Endodontists are dentists who specialize in maintaining teeth through endodontic therapy – procedures, involving the inner tissues of the teeth, called the pulp (or nerve).  The word "endodontic" comes from "endo" meaning inside and "odont" meaning tooth.  All dentists are trained in diagnosis and endodontic therapy, however, some teeth can be especially difficult to diagnose and treat.  That’s why you may have been referred to an endodontic specialist.

An Endodontist is a dentist who has undergone a minimum of two years of advanced postgraduate training beyond dental school.  They study root canal techniques and procedures in greater depth, for diagnosis and treatment of more difficult cases.  For this reason, many dentists choose to refer their patients to Endodontists.  Dr. Baur received his advanced postgraduate training in endodontics at the University of Florida College of Dentistry from 2005-2007.

Dr. Baur is Board Certified by the American Board of Endodontics.  Board certification is an elective process that an endodontist may complete after graduating from an ADA approved postgraduate program.  Board certification involves a written examination to demonstrate knowledge in a broad range of fields related to endodontics, submission of a variety of cases from his/her own practice that demonstrate skills and expertise in the full scope of the field of endodontics, and an oral exam demonstrating clinical problem solving and decision making related to treatment of endodontic disease.

In addition to providing quality treatment, Dr. Baur is also committed to his role as an educator.   It is important that patients understand why they require endodontic treatment, what treatment options are available, what treatment may involve, the likelihood of success for each treatment option and what they can do to ensure the best possible outcome.

A root canal is a common dental procedure performed to save a tooth that may otherwise need to be extracted.  In order to understand the root canal procedure, it helps to review the anatomy of the tooth.  Teeth have several layers.  The outer surface of the tooth is composed of a hard enamel layer.  Supporting this layer is an inner dentin layer, which has at its center a soft tissue referred to as pulp.

The pulp contains blood vessels, nerves and other supporting tissues that are primarily responsible for forming the hard outer layers of the tooth during development.  After development of the tooth, the pulp is no longer necessary for function of the tooth.

Endodontic treatment becomes necessary when the pulp becomes inflamed or the canals containing the pulp become infected.  The most common reasons for inflammation or infection inside the tooth are deep decay, trauma, cracks and fractures, or multiple/repeated dental procedures.  Symptoms associated with endodontic inflammation or infection include an abnormal or prolonged sensitivity to cold or hot, biting sensitivity, tenderness deep in the bone, spontaneous throbbing pain, discoloration of the tooth, or swelling.  Sometimes there are no symptoms and the results of the inflammation or infection are visualized on diagnostic xrays.  Left untreated, inflammation of the pulp or infection of the canals can lead to pain, abscess and eventual loss of the tooth.  If you experience any of these symptoms, your dentist will likely recommend root canal treatment to save your tooth, relieve pain and eliminate infection.

During the root canal procedure, the inflamed pulp is removed and the root canal system is thoroughly cleaned and sealed.  Root canal treatment is performed under local anesthetic.  The procedure should not be painful.  Dr. Baur takes extra precautions prior to initiating any treatment to make certain that patients are comfortable and that the tooth and the surrounding tissues are completely anesthetized.  Root canal treatment is typically completed in one appointment in our office, but the number of visits depends on your particular case.  Some reasons a tooth may need a second appointment are calcified roots, significant inflammation or infection, significant root curvatures or difficult root anatomy.  Occasionally more than two appointments are needed.  It is more important to do the very best we can, than to meet a specific time criteria. 

Success for root canal treatment occurs in approximately 90% of cases.  Factors affecting the success of the root canal procedure include the amount of natural tooth structure remaining after removal of decay, trauma, cracks extending into the root, long standing or chronic infections, the health of the supporting bone and gingival tissues and prompt restoration of your root canal treated tooth by your restorative dentist.  If your tooth is not amenable to endodontic treatment or the chance of success is unfavorable, you will be informed at the time of consultation or when a complication becomes evident during or after treatment.

After your root canal treatment has been completed in our office, a report will be sent to your restorative dentist.  You should contact their office for a permanent restoration within a few weeks after finishing in our office.  We recommend that a full coverage crown be placed on all root canal treated posterior teeth such as molars or premolars and occasionally on anterior teeth depending upon the amount of tooth structure remaining.  Your restorative dentist will decide what type of restoration will be most appropriate for protecting your endodontically treated tooth.  

Oral pain such as toothaches or cracked/fractured teeth can often be difficult to pinpoint.  Because of the vast network of nerves in the mouth, the pain of a damaged or diseased tooth often is felt in another tooth and/or in the head, neck or ear.  An Endodontist is a specialist in diagnosing this type of pain.  Once the offending tooth is identified, Dr. Baur will discuss treatment options with you to eliminate the pain.

Pulp damage can sometimes be caused by trauma to the teeth, such as a blow to the mouth or an accident.  An Endodontist specializes in treating these traumatic injuries.  

Occasionally a tooth that has undergone endodontic treatment fails to heal or pain continues despite therapy.  Although rare, sometimes a tooth initially responds to endodontic therapy but becomes painful or infected months or years later.  When either of these situations occur, the tooth often can be maintained with a second endodontic treatment.   Root canal retreatment is typically completed in two appointments in our office, but the number of visits depends on your particular case.  Retreating a tooth that has already had endodontic treatment is frequently more difficult than initial root canal treatments.  Root canal filling materials need to be removed as well as any material placed in the canals for support such as posts.  Previously root canal treated teeth often have obstructions that may need to be overcome to completely clean the root canal system.  These obstructions include ledges, calcifications, separated instruments or difficult to remove filling materials.  Spreading the treatment over two appointments gives Dr. Baur additional time to properly treat the tooth while keeping the patient comfortable.  Equally important, at the first appointment Dr. Baur places a medicated paste in the roots of the tooth that actively disinfects the tooth even when the patient is not in the chair.  Occasionally this medication may need to be replaced over multiple visits to adequately control the infection or inflammation associated with a tooth.

Typically a root canal is all that is needed to save an inflamed or infected tooth from extraction.  Occasionally, root canal treatment or retreatment will not be sufficient for your tooth and the surrounding tissues to heal properly.  In these cases Dr. Baur may discuss a surgical option to attempt to save the tooth from extraction.

During an apicoectomy procedure, an incision is made in the gum tissue to expose the underlying bone.  A small opening is created in the bone over the tip of the root to expose the disease area.  The diseased tissue is removed and the root tip cleaned and sealed with a root end filling.  Sutures are used to hold the gum tissue back in place.  Surgical endodontic treatment is performed under local anesthetic.  The procedure should not be painful.  Dr. Baur takes extra precautions prior to initiating any treatment to make certain that patients are comfortable and that the tooth and the surrounding tissues are completely anesthetized.  Endodontic Surgery is completed in one appointment.  A second appointment, typically one week following the surgery, is needed to remove any sutures that are still present and to check the healing of the gum tissues.  Bone will naturally heal around the root over a period of months, during which time the patient should not have any symptoms.

For additional information about your endodontic procedure, including guidelines for post-treatment care and education videos, please visit the American Association of Endodontists' website by clicking on the link to the right.