Dr. R. Shirley Stella Josephine, MDS (Endodontics), The Tamil Nadu Dr. MGR Medical University, Chennai, India (2020-2023) 
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Endodontics 101: Dr. Shirley R on Saving Tooth and Educating Patients (Part 1)

Dr. Shirley Stella Josephine. R, MDS discusses the specialization of Endodontics, patient fears, public perception of oral health, and patient education

MBT Desk

Pondering whether to preserve a tooth or opt for extraction? Join us as we explore the crucial decision-making process surrounding dental health, guided by the insights of Dr. Shirley Stella Josephine. R, MDS.

Welcome to our exclusive Docscopy section, where Dr. Nirainila Joseph of MedBound Times had an opportunity to engage with Dr. Shirley Stella Josephine. R.

Dr. Shirley Stella Josephine. R obtained her BDS degree from SRM University, (2014-2019) at Kattankulathur, Chengalpattu, Tamil Nadu, India. She pursued her MDS degree from The Tamil Nadu Dr. MGR Medical University (2020-2023) at Chennai, India. She is currently practicing as a Consultant Endodontist at Tirunelveli, Tamil Nadu, India, dedicated to elucidating the significance of saving teeth for optimal oral health.

Dr. Nirainila Joseph: Before we explore your specialization, could you kindly introduce yourself to our readers?

Dr. R. Shirley Stella Josephine: I'm Dr. R. Shirley Stella Josephine, a Restorative Dentist and Endodontist. I have completed my BDS under SRM UNIVERSITY (2014-2019) and have finished MDS under The TAMILNADU Dr. MGR MEDICAL UNIVERSITY (2020-2023).

Dr. Nirainila Joseph: As an endodontist, could you provide us with an overview of what endodontics entails and why it's crucial for maintaining dental health?

Dr. R. Shirley Stella Josephine: Endodontics is a branch of dentistry focused on the study and treatment of dental pulp and the tissues surrounding the roots of a tooth. Its primary procedure is root canal therapy, which involves removing infected or damaged pulp from inside the tooth, cleaning, disinfecting, and then sealing it. This treatment is crucial because it can save a tooth that might otherwise need to be extracted due to infection or decay, preserving natural teeth and promoting overall dental health.

Endodontics is a branch of dentistry focused on the study and treatment of dental pulp and the tissues surrounding the roots of a tooth. (Wikimedia Commons)

Dr. Nirainila Joseph: Could you share your journey of becoming an endodontist? What inspired you to specialize in this field?

Dr. R. Shirley Stella Josephine: Becoming an endodontist is a rewarding journey that requires dedication and passion for saving teeth. During my undergraduate days, I was very much amazed by root canal treatment that it relieves the most common complaint of the patients i.e pain. The inspiration to specialize in this field was from the fascination with the intricate anatomy of teeth, a commitment to preserve natural dentition and also the desire to alleviate patient's pain.

Dr. Nirainila Joseph: Considering your journey and inspiration to specialize in endodontics, could you now discuss the reasons why patients seek treatment from an endodontist?

Dr. R. Shirley Stella Josephine: Patients typically visit endodontists for various reasons related to the health of their teeth and surrounding tissues. The most common reasons include: 1) Severe tooth pain: Endodontists specialize in diagnosing and treating tooth pain, especially when it's caused by infections or inflammation of the dental pulp. 2) Dental trauma: Patients may require endodontic treatment following dental injuries, such as fractures or dislodgment of teeth, to save the affected tooth and restore its function. 3) Tooth sensitivity: Endodontists address tooth sensitivity issues, which can indicate underlying dental problems like exposed dental pulp or nerve irritation. 4) Failed root canal treatment: In cases where a previous root canal treatment has failed to resolve the issue, patients may be referred to an endodontist for retreatment or alternative treatment options

Dr. Nirainila Joseph: From your answer, I could gather that people approach endodontists for a variety of dental diseases. So, could you elaborate on the various endodontic procedures you frequently perform in your practice?

Dr. R. Shirley Stella Josephine: Certainly! In an endodontic practice, the range of procedures commonly performed includes: root canal therapy, endodontic retreatment, apicoectomy and root canal surgery for complex cases or teeth with unusual anatomy. Other procedures involve vital pulp therapy, regenerative endodontic procedures and internal bleaching to address discoloration of teeth that has occurred as a result of trauma or previous root canal treatment. These procedures aim to alleviate pain, save natural teeth, and restore oral health and function for patients.

In an endodontic practice, the range of procedures commonly performed includes: Root canal therapy (in picture), endodontic retreatment, apicoectomy, root canal surgery, vital pulp therapy , regenerative endodontic procedures and internal bleaching. (Wikimedia Commons)

Dr. Nirainila Joseph: Given the abundance of dental misinformation, and quackery, how do you address common misconceptions or myths about endodontic treatment that you encounter in your practice?

Dr. R. Shirley Stella Josephine: Patient communication and education are essential aspects of my practice as an endodontist. During consultations and treatment, I strive to effectively communicate with patients and educate them about the importance of saving natural teeth. I start by establishing a trusting relationship with each patient, creating an environment where they feel comfortable asking questions and expressing their concerns. I also listen attentively to patient's needs and concerns, allowing them to voice their fears or reservations about treatment. This helps me address their specific worries and tailor my communication accordingly.

We also utilize visual aids, diagrams, and educational videos to explain dental anatomy, the root canal procedure, and the consequences of untreated dental issues. These materials help patients better understand their condition and treatment options. I encourage patients to ask questions at any stage of the consultation or treatment process. This empowers them to become active participants in their dental care and ensures that they have a thorough understanding of their treatment plan. By adopting these approaches to patient communication and education, I aim to empower my patients to make informed decisions about their oral health and inspire them to prioritize the preservation of their natural teeth.

Dr. Nirainila Joseph: Since many people come late for dental treatments and may not fully understand the value of tooth preservation, how do you approach patient communication and education during consultations and treatment?

Dr. R. Shirley Stella Josephine: Some common misconceptions or myths about endodontic treatment include that many people believe that root canal treatment is extremely painful. However, with modern techniques and anesthesia, patients often experience little to no discomfort during the procedure. Some individuals think that extracting the tooth is a better option than undergoing root canal treatment. However, preserving the natural tooth through root canal therapy is typically the best long-term solution for oral health and aesthetics. Some people also believe that root canal-treated teeth become fragile over time. In reality, after a root canal, the tooth is usually restored with a crown, which reinforces its strength and durability. Some may misunderstand that one visit is enough to complete the treatment. While some cases can be completed in one visit, others may require multiple appointments for thorough cleaning and disinfection. So, I explain the importance of thorough treatment to my patients to ensure the success of the procedure.

Patient communication and education are essential aspects of clinical endodontic practice. (Representational image: Wikimedia Commons)

Dr. Nirainila Joseph: Nothing resonates with the public quite like real-life tales. Can you share any memorable patient success stories or challenging cases that highlight the impact of endodontics?

Dr. R. Shirley Stella Josephine: One memorable case involved a patient who had suffered a traumatic dental injury resulting in a cracked tooth. The fracture extended into the root, causing significant pain, jeopardizing the tooth's viability. Despite the complexity of the case, we performed a delicate root canal procedure, carefully removing the damaged tissue and sealing the root canal to prevent further infection. Through meticulous treatment and follow-up care, the tooth was saved, restoring both function and aesthetics for the patient. This case was one of the most memorable moments as the patient had complete relief from the pain and satisfaction of preserving their natural tooth and this case also underscores how endodontics can effectively address traumatic injuries and preserve teeth for long-term oral health.

Stay tuned for part II of the interview!

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