An endodontist is a dental specialist who focuses on the interior of the tooth, specifically the dental pulp and the tissues surrounding the tooth roots. Endodontists typically do not perform routine, permanent fillings; that restorative work is the domain of general dentistry. The endodontist’s specialized training centers on saving the tooth from the inside after infection or injury, while the general dentist handles the final structural restoration of the tooth’s outer surface.
What Endodontists Specialize In
The core expertise of an endodontist lies in the diagnosis and treatment of conditions affecting the soft tissue, known as pulp, inside the tooth’s root canals. They complete an additional two to three years of advanced postgraduate training after dental school, concentrating exclusively on endodontic procedures. This rigorous education equips them with the skills to manage complex internal anatomy and challenging cases referred by a general dentist.
The most recognized procedure they perform is Root Canal Therapy (RCT), which involves removing infected or inflamed pulp, cleaning and shaping the canal system, and then sealing the interior of the tooth. Endodontists also specialize in retreatment procedures, necessary when a tooth fails to heal after an initial root canal or when infection returns. They also handle an apicoectomy, a surgical procedure involving removing the tip of the tooth root and sealing the root end when a standard root canal is insufficient. Their practice focuses on internal, tooth-saving treatments rather than external restoration.
The General Dentist’s Role in Restorative Care
General practitioners (GPs) serve as the primary care providers for all aspects of oral health, focusing on preventative care, diagnosis, and routine treatment. Their scope of work includes regular cleanings, examinations, and the identification of issues like decay and structural damage. When a cavity or minor fracture is detected, the general dentist performs the common procedure of placing a permanent filling.
This restorative work, which uses materials like composite resin or amalgam to repair the outer structure of the tooth, is a primary duty of the GP. A permanent filling restores the tooth’s form and function following decay removal. They ensure the tooth is structurally sound and protected for normal chewing and biting forces. The general dentist manages the overall long-term maintenance, including the definitive external repair of teeth that have undergone specialized internal treatment.
Addressing the Filling Question: Temporary vs. Permanent Restoration
The confusion about whether endodontists place fillings stems from the necessary steps taken immediately after a root canal procedure. After the endodontist cleans, shapes, and permanently seals the internal root canal system with gutta-percha, they must protect this work. The access hole created on the chewing surface of the tooth is then closed with a temporary filling material.
This temporary seal, often made of materials like zinc oxide-eugenol or glass ionomer, prevents bacteria and saliva from re-entering and contaminating the sealed root canals. The temporary filling protects the tooth for a short period, typically a few weeks, while the patient returns to their general dentist for the final restoration. Even a small compromise in this seal can allow bacteria to re-contaminate the root canal within weeks, highlighting the importance of timely follow-up care.
The patient must next see their general dentist, who removes the temporary filling and places the final, permanent restoration. This restoration may be a composite filling for smaller defects, but most often involves placing a dental crown or an onlay for maximum structural support. While the root canal procedure saves the tooth, it can weaken its structure, making the final, permanent restoration by the general dentist a necessary step for the tooth’s long-term survival and function.