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Dental Visits - The Endodontic Examination Appointment

On most occasions, the endodontic examination and the endodontic consultation take place at the same visit. Most dentists prefer this. This section will look at each process separately.

What Is the Purpose of the Endodontic Examination?

The purpose of the endodontic examination is to determine the state of health of the pulpal tissues of a tooth or group of teeth. The dentist hopes to collect specific information to assist in diagnosis and treatment planning. During the examination portion of the visit, the dentist will:

• Review the patient's medical history and evaluate the patient's current medical status and in order to determine how it might influence the dental diagnosis and/or treatment plan.
• Review the patient's dental history and, in particular, its relationship to the specific reason for the visit, also called the "chief complaint."
• Perform a thorough clinical examination.
• Perform certain endodontic tooth tests to help establish an accurate diagnosis of the condition of the pulpal tissue.
• Perform a radiographic examination. Two or three different radiographic angles of the same area are often required to adequately visualize the various teeth, the root canal spaces within each tooth, and the surrounding bone and structures. Since a single radiograph is a two-dimensional picture of a three-dimensional object, two or more radiographs with different angulations can provide important additional information. Radiographs reveal many things that the dentist is unable to see with the clinical examination alone.

What Is the Purpose of the Endodontic Consultation?

The purpose of the endodontic consultation is to present a root canal treatment plan to the patient. Once the dentist has collected and evaluated all of the diagnostic information, the goals of the consultation visit are to:

• Share the examination findings and the resultant diagnosis with the patient.
• Discuss the prognosis.
• Discuss the treatment recommendations and any perceived complications.
• Discuss the treatment alternatives and their respective ramifications.
• Discuss the number and length of appointments necessary to complete the recommended treatment.
• Review the cost of the recommended treatment and the various treatment options.
• Answer questions that the patient may have regarding the diagnosis and various treatment options.

On occasion, the dentist may need to consult with other professionals or obtain additional information before all of the goals listed above can be accomplished.

By Clifford J. Ruddle, DDS, in collaboration with Philip M. Smith, DDS

Root Canal Dentist, Tooth Pain and Endodontic Disease

What Are the Most Common Symptoms of Endodontic Disease?

Endodontic disease can manifest itself with a wide variety and combination of symptoms. Common symptoms of endodontic disease include:

• Lingering tooth sensitivity to cold liquids.
• Lingering tooth sensitivity to hot liquids.
• Tooth sensitivity to sweets.
• Tooth pain to biting pressure.
• Tooth pain that is referred from a tooth to another area, such as the neck, temple, or the ear.
• Spontaneous toothache, such as that experienced while reading a magazine, watching television, etc.
• Constant or intermittent tooth pain.
• Severe tooth pain.
• Throbbing tooth pain.
• Tooth pain that may occur in response to atmospheric pressure changes, such as when flying or scuba diving.
• Tooth pain that may occur in response to postural changes, such as when going from a standing to a reclining position.
• Tooth Swelling.

If you have any of these symptoms, it would be wise to see your dentist because you might have root canal disease or another dental problem.

Some of these endodontic disease symptoms may also be attributable to decay, defective fillings, periodontal diseases, cracked teeth, or other tooth or bite-related problems.

On other occasions, the symptoms may even be caused by disorders that are not related to the teeth.

Why May Endodontic Disease Cause Swelling?

When the pulpal tissue becomes severely diseased and necrotic, the resultant infection can spread from inside the tooth into the adjacent bone and soft tissues. As a result, swelling can occur in the tissues immediately surrounding the tooth.

If this situation is not treated and the endodontic disease process is not kept under control by the body's defenses, the infection can begin to spread into other tissue spaces, such as those around the eye or in the neck. In some situations, this can become a serious medical emergency.

By Clifford J. Ruddle, DDS, in collaboration with Philip M. Smith, DDS

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