Endodontics
Meet Your Endodontist
Dr Theo Chan
Endodontist
BDSc (Melb), DCD (Endo)
Dr. Theo Chan obtained his Bachelor of Dental Science from the University of Melbourne in 2004. In 2005, he completed the graduate dentist program at the Goulburn Valley Health (GVH) in Shepparton. He then returned to Melbourne and worked in private practice from 2006-2012, before returning to The University of Melbourne for his endodontic specialist training. Since graduating with a Doctor of Clinical Dentistry in Endodontics in 2015, Theo has been working at Malvern Endodontics.
What is an endodontist?
Endodontists are dental specialists who are experts in the field of endodontics and provide treatments for patients to help them retain their own natural teeth.
What is endodontics?
Endodontics (derived from Greek: endo- meaning “inside” and odont- meaning “tooth”) involves the diagnosis, prevention and treatment of diseases and injuries of the dental pulp (the vital tissue housed inside the root canal that keeps the tooth alive), the roots and tissues surrounding the root.
What endodontic procedures do endodontists perform?
Endodontists can perform a variety of procedures. The most common treatment is root canal treatment. Many problems (such as dental decay, cracks and trauma) can cause injury and disease to the dental pulp, including root canal infection, which can be painful and distressing for the patient. In these instances, the endodontist can perform root canal treatment and help the patient keep their affected teeth and restore their normal dental function, aesthetics and quality of life. Anyone who has had a bad toothache will understand how much it can affect their everyday activities!
Apart from normal root canal treatment, endodontists can also provide other treatments to help the patient keep their teeth, including:
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Root canal retreatment – to treat a tooth that has had previous root canal treatment but is causing an issue
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Root repair and surgery
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Vital pulp therapy – treatments to the dental pulp to keep it alive
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Dental trauma management – physical injuries to the teeth can affect dental pulps and surrounding roots
In the appropriate case, when root canal treatment is performed by an endodontist, the loss of an important tooth can be avoided and the tooth can remain functioning for many years.
Can’t my dentist do root canal treatment?
Your dentist can usually perform standard root canal treatment. However, there are cases where it may be difficult to diagnose the cause of dental pain, or the treatment may be more complex. For example, some molar teeth can have many canals that are difficult to find, or are narrow and curved, which makes root canal treatment challenging. Sometimes, the root canals may be blocked, or the tooth might be covered by a crown or bridge. And most cases of root canal retreatments can be difficult, because there are materials (e.g. previous root fillings, posts) blocking access to the root canal.
Endodontists, through years of specialised education and practice, have gained the expertise, knowledge, skill and experience to manage these complex cases. They also have the advanced technology, such as the dental operating microscope, as well as specialised materials and equipment, to treat patients and manage cases more efficiently.
Do I need a referral to see an endodontist?
In most cases, if your dentist has identified dental issues that they think are best managed by a specialist, they will refer you to an endodontist. Dr Chan will promptly triage all incoming referrals with relevant radiographs to offer you the most appropriate specialist appointment in each case.
I hear that root canal treatment is painful?
We understand that sometimes, a patient will present with a bad toothache and be distressed. The endodontist will ensure that the patient is put at ease and that treatment will be provided comfortably. This includes giving appropriate local anaesthetic so that the patient is pain-free when the endodontist performs treatment.
How many visits will root canal treatment take?
The number of appointments to treat a tooth will depend on the nature and complexity of the case. In most cases, the patient will attend 2 treatment appointments:
1) The first visit is to commence treatment, where the root canals are located and disinfected.
2) The second visit is to complete treatment, by placing the root filling to seal the canals.
Some cases may only require one visit to complete, if the treatment is straight forward and enough time is allocated, while others may require more than 2 appointments. For example, complex retreatment cases, or cases with persistent infection that requires additional visits to disinfect the root canals adequately.
Can I keep a tooth that has ‘died’?
Diseases to the dental pulp, often caused by deep dental decay or fractures, can cause the pulp within the root canal to be severely damaged or necrose (localised tissue death), which can lead to root canal infection. In these instances, severe pain and/or swelling can result and the only way to keep the tooth is with root canal treatment. While the dental pulp keeps the tooth ‘alive’, a tooth without a dental pulp can still function as normal, as long as the pulp disease has been properly managed. This requires the root canals to be sealed with root canal treatment, and the tooth to be restored appropriately.
What happens after my tooth is treated by the endodontist?
When the root canal treatment is completed by the endodontist, the patient will be advised to return to their general dentist for the proper restoration of the tooth (e.g. with a crown). This will ensure that the tooth is sealed permanently and protect the tooth from fracturing in the future, so that the tooth can function as normal and have the best longevity.
Isn’t it better to extract the tooth and replace it with an implant?
While replacement with an implant is a viable option for a tooth with endodontic disease, it is often preferable to keep your own tooth if the endodontist determines that the tooth has a good long-term outcome with treatment. With proper case selection and management, an endodontically treated tooth has excellent survival and can last a long time, and only requires normal maintenance as per other natural teeth. The treatment period for an implant can be lengthy (e.g. for healing of the tooth socket after extraction and/or bone graft, healing and integration of the implant in the jaw bone), and an implant will ideally require regular reviews and sometimes specialised maintenance to ensure its longevity. In some cases, replacement of a tooth with an implant might be complex (e.g. in areas where there is not enough bone, a bone graft would be needed) or not possible (e.g. unsuitable site, complex medical conditions). In these particular cases, keeping the tooth with root canal treatment is recommended, and the option of an implant may still be available later on if the endodontically treated tooth becomes unsalvageable in the future.
