The main purpose of a root canal (endodontic treatment) is saving your natural tooth. The alternative to a root canal is the extraction of a tooth. Nothing can truly replace what was biologically designed as a functioning natural tooth. Well over 22 million endodontic procedures are performed each year; nearly 15 million are root canals. The endodontic treatment removes the injured pulp (soft inner tissue) of your tooth and fills and seals the space.

If your tooth cannot be saved — and some cannot — you may consider replacements such as a bridge or dental implant. Your options may depend upon the condition of surrounding teeth and bone structure. Dental implant procedures can be complex, costly and they often require several visits and several months’ healing time before the procedure can be completed.

The cost associated with an endodontic treatment can vary depending on factors such as the severity of damage to the affected tooth and which tooth is affected. In general, endodontic treatment is much less expensive than tooth removal and replacement with an artificial tooth. Do everything possible to save your teeth before considering extraction. Nothing is as good as your natural tooth!

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. If you have severe pain that lasts more than a few days, call your endodontist.

Your dentist or endodontist is suggesting endodontic surgery because he or she believes it is the best option for saving your own natural tooth. Of course, there are no guarantees with any surgical procedure. Your endodontist will discuss your chances for success so that you can make an informed decision.

When the outer hard tissues of the tooth are cracked, chewing can cause movement of the pieces and the pulp can become irritated. When biting pressure is released, the crack can close quickly resulting in a momentary, sharp pain. Irritation of the dental pulp can be repeated many times by chewing. Eventually the pulp will become damaged to the point that it can no longer heal itself. The tooth will not only hurt when chewing but may also become sensitive to temperature extremes. In time a cracked tooth may begin to hurt all by itself. Extensive cracks can lead to infection of the pulp tissue, which can spread to the bone and gum tissue surrounding the tooth.

Cracked teeth show a variety of symptoms, including erratic pain when chewing, possibly with release of biting pressure, or pain when your tooth is exposed to temperature extremes. In many cases, the pain may come and go, and your dentist may have difficulty locating which tooth is causing the discomfort

There are many different types of cracked teeth. The treatment and outcome for your tooth depends on the type, location, and extent of the crack.

Unlike a broken bone, the fracture in a cracked tooth will not heal. In spite of treatment, some cracks may continue to progress and separate, resulting in loss of the tooth. Placement of a crown on a cracked tooth provides maximum protection but does not guarantee success in all cases.

The treatment you receive for your cracked tooth is important because it will relieve pain and reduce the likelihood that the crack will worsen. Once treated, most cracked teeth continue to function and provide years of comfortable chewing. Talk to your endodontist about your particular diagnosis and treatment recommendations; (s)he will advise you on how to keep your natural teeth and achieve optimum dental health.

While cracked teeth are not completely preventable, you can take some steps to make your teeth less susceptible to cracks.

• Don’t chew on hard objects such as ice, un-popped popcorn kernels or pens.
• Don’t clench or grind your teeth.
• If you clench or grind your teeth while you sleep, talk to your dentist about getting a retainer or other mouth-guard to protect your teeth.
• Wear a mouth-guard or protective mask when playing contact sports.

Chipped teeth account for the majority of all dental injuries. Dislodged or knocked-out teeth are examples of less frequent but more severe injuries. Treatment depends on the type, location and severity of each injury. Any dental injury, even if apparently mild, requires examination by a dentist or an endodontist immediately. Sometimes neighboring teeth suffer an additional, unnoticed injury that will only be detected by a thorough dental exam.

Chipped primary (or “baby”) teeth can be esthetically restored. Dislodged primary teeth can, in rare cases, be repositioned. However, primary teeth that have been knocked out typically should not be replanted. This is because the replantation of a knocked-out primary tooth may cause further and permanent damage to the underlying permanent tooth that is growing inside the bone.

Children’s permanent teeth that are not fully developed at the time of the injury need special attention and careful follow up, but not all of them will need root canal treatment. In an immature permanent tooth, the blood supply to the tooth and the presence of stem cells in the region may enable your dentist or endodontist to stimulate continued root growth.

Endodontists have the knowledge and skill to treat incompletely formed roots in children so that, in some instances, the roots can continue to develop. Endodontists will do all that is possible to save the natural tooth. These specialists are the logical source of information and expertise for children who are victims of dental trauma.

The nature of the injury, the length of time from injury to treatment, how your tooth was cared for after the injury and your body’s response, all affect the long-term health of the tooth. Timely treatment is particularly important with dislodged or knocked-out teeth in order to prevent ‘root resorption’.

Resorption occurs when your body, through its own defense mechanisms, begins to reject your own tooth in response to the traumatic injury. Following the injury, you should return to your dentist or endodontist to have the tooth examined and/or treated at regular intervals for up to five years to ensure that root resorption is not occurring and that surrounding tissues continue to heal. It has to be noted that some types of resorption are untreatable.