What This Guide Covers
Endodontists are dental specialists who treat the soft tissue inside teeth, relieve tooth pain, and perform root canals focused on saving teeth.[11]
This guide explains what do endodontists do, the conditions they treat, and how endodontic treatment works. It is written for patients who are experiencing tooth pain, who have been told they need a root canal, or who were referred to a specialist by a general dentist. You will also learn how these specialists approach treating tooth pain, what affects cost, and when to choose a specialist over a general dentist.
Endodontics is one of several recognized dental specialties. For a broader look at the field, visit the endodontics page. This article focuses on the daily work these specialists do and how their care helps save your natural teeth.
What Endodontists Do and How They Train
Wondering what do endodontists do? They diagnose problems inside the tooth, treat the dental pulp, and perform root canals that general dentists refer to them.[11]
Training Beyond Dental School
Every endodontist first finishes dental school and earns a general dental degree. After that, they complete two or more years of training beyond dental school in an accredited program. This is the same path other dental specialists follow when they focus on one area. Because of this added training, endodontists perform root canals every day and treat the complex cases that general dentists send to them.[11]
Clinical guidelines help endodontists give consistent care. According to the European Society of Endodontology, structured guidelines support decisions about diagnosis, root canal therapy, and follow-up.[2] These standards aim to improve outcomes and help patients understand their treatment options.[2]
Conditions Endodontists Treat
Endodontists treat problems that begin inside the tooth. The most common reason for a visit is pain that does not go away. Lingering tooth pain, sensitivity to hot or cold, and swelling can all signal that the pulp is inflamed or infected. A diseased tooth often needs root canal treatment to remove the infection and stop the pain.
Endodontists also manage traumatic dental injuries, such as a tooth that is cracked, knocked loose, or knocked out. Fast care after an injury can improve the chance of saving teeth. In children and young adults, the specialist weighs the age of the tooth and the health of the pulp before choosing a procedure.[3]
- Severe pain or lingering pain when biting down
- A diseased tooth with deep decay or infection
- Traumatic dental injuries to the teeth or roots
- A tooth that needs retreatment after an earlier root canal
A Focus on Saving Natural Teeth
The main goal of this specialty is keeping your natural teeth. A root canal lets a damaged tooth stay in place and keep working, which protects your bite and the teeth next to it. Keeping a natural tooth is often better for long-term oral health than removing it and adding a replacement.[11][12]
When the pulp is still healthy enough, endodontists may try to protect it instead of removing it. Vital pulp therapy is a treatment that aims to keep the living pulp alive after deep decay or injury. A systematic review and meta-analyses of vital pulp therapy in permanent teeth reported encouraging results, though success varies by case.[4] Researchers are also studying regenerative endodontics, which uses the body's own cells to help repair damaged pulp tissue, in recent clinical trials.[6]
What to Know Before You See an Endodontist
See an endodontist when pain in a tooth lasts, when a dentist refers you, or when a root canal is complex.
Most patients reach an endodontist through a referral. Your general dentist may send you when a case needs special tools or extra experience. You can also ask for a referral if you are experiencing tooth pain that does not improve. Bring any recent X-rays, a list of your medicines, and your dental insurance details to the first visit.
A root canal can be done on adults and children once a tooth has formed. In permanent teeth, the choice between a full root canal and vital pulp therapy depends on how healthy the pulp is.[3] In baby teeth, vital pulp therapies are common and help keep the tooth until it falls out on its own.[5] For traumatic dental injuries, see a specialist quickly, since fast care improves the odds of saving the tooth.
Before treatment, the endodontist examines the tooth, tests how the pulp responds, and takes images. Some offices use cone-beam CT, a 3D scan that shows the tooth and roots in detail.[8] This helps the specialist find hidden canals and plan the endodontic procedure.
What to Expect During a Root Canal
During root canal therapy, the endodontist numbs the tooth, removes the infected pulp, cleans the canals, and seals the space.[2]
Most root canals take one or two visits. First, you get local anesthesia so the area is numb. The endodontist places a thin sheet called a dental dam to keep the tooth clean and dry. Then they make a small opening in the top of the tooth to reach the pulp.
Next, the specialist removes the diseased pulp and cleans each canal inside the root. They shape the canals and fill them with a rubber-like material that seals the space. A filling closes the opening. In many cases, your general dentist later adds a crown to protect the tooth.
Some teeth need more than a standard root canal. When infection stays near the tip of the root, an endodontist may perform endodontic surgery called apical microsurgery. A systematic review and meta-analysis found that this surgery has favorable long-term outcomes for many patients.[10] Newer planning tools, including guided endodontics, can make the procedure more precise.[9] Mild soreness for a few days after any root canal is common and usually eases with over-the-counter pain medicine.
- Numbing the tooth with local anesthesia
- Removing the infected pulp and cleaning the canals
- Sealing the canals and closing the opening
- Returning to your general dentist for a crown in many cases
What Affects the Cost of Endodontic Treatment
The cost of root canals depends on the tooth, the number of canals, and how complex the case is. Costs vary by location, provider, and case complexity.
Back teeth, such as molars, have more canals than front teeth, so they usually take more time and cost more. Retreatment of a failed root canal and endodontic surgery often cost more than a first-time procedure. A crown to restore the tooth afterward is a separate cost handled by your general dentist.
Many dental plans cover part of the cost, but yearly limits and maximums vary. Ask the office for a written estimate, and check what your plan pays before treatment begins. When you compare treatment options, weigh the cost of saving a natural tooth against removing it and adding an implant or bridge, since a replacement can cost more over the years.
When to See an Endodontist Instead of a General Dentist
See an endodontist when pain is severe or lingering, when a tooth is injured, or when a root canal is complex.
General dentists handle many simple root canals on their own. They refer patients to endodontists for harder cases, such as teeth with curved or extra canals, a previous root canal that needs retreatment, or unclear sources of pain. Endodontists are dental specialists who focus only on this work, so they bring extra training to difficult problems.
If you are experiencing tooth pain, do not ignore it. Early care protects the pulp and improves the chance of saving teeth. Many patients have worries about the procedure, and research shows these concerns are common, so ask your dentist or endodontist to explain your options.[1]
- Severe pain or lingering pain that does not improve
- Swelling, a gum pimple, or other signs of infection
- Traumatic dental injuries to a tooth or its root
- A previous root canal that still hurts and may need retreatment
- A diseased tooth your general dentist finds too complex
Find an Endodontist Near You
If you need endodontic care, you can find a specialist who focuses on root canals and saving teeth. Look for an endodontist whose training and experience match your case, and bring your referral and records to the first visit. Be careful with online videos about procedures like endodontic surgery, since their quality varies widely.[7] To learn more about the specialty, visit the endodontics page, and remember that early care helps protect your natural teeth and your long-term oral health.
Search Endodontists in Your Area
