Updated: Oct 15
Unfortunately, a periodontist does not do root canals since they're a gum specialist and a root canal is NOT a gum procedure. Gum procedures treat dental conditions, which affect the gums that surround the teeth such as gingivitis or periodontitis.
Root canals on the other hand, affect the nerve of the tooth rather than the gums. This means that it is a nerve procedure and not a gum procedure. Since it does not affect the gums, it is not considered periodontal surgery.
Who does root canals?
Since root canals treat nerve conditions related to the tooth, they are usually performed by an endodontist, otherwise known as a root canal specialist.
A root canal procedure involves removing the nerve from the tooth. Essentially the nerve gets taken out of the tooth and out of the mouth but the tooth remains in the mouth. The primary reason to get a root canal is when the nerve is unhealthy or it becomes infected.
Here is what a root canal looks like before and after it is completed on an x-ray:
Other procedures that endodontists do:
Root canal retreatment. This is when the tooth already had a root canal but it needs to be redone due to a recurrent infection.
Apicoectomy. If retreatment does not work, they can also drill through the bone and cut off the tip of the root. This can sometimes salvage the root canal by getting rid of the abscess at the tip directly.
Post removals. The endodontist can go in with a microscope and remove old posts in teeth with crowns on them.
Implant screw removals. Surprisingly, they can help retrieve broken implant screws. The screws can break sometimes and it becomes an issue.
That is the gist of what root canal specialists do. Another main differentiating factor is that they tend to have a large microscope for all of their work. This microscope can zoom in about 20-40x depending on the brand and model. That helps them see into the tiny canals of your teeth.
This is also the reason why if you need a root canal on a molar tooth you should do it with the specialist because they can see better with the microscope. Your dentist may only be able to zoom in about 4x with their loupes at most.
Last but not least if you had a root canal that needs to be retreated, you should definitely seek out an endodontist and not another general dentist. It is not that your restorative dentist can't do it but sometimes the microscope makes a big difference in the treatment outcome.
What does the periodontist do?
The periodontist only does gum related procedures. Their name even implies that because they are a dentist who treats structures around the tooth. What surrounds the tooth are the gums and the bones, which is precisely what they treat.
Procedures that periodontists may do:
Teeth cleanings. They will remove all of the plaque and tartar around your teeth.
Deep teeth cleanings. They will clean deep below the gumline to remove all of the tartar that is deep beneath the gums. You may or may not need dental anesthesia for this.
Gum surgery or Osseous Surgery. They will literally open up your gums so that they can visualize all of the tartar. This is the most effective and efficient way of making sure your teeth are clean. This procedure is reserved for severe cases of gum disease.
Gum grafting. If you're having gum recession, this is the procedure to do. They will try to regrow the gums via this treatment.
Dental implants. If you're missing a tooth they can plant a new one and grow it for you.
Cosmetic gum procedures. If you have a very gummy smile, they can get rid of it for you.
Basically all of these have nothing to do with the inside of the tooth, which is what a root canal is. Periodontists wouldn't even remember how to do one if you went to them for that problem!
If you're having a gum problem you should see a periodontist but if you're having a nerve problem, you should see an endodontist because they're the ones who do root canals. This is why it is very important to correctly diagnose your dental problem so that you can go see the correct type of dentist.
If you needed a root canal and you booked an appointment with the periodontist, they wouldn't be able to help you. You need to specifically search for a root canal specialist, an endodontist if you're having tooth nerve pain. An endodontist is the best doctor for root canals since they specialize in doing them.
Author: Written by Dr David Chen DDS, a general dentist in long island city.