and money.

Will the tooth need any special care or additional treatment after endodontic treatment?

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, so you should see your dentist for a full restoration as soon as possible. Otherwise, you need only practice good oral hygiene, including brushing, flossing, and regular checkups and cleanings.

Most endodontically treated teeth last as long as other natural teeth. In a few cases, a tooth that has undergone endodontic treatment does not heal or the pain continues. Occasionally, the tooth may become painful or diseased months or even years after successful treatment. Often when this occurs, redoing the endodontic procedure can save the tooth.

What causes an endodontically treated tooth to need additional treatment?

New trauma, deep decay, or a loose, cracked or broken filling can cause new infection in your tooth. In some cases, the endodontist may discover additional very narrow or curved canals that could not be treated during the initial procedure.

Can all teeth be treated endodontically?

Most teeth can be treated. Occasionally, a tooth can’t be saved because the root canals are not accessible, the root is severely fractured, the tooth doesn’t have adequate bone support, or the tooth cannot be restored. However, advances in endodontics are making it possible to save teeth that even a few years ago would have been lost. When endodontic treatment is not effective, endodontic surgery may be able to save the tooth.