Endodontists do not remove wisdom teeth. They are dental specialists with advanced training focused on saving natural teeth, not extracting them. Their expertise involves the complex internal structures of the tooth, specifically the dental pulp, which contains nerves and blood vessels. The goal of endodontic care is to preserve a tooth that might otherwise be lost due to deep decay, trauma, or infection.
The Endodontist’s Primary Focus
An endodontist’s training involves an additional two to three years of post-doctoral education, concentrating on diagnosing and treating diseases of the tooth’s interior. This deep specialization allows them to handle complex cases that a general dentist might refer out. The core of their practice is dedicated to maintaining the tooth’s integrity and function within the jawbone.
The most recognized procedure performed by an endodontist is root canal therapy. This treatment involves carefully accessing the pulp chamber, removing the infected or inflamed pulp tissue, and cleaning and disinfecting the internal root canal system. Once the inside of the tooth is sterilized, it is filled with a biocompatible material, such as gutta-percha, and sealed to prevent any future microbial contamination.
Endodontists also perform endodontic retreatment when a previous root canal fails or develops a new infection. This involves reopening the tooth, removing old filling materials, and searching for additional sources of infection before resealing. Apical surgery, or apicoectomy, is a microsurgical procedure performed when infection persists at the root tip after a conventional root canal. During an apicoectomy, the endodontist removes the root tip and surrounding infected tissue, then seals the end of the root.
The Specialist Who Handles Complex Extractions
The dental specialist responsible for complex tooth removal, including wisdom teeth, is the Oral and Maxillofacial Surgeon (OMS). This specialty requires extensive hospital-based residency training, often four additional years beyond dental school, alongside medical residents. This advanced training encompasses surgical techniques for the mouth, jaw, face, and neck, preparing them to manage a broad range of surgical conditions.
Wisdom teeth, or third molars, frequently require the expertise of an OMS because they are often impacted. Impaction means they are trapped beneath the gum line or bone and cannot erupt properly. This condition can lead to pain, infection, cysts, or damage to adjacent teeth, necessitating surgical removal. The surgeon uses detailed imaging, such as 3D scans, to plan the procedure, especially when the tooth is in close proximity to major nerves or the sinus cavity.
Oral surgeons are trained to provide various forms of anesthesia and sedation, including intravenous (IV) sedation and general anesthesia, often necessary for complex extractions. While general dentists can perform simple extractions, the surgical removal of impacted wisdom teeth is routinely referred to the OMS. This referral is due to the specialized surgical skill, advanced equipment, and anesthetic capabilities required.
Understanding Dental Referral Pathways
The journey to seeing a specialist typically begins with a visit to the general dentist, who acts as the primary caregiver and diagnostician. The general dentist assesses the patient’s overall oral health and determines whether a specialized procedure is necessary. This initial assessment and diagnosis is the gatekeeping step that decides the appropriate referral.
If a tooth is salvageable but requires internal repair, the patient is referred to an endodontist. If the tooth is severely damaged, impacted, or deemed non-restorable, such as a problematic wisdom tooth, the patient is referred to an Oral and Maxillofacial Surgeon.
Clear communication between the general dentist and the specialist is essential, often involving the transfer of diagnostic records like X-rays and treatment notes. Patients should view their general dentist as the coordinator of their care, directing them to the most qualified expert for their specific need. This system ensures patients receive the appropriate level of focused expertise, whether the goal is preservation or surgical removal.