An Endodontist is a dentist who has undergone a minimum of 2 years of extra postgraduate training. This Specialist training allows an Endodontist
to:

1. deal with diseases of the dental pulp and supporting structures
2. diagnose facial pain and related problems.

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. Welk's role is also that of educator. It is important that patients understand why they require treatment, what treatment involves and what they can do to ensure the best possible outcome. Dr. Welk believes that a properly informed patient has the best chance of achieving the optimal result.

What is a board certified endodontist or diplomate of the American Board of Endodontics?

To attain Board Certified, successful completion of the following three examinations is required.

1. The Written Examination tests a broad range of fields, including anatomy, biochemistry, pathology, immunology, microbiology, pharmacology, radiology, statistics, clinical endodontics and related disciplines.

2. The Case History Examination requires submission of documentation of a variety of cases from the endodontist’s own practice. The cases must be diverse and complex enough to demonstrate exceptional knowledge, skills, and expertise in the full scope of the field of endodontics.

3. The final phase of the Board Certification process is an Oral Examination. In the Oral Examination, a team of experts question the endodontist about a variety of endodontic diagnosis and treatment situations. Through the extensive interviews, a high level of skill in problem solving, decision making, analysis, creativity and evaluation must be demonstrated.

An endodontist, who has satisfied all requirements of the Board Certification process of the ABE, is declared Board Certified by the Directors of the ABE. This individual is a Diplomate of the American Board of Endodontics.

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 inflammation 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 prolonged sensitivity to heat or cold, discoloration of the tooth, swelling or tenderness 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 performed in a single appointment ranging from 30-60 minutes (depending on the number of canals). Once treatment is completed, you may be instructed to return to your dentist for permanent reconstruction. The restoration of the tooth is an important part of treatment because it seals the cleaned canals from the oral environment, protects the tooth and restores it to function.

Toothache type pain is the main reason for patients seeking treatment. Fortunately, modern anesthetics can make the procedure pain free in most cases. Seeking treatment early makes the procedure more comfortable, so don't wait. When caught early, treatment should feel no different than having a regular filling. For the first few days after treatment, there may be some sensitivity to biting pressure, especially if there was pain or infection before the procedure. Over-the-counter anti-inflammatory medications (like Advil) are recommended for a day or two. Dr. Welk can prescribe other medications but they are rarely required.

If you have further questions, contact our office at 503-855-4546.