November 13, 2019

What is an Endodontist? Learn How an Endodontist Can Help You


So far in this series I have reviewed the seven different types of dentists and how they can help you, what a general dentist does, as well as answering what is a periodontist. Next up? We discuss what is an endodontist, tooth anatomy, causes of nerve pain, signs of a dead or necrotic nerve, what does an endodontist do, success of endodontic surgical procedures, how to avoid going to an endodontist and how to find top endodontic services in Coral Gables.

What is an Endodontist?

Many of my patients ask me, “What’s an endodontist?” According to the American Association of Endodontists (AAE), endodontists are highly skilled dental specialists in diagnosing and treating tooth pain and performing root canal treatment. They specialize in treating the infected pulp or the nerve of a tooth, plus the infected areas around the bone that supports the tooth. 

Similar to the additional training required for periodontists, endodontists attend a residency program for approximately two to three years after graduating from dental school. 

To better comprehend the answers to the questions what is an endodontist and what does an endodontist do, it helps to start with understanding the anatomy of a tooth, causes of nerve pain and signs of a dead or necrotic nerve.

Tooth Anatomy 

Teeth are made up of three distinct layers of dental tissue: the enamel, the dentin and the pulp or nerve. I’ll briefly review these three layers below.

1. Enamel

Enamel is the outer shell of the tooth. It’s a very hard biomaterial that actually has a higher hardness and mineral content than bone. This layer is usually 0.5 mm to 2.0 mm thick depending on which surface of the tooth is being viewed.

2. Dentin

The dentin is the next layer and it’s four times softer than the enamel. Inside of the dentin, the dentinal tubules connect to the nerve tissue. If exposed it can be sensitive and decay much more quickly than the enamel. If the dentin is exposed from wear or tooth decay (also known as dental caries or cavities), it can become quite sensitive.

3. Nerve / Pulpal Tissue

The nerve or the pulpal tissue is the most internal layer of a tooth. This tissue has a blood supply and nerve tissue in a healthy situation. An unhealthy pulp can cause bone loss, inflammation, bleeding, infection and severe pain.

Causes of Nerve Pain

We all want healthy teeth, but sometimes trauma or deep decay in a tooth can introduce bacteria and affect or actually kill the nerve of a healthy tooth. Inflammation in the nerve of a tooth is called pulpitis, which can be reversible or irreversible. Pulpitis that is caught early can be reversible if the cavities are treated, the irritating factor of bacteria in the cavity is removed and the tooth is restored with a dental filling, allowing the nerve and the tooth to heal. If the cavity is allowed to spread and progress and the bacteria infiltrate into the live nerve tissue, irreversible pulpitis can occur. This can actually lead to the next stage of pulpal involvement called necrosis, or death of the nerve. 

Signs of a Dead or Necrotic Nerve

When the tooth’s nerve dies, the tissue decays and produces toxins that sometimes have nowhere else to expand, except into the bone. This can lead to pressure and excruciating pain. As a general dentist, I see patients in our practice every day who come in with the classic signs of a dead or necrotic tooth. Signs include: 

  • Pain upon biting or tapping on the tooth, also called percussion
  • A spontaneously throbbing or aching tooth, especially at night, that comes and goes at will 
  • Swelling in the area of bone where the tooth is located

In a more chronic situation, the infection can actually dissolve the bone and cause swelling, and release pus and bacteria throughout the gums. This is called a dental fistulous tract.


What Does an Endodontist Do?

Patients frequently ask me and my team, “What does an endodontist do?” An endodontist performs a variety of endodontic treatments that can help take care of tooth pain or a dead or necrotic nerve. Three common endodontic procedures include pulpectomies, root canals and apicoectomy. I’ve provided a brief overview of procedures that address what does an endodontist do:

Endodontists Perform Pulpectomies 

When a tooth is very inflamed, an endodontist can obtain access to the nerve chamber by drilling a hole in the top of the tooth, cleaning the infection, removing the nerve, drying the chambers and nerve canals, and finally applying a medicated paste that soothes the infected tooth and helps it heal. A pulpectomy is the first stage of a full root canal procedure.


Endodontists Perform Root Canals

During a root canal, the endodontist opens the nerve chamber with a small drill to gain access to the nerve, removes the infected nerve, cleans the infection using both rotary and hand-held titanium files to shape the canal, dries the chambers and nerve canals, and then fills the canals with a cement and gutta percha, a rubber-like material that completely seals the tooth from bacteria. 

Endodontists Perform Apicoectomies

The endodontist opens the gum tissue near the tooth to view any underlying bone and to remove inflamed or infected tissue. The endodontist also removes the very end of the root. The doctor may add a small filling in the root to seal the end of the root canal, and then add a few stitches or sutures in the gingiva, or gums, to assist the tissue’s healing process.

Success of Endodontic Procedures

Like with any medical surgery, it’s vital that patients follow their doctor’s pre- and post-operative instructions for any endodontic surgery or endodontic procedure. Common post-operative instructions include not using a straw, eating a soft diet, not brushing the area for a certain amount of time and no vigorous rinsing. Similar to periodontal surgery, part of the natural healing includes build-up of a clot that allows the gum to heal underneath, so it’s vital that the patient doesn’t do anything that removes the clot.

How to Avoid Going to an Endodontist

While not guaranteed, with proper self care and visiting your dentist every six months for professional dental cleanings and check-up bitewing or full mouth digital x-rays, you likely won’t need an endodontist’s services. To keep teeth and gums healthy, always brush after meals or snacks and floss daily. Maintaining your dental health is the best strategy for keeping a healthy mouth, a beautiful smile and avoiding the endodontist. 

See One of the Best Endodontists in Coral Gables, FL 

When you visit the team at South Gables Dental, we clean your teeth and inspect your gums. If you have gum pain or your teeth indicate there may be signs of a dead or necrotic nerve, we fortunately have a top Coral Gables endodontist, Dr. Shah Rassoulian, that works at our practice. Learn more about Dr. Rassoulian here.

Thanks for reading our blog that addressed what is an endodontist, tooth anatomy, causes of nerve pain, signs of a dead or necrotic nerve, what does an endodontist do, success of endodontic surgical procedures, how to avoid going to an endodontist and how to find top endodontic services in Coral Gables. If you have additional questions about the information provided or if you or your family have questions about what is an endodontist that weren’t addressed, please contact us at


Whether you need a general dentist, periodontist, endodontist, orthodontist, oral surgeon, prosthodontist or pedodontist (children’s dentist), the team at South Gables Dental can help! Plus we offer emergency dental services in Coral Gables.

We’re seeing new patients, so you can contact us to schedule an appointment for all of your Coral Gables or Miami dentist needs.

I’m Dr. Lawrence Lesperance, a Coral Gables dentist who specializes in preventative dentistry, general dentistry services, and cosmetic dentistry services. My team and I provide personalized dental services for the whole family and offer orthodontic treatments, implant dentistry, periodontic services and botox treatments (for TMJ and migraines and cosmetic botox) and much more. Contact us to experience the South Gables Dental difference today!

Learn about different types of dentists.

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