Saving Teeth from the Inside

Endodontics is the branch of dentistry concerned with the dental pulp, the soft tissue inside the tooth. When infection, inflammation, or injury affects the pulp, endodontic treatment can address it and, in many cases, keep the natural tooth.

The pulp contains the nerves and blood vessels that nourished the tooth while it developed. It runs from the inner chamber of the tooth down through one or more root canals to the tip of the root.

Once a tooth is fully developed, it can survive without the pulp, because the surrounding bone and gum continue to nourish it. That means diseased or damaged pulp tissue can often be removed without losing the tooth itself.

Endodontic treatment is considered when the pulp inside a tooth has been compromised by infection, inflammation, or physical injury. This can happen because of:

• Deep decay that has reached the pulp chamber
• A crack or fracture that extends into the pulp (see cracked tooth treatment)
• Trauma to the tooth, such as a blow that damages the nerve even without a visible fracture (see traumatic dental injuries)
• Repeated dental procedures on the same tooth, which can affect the pulp over time
• A tooth that has become non-vital (the pulp has died)

Sometimes there are noticeable symptoms, such as pain, swelling, or sensitivity. Other times, pulp problems are found on x-rays or during an exam before any symptoms appear.