What is Endodontics?

Endodontics is a branch of dentistry recognized by the American Dental Association involving diagnosis and treatment of the pulp (root canal) and surrounding tissues of the tooth. When you look at your tooth in the mirror, what you see is the crown. The rest of the tooth, the portion hidden beneath the gum line, is called the root. Though the outer portion of the root is a hard tissue called dentin, the inside channel or “root canal” contains a pulp of soft tissue, blood vessels and nerves. Bacteria that are introduced into the pulp as a result of tooth decay, trauma, periodontal disease, tooth fracture or other problems, can severely damage the pulp. When that happens, an endodontic specialist removes the diseased pulp to save the tooth and prevent further inflammation and infection. After successful endodontic treatment, the tooth continues to perform normally. Read more about endodontists.

I’m worried about X-rays. Should I be?

No. While x-rays will be necessary during your endodontics treatment, we use an advanced non-film computerized system, called digital radiography, which produces radiation levels up to 90 percent lower than those of already low dose conventional dental x-ray machinery. These digital images can be optimized, archived, printed and sent to co therapists via e-mail. For more information contact Schick Technologies, Inc.

What about infection control?

Again, there’s no need for concern. We adhere to the most rigorous standards of infection control advocated by OSHA (Occupational Safety and Health Administration), the CDC (Centers for Disease Control) and the ADA (American Dental Association). We utilize autoclave sterilization and barrier techniques to eliminate any risk of infection.

What happens after treatment?

When your root canal therapy has been completed, original radiographs and a record of your treatment will be sent to your restorative dentist. You may need to contact the office for a follow-up restoration within a few weeks of completion at our office. Your restorative dentist will decide on what type of restoration is necessary to protect your tooth. It is rare for endodontic patients to experience complications after routine endodontic treatment or microsurgery. If a problem does occur, however, we are available to respond within working hours.

Why can’t you use the X-rays my dentist took?

We use digital X-rays that offer us a much higher resolution. In addition, they give us the ability to measure the length of your canals during the procedure. It is also necessary to take X-rays during treatment to help us measure your root length. These X-rays are also used for our records and are submitted to your insurance company because they require them prior to paying for the procedure.

What is calcification?

The tooth produces layers of mineral and calcium to protect the pulp tissue from injury. Over the years, this can partially or completely obstruct the root canal space, making it very difficult to locate and clean out the root canal space. In some instances, a tooth can become so calcified that the canal is completely closed, off making it inaccessible.

What is the difference between an endodontist and a general dentist?

Primarily, in our practice we focus solely on endodontic therapy, whereas most general dentists perform a broader scope of dental procedures. An average dentist may perform 5 root canals a month and an average endodontist would perform nearly 100.

Secondly, our equipment is more sophisticated than a general dentist’s. Our equipment helps us produce a more precise and predictable procedure. A good example of this is our use of a high-powered surgical microscope that gives an unparalleled view of the working area.

Third, the speed at which we will be able to complete your procedure will be much faster than a general dentist’s simply because we do so many. Most procedures are done in an hour or less and only take one appointment. We also see the most difficult cases on a consistent basis, such as curved canals, calcified canals, or retreats. Constant exposure to these complicated cases is very valuable in being able to offer the best treatment possible to our patients.

Does the fee for the root canal cover the crown?

No. The root canal fee only covers the root canal. The crown is a separate fee and should be performed by your general dentist.

Why can’t you do the crown since I’m here and numb?

The crown is done by your general dentist because that is their area of expertise. We focus only on root canal therapy.

Why is Ibuprofen (aka Motrin) recommended?

Motrin or Ibuprofen is an NSAID, which stands for Non-steroidal anti-inflammatory medication. It is very effective in treating tooth pain because of its dual analgesic and anti-inflammatory action.

Do I have to choose between nitrous and “the shot”?

An injection with local anesthetic prior to any procedure is always administered. The nitrous is given to alleviate the patient’s anxiety and does have some beneficial analgesic effects.

Will the nitrous make me go to sleep?

Some patients do fall asleep using Nitrous Oxide (N2O). It has a very relaxing effect, and most people become very calm and euphoric.

Will I still feel the shot with the nitrous?

In most cases, the anticipation of the injection is much worse than the discomfort. In effect, most patients state that they don’t feel the shot as much, or hardly at all, when they use the nitrous.

Why is there cotton in my tooth?

Cotton makes it much easier for your dentist to remove the temporary filling before placing the permanent one. It’s easier to remove a piece of cotton covered by a temporary filling then a big block of temporary filling. It also lets the dentist know where to stop in order to avoid digging too far to remove your temporary filing.

What do you fill the canals with?

Your canals are sealed with Gutta-percha. This is a rubber-like material that we can heat up and conform into the inner canal space

Why do I need another root canal if I already had one?

There are several reasons why a root canal may need to be retreated. Sometimes a canal is missed during the original treatment, or the canals may have not been cleaned out thoroughly enough the first time. There could also be leakage of the restoration or crown.

What is the success rate of a root canal?

When done properly, root canals have a success rate of 95-98%. A recent study shows that success rates are significantly higher when done by an endodontist as opposed to a general dentist.

What is an apicoectomy?

An apicoectomy is essentially a surgical root canal. We approach the roots from under the gum instead of doing it from inside the tooth. We approach from the apex or apical portion of the root. After removing the apex of the root we clean out the root and seal it.

Why would I need an apicoectomy?

This procedure is used when a root canal is done, but the infection in the surrounding bone still isn’t able to heal. People have different immune systems, and sometimes eradicating the infection surgically is what’s needed for the body to heal completely. Apicoectomies are also used if we are unable to clean all the way to the end of the root. Sometimes, removing the last few millimeters of the root tip is the only way to get rid of all the bacteria inside the tooth root. Apicoectomies are useful procedures and very helpful as an adjunct to conventional root canal therapy.

Why would I need a crown?

A crown seals your tooth so the root doesn’t get infected, protects your tooth from cracking, and makes your tooth look natural again.

How long can I wait to put my crown on?

You shouldn’t wait longer than two weeks.

Do you kill the nerve when doing a root canal?

No. We remove the pulp tissue from inside the tooth, sterilize the inside of the root and seal it.

How much will a root canal cost? What is my copay?

Depending on what tooth is being done, root canals can range anywhere from $700 to $1500. Depending on your coverage, your copay is usually ranging from 20% to 50% of the root canal fee.

Do you have any payment plans?

Yes. We work with a third party financing group that offers payment plans.

Can I be put to sleep?

Yes. We offer IV sedation.

Will I be able to drive after using nitrous oxide gas?

Yes. Nitrous oxide is completely flushed out of your system with oxygen after the procedure, so you will be able to drive.

Why does everyone say root canals are so awful?

Root canals have a bad reputation because in the past they took very long to complete. They were also not as predictable as they are now, and techniques for obtaining sufficient anesthesia were not as good.

How is the root canal experience different now? Will it hurt?

The procedure is much more predictable because of an increase in knowledge and more sophisticated equipment.

Most root canal procedures done by our office can be done in an hour or less and usually takes just one visit. We are also experts at getting patients properly numb. A large portion of an endodontic residency focuses solely on pain control and the technique of obtaining proper anesthesia.

Can I go to work after?

Yes. Most patients go back to work the same day.

Will it hurt during or after the procedure?

During the procedure, you will not feel any pain, just some pressure and vibration. After the procedure, your sensitivity to temperature will be completely gone on that tooth. You will be tender to pressure or biting on that tooth. Tenderness to bite typically goes away in 3-4 days.

Can I have a root canal done if I am pregnant?

Medical clearance from your OB GYN is necessary prior to all root canal treatment. We require clearance by your physician as a precautionary measure. For the most part, it is extremely safe to have dental work done during pregnancy, with second trimester being the best term to have work done.

How long does a root canal take?

Most root canals done in our office take an hour or less.

Do I have to come for multiple visits?

Most treatment is completed in one visit.

Do I need to stop my blood pressure or any other medications before coming in for a root canal?

You should take your blood pressure medications as directed.

How long will I be numb?

You will be numb for 2-3 hours.

How long after a root canal treatment should I visit my general dentist?

You should go back to your general dentist within two weeks.

Can I eat on that side of the mouth after the treatment?

Avoid eating for the first hour after treatment, then be gentle with that tooth for the first week following treatment.

Will I be able to swallow during the treatment?

Yes. We also suction for you throughout treatment.

How much pain will I be in after the treatment?

Most people feel a tenderness to bite on that tooth that gradually dissipates with time.

Will my dentist know what was done?

Yes. We send your dentist a copy of the X-Ray and a full report of the treatment.

Will I feel the shots?

Most people feel a slight pinch or don’t feel them at all.

Why don’t we just pull the tooth?

Extraction is always a treatment option, however there are many negative side effects such as less teeth to chew with, having all of your other teeth shift places, and the high cost of filling that gap if you decide to repair it in the future. We always recommend keeping your natural tooth if it is feasible.

Why doesn’t the infection go away with just the antibiotics?

Antibiotics are great at fighting the infection while you take them and making you feel better. The problem with antibiotics is that they don’t eliminate the source of the infection, which is the infected pulp tissue inside of your tooth. The only way to eliminate infected pulp tissue without an extraction is by doing endodontic treatment.

Why did my face get swollen?

Your face gets swollen because an infection that started from a tooth has spread into the tissue inside your body.

Why do you have to do the root canal in two visits?

Sometimes we need two visits because the infection in your tooth is so bad that we have to leave an antibiotic paste inside your tooth before we bring you back to seal your roots.

Can I get sedated for the treatment?

Yes. We offer oral conscious sedation or IV sedation.

Why didn’t my tooth ever hurt before? Why do I need a root canal if I’m not in any discomfort?

Sometimes teeth that need root canals aren’t painful. When the pulp becomes necrotic, or dies, the tooth can be asymptomatic for a long time before it becomes a problem. Also, slow chronic infections tend not to be as painful as acute ones. The tooth will eventually become painful because the pulp is infected. Delaying treatment could result in a Dental emergency, and those usually happen at the most inconvenient times.

Why didn’t they just schedule me for a CT scan to begin with?

Most teeth can be treated without the use of a CT scan. A CT scan is very useful in the more difficult cases, i.e. Calcified canals, or prior to apicoectomy procedures.