(2) The infection process. When the pulp of a tooth is damaged beyond repair,
it deteriorates. Tissues of the pulp break down and the pulp chamber and canals become
a source of infection, harboring pathogenic bacteria. These breakdown products cause a
deterioration of the healthy tissue about the root end or apex of the tooth. Apical infection
(tooth root infection) not only destroys this healthy tissue, but can impair the patient's
health. Before the advent of endodontics, the treatment for this condition was extraction.
The loss of a tooth can cause changes in the masticatory function of the teeth and mental
anguish to the patient. Replacement of the tooth often requires extensive procedures.
Sometimes, replacement is not feasible. Therefore, as long as supporting structures of the
teeth are healthy, endodontics may be indicated to preserve the dentition in its most nearly
b. The Role of the Dental Specialist in Endodontics. In addition to general
clinical duties, the dental specialist assigned as an assistant in endodontics will be
expected to become familiar with the techniques, materials, and instruments used by the
(1) Constant awareness of need for asepsis. Most important, the dental
specialist must always be aware of the need for cleanliness, disinfection, and proper
sterilization. One contaminated instrument can lead to endodontic failure. Personal
hygiene and tidy appearance are most reassuring to all concerned.
(2) Patient care technique. The dental specialist also should make a special
effort to be extremely tactful with patients. For example, patients automatically associate
the nerve of a tooth with pain. Reassuring gestures and attitude are helpful in gaining the
(3) Proficiency in using x-rays. Endodontics requires the dental specialist to
be familiar with basic radiographic techniques, effects of radiation, and protection of the
patient by the use of a lead apron. He should review techniques for developing
radiographs as he will often be required to develop them for the endodontist.
(4) Proficiency with tooth numbering system. He should be aware of the
tooth numbering system and nomenclature used in the armed services because he will be
required to transcribe the information gained from each appointment to the patient's
record. This is especially important when a tooth with several root canals is involved. If
any doubtful situation arises, the dental specialist should always consult the dental officer.
(5) Flexibility. Each dental officer uses the techniques of instrumentation and
the particular methods that work best for him. The endodontic assistant should be flexible
enough to adjust to different techniques.