An endodontist is a dental specialist who completes two to three additional years of advanced training focused on the interior of the tooth (endodontics). This specialty concentrates on the dental pulp—the soft tissue containing nerves, blood vessels, and connective tissue—and the tissues surrounding the tooth roots. Their core function is to diagnose and treat complex dental pain and infection within the tooth structure. The direct answer to whether an endodontist pulls teeth is generally no; their primary goal is the exact opposite: to preserve the natural tooth.
The Mandate of Tooth Preservation
The philosophy of endodontics centers on retaining the natural dentition, earning endodontists the nickname “tooth savers.” Preserving the original tooth structure is significantly advantageous for a patient’s long-term oral health. A saved tooth helps maintain the proper alignment of adjacent teeth and ensures the jawbone receives the necessary stimulation to prevent deterioration.
When a tooth is threatened by deep decay, trauma, or internal infection, the endodontist eliminates the disease while keeping the tooth firmly in its socket. This preservation effort allows the patient to maintain their natural bite, sensation, and function. Saving the tooth often prevents the need for more extensive and costly procedures later, such as bridges or dental implants, which become necessary after an extraction.
Defining the Scope of Endodontics
An endodontist’s practice focuses on internal repair procedures designed to treat infected or inflamed dental pulp. The most common procedure is root canal therapy, where the specialist removes the diseased pulp from the interior chambers of the tooth. They then clean, disinfect, and shape the hollow root canals before sealing the space with a biocompatible material to prevent reinfection.
Endodontists also manage cases where a tooth has not healed properly after a previous root canal, performing a procedure called endodontic retreatment. This involves reopening the tooth, removing the old filling material, and using specialized tools to treat complex anatomy or persistent infection. When infection persists at the root tip after a conventional root canal, the endodontist may perform a microsurgical procedure called an apicoectomy. During this surgery, the specialist accesses the root tip through the gum tissue, removes the infected tissue and a small portion of the root end, and seals it with a small filling.
Coordinating Care: Who Performs Extractions
Since an endodontist specializes in saving teeth, the task of tooth removal falls to other dental professionals. Most routine extractions, such as those for teeth with simple decay or mobility, are performed by a general dentist. General dentists manage most straightforward dental procedures, including simple extractions of visible teeth.
For more complex cases, such as impacted wisdom teeth, teeth fractured below the gumline, or those requiring significant bone removal, a patient is referred to an oral and maxillofacial surgeon. These surgeons complete hospital-based surgical training that qualifies them to perform complex surgical extractions and manage associated facial and jaw issues. An endodontist only recommends extraction when the tooth damage is severe—such as a vertical root fracture or extensive loss of supporting bone—making preservation no longer a viable option. In such instances, the endodontist refers the patient to either a general dentist or an oral surgeon for the removal procedure.