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Endodontics Working Challenges

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By Author: Dr C R Rajkumar
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Endodontists are in the role of rescuing dying teeth, i.e. who have been suffered in teeth pulp. Their procedure of choice is the root canal, and their tools tend to be burs, files and irrigants. They may also use technologies such as operating microscopes, electronic apex locators, ultrasonics and digital imaging, to perform their services.

Goerig has a unique perspective on the state of his profession. Not only that he practices endodontic at Northwest Endodontic Specialists, a two-doctor practice in Olympia, Wash., but since 1996, he has been coaching & training endodontists around the country on how to improve their operations. He figures he has coached a couple of hundred of the roughly 4,800 endodontists who practice in the United States today.
Initial Training Challenges
Despite most dentists receive training in endodontic treatment in dental school, and are capable of doing routine root canal treatment, there are many procedures that are more complicated and are best left in the hands of specialists, says Goerig. "The greatest enemy of the general practitioner is unpredictability." For example, a general dentist may find himself, after a couple of hours working on a patient, unable to get down a root canal that has become calcified. He or she then has to refer the patient to the endodontist. “General Dentists can be much more profitable if they refer these cases out," he says.

Another challenge facing endodontist is the familiar of dental implants. Instead of saving a tooth through root canal treatment, some dentists elect to pull it and insert an implant and crown. First of all, a root canal is cheaper and quicker than an implant, which requires multiple visits over several months. More important, dental literature shows that root canals enjoy the same high rate of success as implants - around 97%, he says. "If you asked the patient, they would rather have their own tooth instead of an implant, but many times they are not given the option." For these reasons, many endodontists are now doing implants to help their patients in an unbiased decision-making process, as they contemplate an implant, he says. "We want to make sure the diagnosis is exact, and that the tooth absolutely cannot be saved through a root canal."
Patients management with Systemic Complications
When a tooth becomes infected and painful, the dentistry provides two possibilities. However, many individuals select the option of saving the teeth rather than extraction option. Endodontic treatment is a judicious procedure of removing the infected dental pulp and periradicular exudates using appropriate instruments and biocompatible chemicals in adjunct to medicaments to preserve the inert nature of the tooth. When the procedure is carried out in healthy individuals, it is enough to concentrate on the technical course of action, but when there is an insistence to uphold the tooth for patients with systemic illness and who are under medical management, it is equally significant to avoid the potential medical emergencies. Hence, practitioners must know the common diseases, and drugs that have an impact in endodontic treatment and the management options in such cases. This review aims to indicate the clinical conditions that require special endodontic attention.

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