An Endodontist Describes Severe Root Canal Cases

An endodontist treats tooth infections with root canal therapy. Although many dentists can provide this treatment, additional training may be necessary to treat the most severe cases. 

What types of root canal cases require an endodontist's input? 

The goal of root canal therapy is tooth loss prevention. Still, various factors can complicate the procedure, making the experience and training of dentists with advanced endodontic training invaluable.

Hidden canals

Persistent pain following root canal therapy may signify an infection within canals invisible on X-rays.  Unfortunately, by the time an endodontist discovers a concealed root canal infection, it is usually advanced. 

Calcified canals

Calcification of an infected root canal can leave little room for a dentist to insert instruments to extract the diseased pulp. Calcium deposits can also conceal an infection until it poses severe symptoms that could rapidly cause tooth loss.

Inadequate canal filling

After removing infected pulp tissue, a dentist packs the empty canal with a rubber-like substance before sealing it with cement to prevent bacteria from re-entering. If the rubber does not sufficiently fill the space, bacteria can re-infect the pulp chamber.

Teeth cracks

Cracked teeth are susceptible to bacterial infiltration. Cracks near a tooth's root can extend toward the chewing surface, where bacteria can quickly enter, progress through root canals, and ultimately infect the jawbone.  

Jawbone abscess

A severe root canal infection can cause a painful pus-filled abscess to form at the bottom of a tooth's root or in the jawbone if it advances. Root canal cases involving jawbone abscesses are particularly severe, putting teeth at risk and potentially causing systemic infections.

How does an endodontist treat severe root canal cases?

Endodontists apply various methods and technologies to treat severe root canal infections. Although avoiding extraction is a significant concern, preventing the bacteria from spreading is paramount.

Re-treatment

Root canal infections can return in cases involving improperly sealed canals. An endodontist can re-open the tooth, remove the existing rubber canal filler, and carefully examine the tooth's interior, looking for signs of infection to remove before re-sealing the tooth. 

Reliance on advanced technology

Highly sensitive radiography, CT scanning, and high-magnification dental microscopes can help obtain multi-dimensional views of a tooth's interior. These technologies, along with knowledge of complex tooth anatomy, facilitate the cleaning of hidden canals to prevent infections from spreading.

Re-shaping and cleaning roots

Endodontists use state-of-the-art equipment and methods to treat narrow canal infections. In addition to powerful imaging technology, endodontists use tools that re-shape root channels along with ultrasonic and hand-held instruments to clean calcified root chambers thoroughly.  

Apicoectomy 

Apicoectomy surgery can treat severe infections at the root tip and jawbone when standard root canal therapy is ineffective. The surgeon enters the gum, cuts away the root's infected tip, and removes the infected pulp. The procedure is often the only alternative to extraction.

Conclusion

An endodontist can provide advanced treatment for the most severe root canal cases that standard treatment protocols cannot address. Still, prompt treatment at the earliest signs of infection can prevent unnecessary dental complications.

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