General Information

An endodontist is a dentist who has undergone a minimum of two years of postgraduate training after four years of dental school.  Endodontics, from the Greek endo (inside) and odons (tooth), is a one of the nine specialties of dentistry recognized by the American Dental Association, and deals with the tooth pulp and the tissues surrounding the root of a tooth.

This specialty training allows an endodontist to be the most qualified dentist to diagnose and treat injuries, diseases, and infections of the tooth pulp.
Your general dentist sometimes refers patients for consultation when the diagnosis is complicated or when treatment is more difficult than normal. Aside from providing treatment, Dr. Horalek's role is also that of educator. It is important that patients understand why they require treatment, what treatment involves and what he/she can do to ensure the best possible outcome.  Dr. Horalek believes that a properly informed patient has the best chance of achieving the optimal result.

Endodontics is a specialty of dentistry that deals with diseases of the dental pulp and its supporting structures. Endodontists are dentists with special post-graduate training in this field. Endodontists are also experienced at finding the cause of oral and facial pain that has been difficult to diagnose.

Although general dentists can perform endodontic treatment, patients are often referred to an endodontist when the case is complicated or more difficult than usual.

In order to understand endodontic treatment, it helps to know something about the anatomy of a tooth. Teeth have several layers. The outside layer of the tooth is composed of a hard layer called enamel. Enamel is supported by an inner layer called dentin, which has at its center a soft tissue known as the pulp.

The pulp contains blood vessels, nerves, and connective tissue that are responsible for forming the surrounding dentin and enamel during tooth development. The pulp receives its nourishment supply from vessels which enter the end of the root.  Although the pulp is important during development of the tooth, it is not necessary for function of the tooth. The tooth continues to be nourished by the tissues surrounding it even after the pulp is removed.

Endodontic treatment is necessary when the pulp becomes inflamed or infected. The most common reasons for inflammation or infection are deep cavities (caries), repeated dental procedures, cracks or chips. Trauma can also cause the blood supply to be disrupted with subsequent pulpal death, and often shows up as discoloration of the tooth. If pulp inflammation or infection is left untreated, it can cause pain or lead to an abscess.

Indications for treatment include lingering sensitivity to heat or cold, discoloration of the tooth, swelling, and tenderness or drainage of the tooth or adjacent gums.  Sometimes there are no symptoms.

The endodontist removes the inflammed or infected pulp, carefully cleans and shapes the canal system and then seals the prepared space. Most treatment is now usually performed in a single appointment ranging from one to two hours (depending on the number of canals and complexity). Sometimes two treatment appointments are required.  Once treatment is completed, the tooth will require a definitive restoration and posterior teeth will most often require a crown to prevent fracture.  The adequate restoration of the tooth is an important part of treatment, because it helps seal the cleaned canals from the oral environment, protects the tooth, and restores it to function.

Toothache pain is the main reason for patients seeking treatment. Fortunately, modern local anesthetic techniques make the procedure pain- free in most cases. Seeking treatment early makes the procedure more comfortable and increases the treatment prognosis, so don't wait.  When caught early, treatment should feel no different than a long filling appointment.   There may be some subsequent tenderness to biting pressure immediately following treatment, especially if there was pain or infection before the procedure. Sometimes over-the-counter anti-inflammatory medications (like Advil or ibuprofen) are recommended for a day or two.  Dr. Horalek can prescribe other medications, but they are rarely required.