Is a Root Canal for you?
Do you have any of the following symptoms?
- Sensitivity to hot or cold that lingers
- Discomfort when chewing or biting
- Dull ache
- Discomfort that wakes you up at night
- Your dentist has diagnosed the need for endodontic treatment either
by clinical exam or x-ray
If you answered yes to any of the above, you might very well need a
root canal.
Please call and schedule for an evaluation.
Be aware not all teeth that ARE in need of root canal therapy
will cause pain. It is possible to be pain-free and still need a root
canal.
What is a Root Canal?
ROOT CANAL is a "lay persons" term for endodontic therapy
or root canal therapy. Root canal therapy is necessary when the nerve
inside the tooth becomes irreversibly damaged or infected. This is usually
due to the entry of bacteria into the center most part of the tooth
called the dental pulp ("nerve"). Root canal therapy involves
the removal of the entire nerve system, as well as cleaning, shaping
and filling 3-dimensionally the canal system with gutta-percha and a
dental sealer.
What is Involved in a Root Canal Procedure?
The endodontist examines the x-ray and the tooth, then administers
a local anesthetic. After the tooth is numbed, a Small protective
sheet, called a dental-dam is placed to isolate the tooth, A Small opening
will be made in the crown of the tooth and Small instruments
will be used to clean the canals and to shape the canal spaces for filling.
Once the canals have been adequately cleaned and shaped, the
canals will then be filled with a rubber-like material called "gutta-percha" and
sealer. A temporary filling is then placed to close the opening. Your
dentist will remove the temporary filling before the tooth is restored.
Is the Root Canal Procedure Painful?
With modern techniques and anesthetics the procedure is much
faster and with less discomfort than there has ever been. A
similar anesthetic as the one used by your dentist will be
used for the root canal. For the first few days after treatment, your
tooth may feel sensitive to the bite. This discomfort can be relieved
with over-the-counter or prescription medications in order to control
normal post-treatment discomfort.
Will I Feel Anything After Root Canal Treatment?
In most cases the quantity and quality of discomfort will
subside dramatically within the first 24-48 hours. Any
sensitivity to cold, hot or even breathing air "in" will be gone after your visit.
Nevertheless, you may experience mild discomfort that will last for
several days after treatment. Taking over-the-counter medications such
as aspirin, Advil, Motrin, or Aleve usually relieves this discomfort.
Tylenol has been proven not to be as effective as aspirin, etc., because
it does not have the anti-inflammatory component as these other medications.
The most common complaint is tenderness to touch, bite, tapping or chewing
on the tooth. It is recommended to refrain from any of the above until
your dentist permanently restores your tooth.
What are the Benefits of Root Canal Therapy Versus Extraction?
The single most important benefit of root canal therapy
is that you keep your tooth. Extraction may lead to other
dental problems. For instance, drifting of teeth, bite
problems, TMJ discomfort, and the need to treat adjacent
teeth that do not otherwise need dental treatment in order
to restore the missing tooth. No matter how effective modern
tooth replacements are - and they can be very effective
- nothing is a good as your natural tooth.
My Dentist said I need treatment, Why do I have
to have another consultation and/or examination?
While your dentist is probably right, we must verify that the tooth does
in fact requires endodontic treatment for both medical and legal reasons. We
are responsible for making sure that treatment is warranted. We will test your
tooth to check if it is temperature sensitive to cold and possibly heat and/or
electrical impulse. Other tests that we routinely complete include tapping
on your tooth to see if inflammation is present, rubbing the gum area near
the end of the roots for sensitivity, and measuring your gums to check the
periodontal health of the area. Sometimes we have you bite on a stick
and/or use a fiber optic light to check for cracks or fractures which go through
your tooth. Usually we will take x-rays at various angles. Not
only are we looking for an abscess but also the anatomy of your tooth. Since
you are 3 dimensional and X-rays are 2 dimensional we lose information that
we attempt to make up by taking specialized angles. X-rays alone are
not sufficient for diagnosis. Just because there's nothing on the X-ray's
does not mean there is not a problem. Early stages of pulp degeneration
and some small abscess are not visible on the X-rays.
Why Does
the Examination Take so Long?
Many things occur during your consultation visit to our office. You
will have some forms to fill out such as a health questionnaire. We
will take your blood pressure, obtain radiographs (x-rays), ask
about your endodontic problem, evaluate symptoms, complete an examination
of the area in question along with endodontic testing and discuss treatment
options available to you. Also we will provide a pretreatment
service estimate. The
length of time in our office varies, many cases are referred
to us because they are more difficult and therefore require more time.
What
Will Insurance Pay for?
The coverage varies depending on both insurance company and
how the plan was set up through your employer. While we don’t
accept insurance or file for it, we will be happy to help you by printing
the forms necessary for you to submit your insurance.
Payment for Services
Payment for services
is required at the time of treatment. We accept VISA MasterCard, cash,
and checks. Payment plan options can be discussed with the front office
staff.
About Endodontics
Root Canal or Non-surgical Endodontic Therapy:
This procedure is performed to save a tooth when the inner
tissue, called the pulp, becomes damaged. Therapy consists of opening
the tooth, removing the pulp, cleaning, shaping, and filling to seal
the root canals. Endodontic therapy is usually highly successful (up
to 90% of the time)!
NOW THAT ENDODONTICS IS COMPLETED
The root canal spaces inside your tooth have been cleaned,
medicated and filled. The tooth opening through which endodontic treatment
was done has been sealed again with a cement filling and the treated
tooth can be tender for some time. This outermost cement filling is
not permanent, so please contact your family dentist within the next
few weeks to arrange to have the tooth restored.
Usually a tooth that requires root canal treatment has had
a past history of decay, large fillings or trauma. It is often
necessary for this type of tooth to receive additional protection
in the form of a crown or an onlay. Your family dentist is best qualified
to determine how to restore your tooth. Until you have had a chance
to visit your dentist again, it's wise to be careful biting or using
the treated tooth so that you do not fracture it.
A note and a copy of your final x-ray film are being sent by
this office to your dentist, informing him or her that treatment
has been completed.
In approximately six months, we would like you to return here
for a re-examination. The progress of healing of your tooth
will be evaluated. There is no additional charge for this visit.
If any difficulties or questions arise concerning your treatment,
please do not hesitate to call.
Re-Treatment
Occasionally a tooth that has undergone endodontic treatment fails
to heal or pain continues despite therapy. Although rare, sometimes
a tooth initially responds to root canal therapy but becomes painful
or diseased months or years later. When either of these situations occurs,
the tooth often can be maintained with a second non-surgical endodontic
treatment.
Endodontic Surgery
Sometimes non-surgical endodontic therapy is ineffective. The endodontist
may then use an in-office surgical procedure called root end resection
and root end filling to remove the root tip and seal the root canals
with a filling in the end of the root.
INSTRUCTIONS FOR HOME CARE FOLLOWING SURGICAL
ROOT CANAL TREATMENT
1. Swelling, minor pain, and/or skin discoloration may be experienced.
This will be temporary.
2. In order to keep possible swelling to a minimum, the use
of an ice pack on the face over the operated area is recommended.
The ice pack should be used; on for 15 minutes, off for 15
minutes, etc. This is done during normal waking hours for 2-4 hours
following surgery.
3. Do not raise lip with your fingers to inspect the treated
area. The operated area should be treated with special care.
4. Eat only soft foods until next visit. Avoid hard or chewy
foods such as potato chips, steak, toast, and peanut brittle.
5. Do not brush teeth near the operated area. Brush teeth in
rest of mouth.
6. Starting tomorrow use warm salt water soaks (½ teaspoon salt
to 8 oz. glass warm water) on the treated area under the lip
or cheek, following each meal and before bedtime. Soak for approximately
5 minutes total time.
7. Get plenty of rest and insure normal Intake of food, especially
liquids such as fruit juices, soups and milk.
8. Take medications according to instructions.
9. Should any difficulties or questions arise, do not hesitate
to call this office at any time, day, night, or weekend.
Traumatic Injuries
A blow to the mouth sometimes causes pulpal damage, and the endodontist
specializes in treating these types of traumatic injuries. For example,
a blow to a child's permanent tooth that is not fully developed can
cause the root to stop growing. A procedure called apexification stimulates
bone to be deposited at the end of the root, which if successful, makes
it possible to then save the tooth later by completion of a root canal
procedure. An endodontist is specially trained in procedures for re-implanting
teeth that have been knocked out of their sockets.
Diagnosis and Treatment of Atypical Pain
Oral pain such as toothaches or cracked
/ fractured teeth can often be difficult to pinpoint. Because
of the vast network of nerves in the mouth, the pain of a
damaged or diseased tooth often is felt in another tooth and/or in
the head, neck, or ear. An endodontist is a specialist in diagnosing
and treating this type of pain.
Non-Vital Bleaching
This procedure is used to lighten a darkly discolored tooth
that has had a root canal.
Toothache
A "toothache" is pain typically
around a tooth, teeth or jaws. In most instances, toothaches are caused
by a dental problem, such as a dental cavity, a cracked or fractured
tooth, an exposed tooth root, or gum disease.
Sometimes problems with the jaw joint (temporomandibular joint
or “TMJ”), or spasms of the muscles used for chewing can
cause toothache like symptoms. The severity of a toothache can range
from chronic and mild to sharp and excruciating. It can be a dull ache
or intense localized pain. The pain may be aggravated by chewing
or by foods and liquids, which are cold or hot. A thorough oral examination,
proper tooth testing and evaluation, along with appropriate dental x-rays,
can help determine the cause. What we want to know is whether
the toothache is really coming from a tooth or somewhere else.
Sometimes, a "toothache" may be caused by a problem not originating
from a tooth or the jaw at all. Pain around the teeth and the
jaws can be symptoms of diseases of the heart (angina,
heart attack), ears (such as inner or external ear infections),
and sinuses (air passages of the cheek bones) such as sinusitis
(infection of the sinus cavities). For example, the pain of
angina is usually located in the chest or the arm. However, in some
patients with angina, a toothache, or jaw pain are the only symptoms
of their heart problem. Infections and diseases of the ears and sinuses
can also cause pain around the teeth and jaws. Therefore, evaluations
by both dentists and doctors are sometimes necessary to diagnose medical
illnesses causing a "toothache."
Keep in mind, while rare, some chronic toothache like pains
are caused by neuralgias and other nerve ailments.
Dental Causes of Toothaches
A dental cavity
or decay, which has inflamed the pulp, can cause dental pain. Left
untreated this will progress to an abscessed tooth. Sometimes,
in spite of the decay removal and restoration the pulp has
become so inflamed that it continues to degenerate.
Decay which has progressed to invade the pulp and cause the pulp tissue
to become infected resulting in an abscessed tooth
Cracked, Split and Fractured teeth can cause inflammation of
the pulp and the tissues around the tooth
Periodontal disease and receding gums can expose tooth roots
making them more sensitive to hot and cold foods. Periodontal
disease can cause pulpal inflammation via small canals that extend from
the outside of the tooth to the inside called lateral or accessory canals.
Surgical Microscope
In our office, we use a Zeiss Surgical Microscope. It provides
enhanced visualization of the endodontic access or surgical
area up to 25 times. This is especially beneficial for accurate
visualization of complex anatomy cases, for locating root
fractures or defects, for root-end surgery, for removal
of separated instruments, and for locating canals. Microscopic
Endodontic Therapy This involves additional magnification
to provide micro-surgical and non-surgical location procedures
and cleansing of the interior root canal spaces, germicidal
treatment and filling of these spaces. Endodontic re-treatment
of previously treated and re-infected teeth utilizing Micro-technique
Endodontics© has also been found
to have broad acceptance.
Nickel Titanium Rotary Instruments
Nickel Titanium has the unique features of flexibility
and shape memory. The instruments are used to clean and
shape the inside of the canal. Previous stainless steel
instruments had the tendency to break and could not take
a curve to follow the shape of the canal, so it was difficult
to clean the canal successfully. Nickel Titanium is 500
times more flexible, so even canals that are sharply curved
can be thoroughly cleaned and shaped. Using these instruments
routinely, allow us not only to be more effective, but also
to work faster and more quietly.
Electric Handpieces
New electric handpieces are virtually silent. This significantly
reduces the anxiety of our patients. These handpieces are designed
to be used exclusively with nickel titanium rotary instruments.
Electronic Apex Locators
It is important for the success of root canal therapy to
clean and fill to the very end of the root, without extending
beyond or being short. The electronic apex locator aids
in measuring the length the canal by determining accurate
position of the apical constriction through a resistance
force.
<< return to top of page
