Endodontics is a branch of dentistry recognized by the American Dental Association involving 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, 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 infection and inflammation. After successful endodontic treatment, the tooth continues to perform normally.

The endodontic procedure of a root canal is the process of removing inflamed or necrotic (dead) tissue from the space within the tooth. During this process it is disinfected to reduce the number of bacteria as much as possible. After the canal space is cleaned and dried, it is filled with a root canal filling material to minimize the re-entry of bacteria.

The roots of your tooth are not removed. The inside of the roots are cleaned and the rest of the root is left to support the tooth.

What constitutes life is a great question for a philosophy class, and if you argue that the tooth was never alive, then it is possible that it could never die. Your tooth will no longer be sensitive to hot or cold, but it will still have feeling due to the bone and ligament that hold your tooth in the jaw.

No. While x-rays will be necessary during your endodontic treatment, we use an advanced non-film computerized system, called digital radiography, that 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 referring doctors via e-mail.

Again, there's no need for concern. We adhere to the most rigorous standards of infection control advocated by OSHA, the Centers for Disease Control and the American Dental Association. We utilize autoclave sterilization and barrier techniques to eliminate any risk of infection.

When your root canal therapy has been completed, a record of your treatment will be sent to your referring dentist. You should contact your referring dentists 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 at all times to respond.

Yes, for most root canal treatments, we recommend that patients return to the office either 6 months or 1 year after the procedure was finished, depending on the specific case. Our office will send a reminder notice to you when you are due for a recall appointment.

Teeth are often uncomfortable after a root canal, and discomfort usually peaks about two days after treatment. It is common for the tooth to still be a little uncomfortable for a week or so. It is important that the tooth is getting better over time.

Your jaw may be sore and your lip may be numb, but you should be in good shape to continue your regular schedule. I don’t recommend leaving your appointment and going straight to an important lunch meeting (unless you wear a bib 🙂 In terms of your schedule, it should be no different than getting a filling or a crown.

Unless there are contraindications (ask your physician) I usually recommend 600-800 mg of ibuprofen (Advil, Motrin, or generic) about every 6 hours. If you are still uncomfortable despite the ibuprofen, then take about 1000mg of Tylenol (acetaminophen) along with the ibuprofen. If you have been given a prescription for either Vicodin or Percocet, then you may take that with the ibuprofen instead of the Tylenol.

If you already have a crown, most of the time the root canal will be done through a small opening in the top. Your dentist will need to repair the opening after your root canal is completed. A new crown may be indicated if there are imperfections that do not lead to predictable dental health.

Crowns with porcelain (tooth colored crowns) are susceptible to fracture of the porcelain (happens less than 5% of the time). If the porcelain fractures in a way that the crown is no longer functional or esthetic, then replacing the crown may be necessary.

Many patients ask if they can come to me for all of their dental work. The answer is that I specialize in root canal therapy and limit my practice to that area of dentistry. Out of respect for your dentist, who has referred you to us, we will return you to their care. If you do not have a dentist, then we can help you find an appropriate match.

We will help you by submitting claims to your insurance company. We do not participate in most capitation plans, but you will find that your out of pocket expense for an out-of-network provider may be close to that of an in-network provider. Call us so that we can help you determine the cost of your care.

One reason for not participating in many insurance plans is that they simply will not reimburse at an acceptable rate. Some companies reimburse specialists and generalists the same amount. This is unacceptable when you consider that the complexity (and therefore the time required) of cases treated by a specialist is much greater than those treated by general practitioners. Some reimburse at rates close to what I experienced in dental school!

Though the care you receive in our office is not affected by the type of insurance you have (or don’t have), we have had to limit ourselves to those companies that recognize and reimburse for the quality care we render.

Maintaining your natural teeth is one of our priorities, but if we feel that root canal treatment is not predictable then a dental implant may be indicated. Implants are great for replacing missing teeth, and will be recommended if it is believed that they will be a better long-term investment in your health. The use of the dental operating microscope helps in predicting the outcome of treatment.

We do not perform extractions in our office. Since an implant may be placed in the site where the tooth is being removed, I often recommend that the person placing the implant should be the one removing the tooth. This way the site will be prepared in a way that is familiar to the person placing the implant.

I acknowledge that you want to spend as little time in the dental chair as possible. The idea in dentistry that faster is better is false (in most cases). You would never tell your cardiologist to do your bypass as fast as possible. Rather, you would say “Please do your best.” If your root canal is taking longer than expected, it is because we care about the quality of care you are receiving, and we are trying to treat the entire anatomy present in your tooth. I re-treat many root canals that were done by a fast-paced practitioner oblivious to the nuances that make root canal therapy successful.

If you have not had your tooth permanently restored in a timely manner, the canal system may have become re-infected with bacteria. In this case a re-treatment may restore your tooth to health. In most cases you will need to pay for the cost of re-treatment, so getting the tooth restored early is a wise use of resources.

The rate of fracture for an unrestored root canal treated tooth is very high. If the tooth has cracked then it may not be restorable, and you will lose what you have invested.

If you are unable to afford the restorative phase of treatment at this time, please discuss this with your dentist. At a minimum, the tooth should get a permanent filling and receive a temporary crown or be removed from occlusion (shaved down so you can’t bite down on it).