The word 'Endodontic'' comes from the Greek "endo" meaning inside and "odont" meaning tooth.  Endodontic therapy, therefore, involves treatment of the soft tissue inside the tooth called the 'pulp'. This is a very complex, unique piece of tissue from which the tooth develops.  Root canal treatment  becomes necessary when this piece of tissue is irreversibly damaged - this usually occurs following dental decay or trauma.

All dentists are trained in diagnosis and endodontic therapy, however some dental problems can be especially difficult to diagnose due to the complexity of the nervous system. Treatment of some teeth can also be difficult due to the complexity of the root canal anatomy.

In the UK, in addition to five years at dental school, endodontists receive further formal advanced education and training before they are accepted on to the Endodontic Specialist Register by the General Dental Council. They study root canal anatomy, treatment techniques and procedures in greater depth, for diagnosis and treatment of more difficult cases. They use their special training and experience in treating these difficult cases, such as teeth with narrow or blocked canals, or unusual anatomyans because they limit their practices to endodontics, they treat these types of problems every day.

For this reason, many dentists choose to refer their patients to specialist endodontists who use advanced technology, such as operating microscopes, ultrasonics and digital imaging, to perform these special services.

Retaining your natural tooth should always be your first choice. 

From the outside, a tooth looks like a hard, solid substance, but this diagram shows that a tooth is really a complex system of various  tissues.

Local anaesthetic is always used in various techniques to achieve adequate anaesthesia. The treatment consists of three or four basic steps, but the number of visits will depend on your particular case. Most treatments take 2 visits; very occasionally 3 appointments are needed; this will all be dependant on the stage of infection/inflammation and degree of treatment difficulty. To us, it's more important to do it  to the best of our ability rather than to meet a specific time criteria.

Endodontic treatment involves the following steps:

1. The endodontist examines and x-rays the tooth, then administers local anaesthetic. 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. It's a bit like using drapes around an operation site.

Oral pain can often be difficult to pinpoint due of the vast network of nerves in the mouth and  the pain of a damaged or diseased tooth often is felt in another tooth and/or in the head, neck, or ear. An endodontist is a specialist in diagnosing and treating this type of pain.

Pulp damage is sometimes caused by a blow to the mouth, and the endodontist specialises in treating these traumatic injuries. For example, a blow to a child's permanent tooth that is not fully developed can cause the root to stop growing. A procedure called apexification stimulates bone to be deposited at the end of the root which makes it possible to then save the tooth through a root canal procedure. An endodontist is specially trained in procedures for replanting teeth that have been knocked out of their sockets.

Sometimes, following trauma, particularly in children,  it may not be necessary to carry out root canal treatment immediately. Every effort  should be made to maintain a healthy pulp to allow the root to mature. Endodontists are trained to test and monitor such cases and know when  to intervene and which treatments to carry out.

Once endodontic therapy is completed, your tooth may need to be examined periodically, usually after 12 months.  This allows us to make sure the tissue aroun the tip of the roots has healed or is healing properly.  You will be sent a reminder when we feel it is appropriate to re-evaluate the treated area.   Occasionally complete healing of a large abscess can take longer and  the practice will  reevaluate the tooth, if necessary, for several years.

Occasionally a tooth that has undergone endodontic treatment fails to heal or pain continues despite therapy and may require retreatment; this can occur with any dental or medical procedure. A tooth may not heal as expected after initial treatment for a variety of reasons, but a simple way of explaining this is to say that problems persist either due to certain pathogenic bacteria surviving in the tooth or managing to get back in later. These causes are detailed below:

• Narrow or curved canals were not treated during the initial procedure.
• Complicated canal anatomy went undetected in the first procedure.
• The placement of the crown or other restoration was delayed following the endodontic treatment.
• The restoration did not prevent salivary contamination to the inside of the tooth.

In other cases, a new problem can jeopardise a tooth that was successfully treated. For example:

• New decay can expose the root canal filling material to bacteria, causing a new infection in the tooth.
• A loose, cracked or broken crown or filling can expose the tooth to new infection.
• A tooth sustains a fracture