Endodontic therapy is commonly known as “root canal”. “Endo” is the Greek word for “inside” and “odont” is Greek for “tooth”. Endodontic therapy treats the inside of the tooth.

Understanding endodontic therapy 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.

The objective of performing root canal therapy is to remove the diseased tissue within the root canal system. The pulp, which supplies the blood supply and the nerve inside the tooth, can become inflamed or infected due to deep decay, repeated dental procedures, and/or cracks or chips in fillings or teeth. The symptoms associated with root canal treatment include lingering pain to cold or hot, inability to chew, and/or spontaneous pain. Swelling and tenderness around the gum tissue at or near the end of the roots can also be symptoms of an infected tooth.

“Root canal therapy is an attempt to retain a tooth which may otherwise require extraction. Although root canal therapy has a high degree of success, it cannot be guaranteed. Occasionally a tooth which has had root canal therapy may require retreatment, surgery, or even extraction.”

In a few cases where nonsurgical endodontic therapy cannot save the tooth, endodontic surgery becomes necessary. The basic idea is to clean out the infection at the end of the root and seal the root end with a filling. This procedure is called an “apicoectomy.”

Endodontic retreatment becomes necessary when a tooth does not heal after the initial root canal therapy. The reasons for this are numerous and can include:

• Narrow or curved canals could not be negotiated during the initial treatment.
• New decay under an old restoration.
• An ill-fitting restoration caused leakage of bacteria along the side of the root canal filling, therefore causing an infection.

Cracked teeth usually occur due to many years of grinding, clenching, and chewing on hard objects. Symptoms associated with cracked teeth include erratic pain upon chewing, especially during the release of biting, and extreme sensitivity to hot or cold. There are many different types of cracks, and these are as follows:

• Craze lines.
• Fractured cusps.
• Cracked tooth
• Split tooth.
• Vertical root fracture

There are several traumatic dental injuries that can occur.

1. Fractured or chipped teeth
2. Dislodged teeth
3. Avulsed teeth
4. Root fractures.

Fractured or chipped teeth can be repaired with a simple filling, or if the nerve is exposed, a root canal might be needed. Teeth can also be dislodged in several ways. Teeth can be pushed in and pushed partially out of the socket and malpositioned. Usually, stabilizing the teeth and testing them for vitality is all that is needed. If the nerve tests abnormally, then root canal therapy might be necessary. The worst prognosis is usually associated with avulsed teeth. This is because the supporting structures for the tooth can become irreversibly damaged. If the tooth is placed back in the socket within a reasonable period of time, then there is a chance to save that tooth. It is important not to handle the root of the tooth excessively and to place it in a moist environment. Milk, saltwater, or specific solutions sold at local drug stores are good mediums for preserving the tooth. Try to get to your dentist as soon as possible.