FAQs

 
 

What is an Endodontist?

Endodontists (root canal specialists) are dentists with at least two additional years of advanced specialty education in diagnosis and root canal treatment. Because they limit their practices to endodontics, they treat these types of problems every day. They use their special training and experience in treating difficult cases, such as teeth with narrow or blocked canals, unusual root canal anatomy, root canal retreatments and specialized surgeries. Endodontists may use advanced technology, such as operating microscopes, ultrasonics and digital imaging, to perform these special services.

 

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Root Canal Treatment

What is Endodontic treatment?

Endodontic treatment (root canal treatment) treats the inside of the tooth. Inside the tooth, under the white enamel and a hard layer called the dentin, is a soft tissue called the pulp. The pulp contains blood vessels and nerves and it extends from the crown of the tooth to the tip of the roots where it connects to the tissues surrounding the root.


Why would I need an endodontic procedure?

Endodontic treatment is necessary when the pulp becomes inflamed or infected. The inflammation or infection can have a variety of causes: deep decay, repeated dental procedures on the tooth, or a crack or chip in the tooth. In addition, an injury to a tooth may cause pulp damage even if the tooth has no visible chips or cracks. If pulp inflammation or infection is left untreated, it can cause pain or lead to an abscess.


What are the signs of needing endodontic treatment?

Signs to look for include pain, prolonged sensitivity to heat or cold, tenderness to touch and chewing, discoloration of the tooth, and swelling, drainage and tenderness in the lymph nodes as well as nearby bone and gingival tissues. Sometimes, however, there are no symptoms.


How does endodontic treatment save the tooth?

The endodontist removes the inflamed or infected pulp, carefully cleans and shapes the inside of the canal, a channel inside the root, then fills and seals the space. Afterwards, you will return to your dentist, who will place a crown or other restoration on the tooth to protect and restore it to full function. After restoration, the tooth continues to function like any other tooth.


Will I feel pain during or after the procedure?

Many endodontic procedures are performed to relieve the pain of toothaches caused by pulp inflammation or infection. With modern techniques and anesthetics, most patients report that they are comfortable during the procedure. For the first few days after treatment, your tooth may feel sensitive, especially if there was pain or infection before the procedure. This discomfort can be relieved with over-the-counter or prescription medications. Follow your endodontist’s instructions carefully. Your tooth may continue to feel slightly different from your other teeth for some time after your endodontic treatment is completed. However, if you have severe pain or pressure or pain that lasts more than a few days, call your endodontist.


Will the tooth need any special care or additional treatment after endodontic treatment?

You should not chew or bite on the treated tooth until you have had it restored by your dentist. The unrestored tooth is susceptible to fracture, so you should see your dentist for a full restoration as soon as possible. Otherwise, you need only practice good oral hygiene, including brushing, flossing, and regular checkups and cleanings. Most endodontically treated teeth last as long as other natural teeth. In a few cases, a tooth that has undergone endodontic treatment does not heal or the pain continues. Occasionally, the tooth may become painful or diseased months or even years after successful treatment. Often when this occurs, redoing the endodontic procedure can save the tooth.


Can all teeth be treated endodontically?

Most teeth can be treated. Occasionally, a tooth can’t be saved because the root canals are not accessible, the root is severely fractured, the tooth doesn’t have adequate bone support, or the tooth cannot be restored. However, advances in endodontics are making it possible to save teeth that even a few years ago would have been lost. When endodontic treatment is not effective, endodontic surgery may be able to save the tooth.


How much will the procedure cost?

The cost varies depending on how complex the problem is and which tooth is affected. Molars are more difficult to treat, the fee is usually more. Most dental insurance policies provide some coverage for endodontic treatment. Generally, endodontic treatment and restoration of the natural tooth are less expensive than the alternative of having the tooth extracted. An extracted tooth must be replaced with a bridge or implant to restore chewing function and prevent adjacent teeth from shifting. These procedures tend to cost more than endodontic treatment and appropriate restoration. With root canal treatment you save your natural teeth and money.


What are the alternatives to endodontic treatment?

When the pulp of a tooth is damaged, the only alternative to endodontic treatment is extraction of the tooth. To restore chewing function and to prevent adjacent teeth from shifting, the extracted tooth must be replaced with an implant or bridge. This requires surgery or dental procedures on adjacent healthy teeth and can be far more costly and time-consuming than endodontic treatment and restoration of the natural tooth. No matter how effective modern tooth replacements are - and they can be very effective- nothing is as good as a natural tooth.

 

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Root Canal Retreatment

What is root canal retreatment?

In certain circumstances, a previous root canal may need to re-treated if it is not healing after the initial treatment. There can be numerous reasons as to why an initial root canal treatment may fail. This will be discussed at the consultation visit.


What will happen during root canal retreatment?

First, the endodontist will discuss your treatment options. If you and your endodontist choose retreatment, the endodontist will reopen your tooth to gain access to the root canal filling material. In many cases, complex restorative materials—crown, post and core material—must be disassembled and removed to permit access to the root canals. After removing the canal filling, the endodontist can clean the canals and carefully examine the inside of your tooth using magnification and illumination, searching for any additional canals or unusual anatomy that requires treatment. After cleaning the canals, the endodontist will fill and seal the canals and place a temporary filling in the tooth. If the canals are unusually narrow or blocked, your endodontist may recommend endodontic surgery. 


Is retreatment the best option for me?

Retreated teeth can function well for years, even for a lifetime. It's always best to save the tooth if we believe retreatment is the best option for you.

Advances in technology are constantly changing the way root canal treatment is performed, so we may even be able to use a new technique that was not available when you had your first procedure. If your tooth has unusual anatomy that was not cleaned and sealed during the first procedure, we may be able to resolve this problem with a second treatment.

Of course, there are no guarantees with any dental or medical procedure. We will discuss your options and the chances of success before beginning retreatment.


How much will the procedure cost?

The cost varies depending on how complicated the procedure will be. The procedure will probably be more complex than your first root canal treatment, because your restoration and filling material may need to be removed to accomplish the new procedure. In addition, we may need to spend extra time searching for unusual canal anatomy. Therefore, you can generally expect retreatment to cost more than the initial endodontic treatment. While dental insurance may cover part or all of the cost for retreatment, some policies limit coverage to a single procedure on a tooth in a given period of time. Our office can help you check with your employer or insurance company prior to treatment to be sure of your coverage.


What are the alternatives to retreatment?

For some patients considering retreatment, endodontic surgery is also an option.

 

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Root Canal Surgery

Why would I need endodontic surgery? 

Usually, a tooth that has undergone a root canal can last the rest of your life and never need further endodontic treatment. However, in a few cases, a tooth may fail to heal. The tooth may become painful or diseased months or even years after successful treatment. If this is true for you, surgery may help save your tooth.

Surgery may be used in diagnosis. If you have persistent symptoms but no problems appear on your x-ray, your tooth may have a tiny fracture or canal that could not be detected during nonsurgical treatment. In such a case, surgery allows us to examine the root of your tooth, find the problem, and provide treatment.

Surgery may also be performed to treat damaged root surfaces or surrounding bone. 
Although there are many surgical procedures that can be performed to save a tooth, the most common is called apicoectomy or root-end resection. When inflammation or infection persists in the bony area around the end of your tooth after a root canal procedure we may have to perform an apicoectomy.


What is an apicoectomy?

In this procedure, we open the gum tissue near the tooth to see the underlying bone and to remove any inflamed or infected tissue. The very end of the root is also removed. A small filling is placed to seal the end of the root canal, and stitches or sutures are placed in the gum to help the tissue heal properly.


Are there other types of endodontic surgery?

Other surgeries we can perform include dividing a tooth in half, repairing an injured root, or even removing one or more roots. We will be happy to discuss the specific type of surgery your tooth requires. In very complex cases, a procedure called intentional replantation may be performed. In this procedure, a tooth is extracted, treated with an endodontic procedure while it is out of the mouth, and then replaced in its socket. These procedures are designed to help you save your tooth.


Will the procedure hurt?

Local anaesthetics make the procedure comfortable. Of course, you may feel some discomfort or experience slight swelling afterwards while the incision heals. This is normal for any surgical procedure. We will recommend appropriate pain medication to alleviate your discomfort and will give you specific postoperative instructions to follow. If you have questions after your procedure, or if you have pain that does not respond to medication, call us immediately.


Can I drive myself home?

Often you can, but you should ask us before your appointment so that you can make transportation arrangements if necessary.


When can I return to my normal activities?

Most patients return to work or other routine activities the next day. We will be happy to discuss your expected recovery time with you.


Does insurance cover endodontic surgery?

Each insurance plan is different. Our office will help you check with your employer or insurance company prior to treatment.


How do I know the surgery will be successful?

We would only suggest endodontic surgery if we believe it is the best option for you. Of course, there are no guarantees with any surgical procedure. We will discuss your chances for success so that you can make an informed decision.


What are the alternatives to endodontic surgery?

Often, the only alternative to surgery is extraction of the tooth. The extracted tooth must then be replaced with an implant, bridge, or removable partial denture to restore chewing function and to prevent adjacent teeth from shifting. Because these alternatives require surgery or dental procedures on adjacent healthy teeth, endodontic surgery is usually the most cost-effective option for maintaining your oral health.

 

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