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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 Canals: Everything You Ever Wanted to Know

Why are root canals done?

Root canal therapy is required when the nerve of the tooth becomes irreversibly damaged. This damage can occur from decay, trauma, or a crack in the tooth.

What is a common root canal symptom?

Pain, swelling, and sensitivity to hot or cold. Another indication of nerve damage is the tooth becoming darker in color. Sometimes, it can only be diagnosed with an x-ray or other tests by an endodontist.

What is done during a root canal procedure?

The purpose of root canal therapy is to clean out the infected tooth pulp tissue within the roots. After all the nerve has been removed, the canals are filled with a sealer.

How long will the procedure take?

Generally, root canals take one or two appointments for a front tooth (anterior), and two or three appointments for a back tooth (posterior). A tooth can have from one to four roots; all of the roots must be treated. Difficult cases may require even more visits.

Will the tooth need any more work after the treatment is finished?

Yes, the tooth will require a permanent restoration. This could range from a simple filling to a large build-up with posts and pins. The tooth is more brittle after a root canal treatment and therefore is more susceptible to fracture. If the filling is large, the tooth may need a crown as well. A crown protects the tooth from breaking.

Isn't it simpler to take out the tooth?

It may seem simpler to have the damaged tooth removed; however, it is really much healthier and more economical to save it. If the extracted tooth is not replaced, the teeth next to it can drift into the empty space. Replacing an extracted tooth involves either expensive bridgework or a partial denture.

Will the root canal procedure hurt?

During the actual treatment, your tooth will be numb as it would be for simply filling a cavity. The treatment is usually started because the tooth is sensitive; it may take a day or two for the tooth to get back to normal. Generally a mild painkiller is enough to keep you comfortable during this time. If something stronger is needed, your endodontist will prescribe it. If the tooth is badly infected, an antibiotic may be needed as well.

How much will it cost?

The cost of root canal treatment and therapy varies with the number of canals which need to be treated. There will be a separate charge for the restoration, depending on the extent of the procedure. Your dentist will be glad to discuss the charges with you for all the expected treatment.

+Jim Du Molin is a leading Internet search expert helping individuals and families connect with the right dentist in their area. Visit his author page.