FREQUENTLY ASKED QUESTIONS
Endodontics is one of the twelve dental specialties recognized by the American Dental Association. Endodontics pertains to the diagnosis, treatment, and management of the dental pulp (root canal system) and surrounding, periapical tissues of a 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, crown or root fracture or other problems, can severely damage the pulp. When such damage occurs, 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.
Endodontic treatment or “root canal treatment,” is necessary when the dental pulp becomes inflamed or infected. The inflammation or infection can have several causes: decay, dental trauma, repeated dental procedures on a tooth such as fillings and crowns, or a crack in the tooth. Some of the indications of damage to the pulp include spontaneous pain, discoloration of the tooth, prolonged sensitivity to hot or cold stimuli, and swelling or tenderness in the gums near the tooth. Occasionally root canal treatment is necessary even when there are no obvious symptoms.
By performing root canal treatment, an endodontist removes the inflamed or infected dental pulp, cleans and shapes the inside of the tooth, namely, the root canal space, and then fills the root canal space to help prevent the ongoing penetration of bacteria into the root canal space. After completion of a root canal, the patient typically needs to return to his/her general dentist to have a crown or other suitable restoration (filling) placed, as this “final filling” seeks to seal the root canal space from bacterial penetration. These procedures should return the tooth to full function and normal chewing.
Many endodontic procedures are performed to relieve pain caused by dental pulp inflammation or infection. With current techniques, many, if not most patients experience no pain during the procedure, as we use a sufficient dose of local anesthetic, and we ensure the tooth and surrounding structures are numb prior to initiating treatment. However, a root canal treated tooth may feel sore or bruised for a few days after treatment as the healing process occurs. Most of the time this discomfort can be easily controlled with over-the-counter medications and/or prescriptions.
There are many factors that contribute to the duration of an endodontic appointment. The actual treatment time is often dependent on the technical difficulty of the given root canal space, as each tooth and therefore each root canal system is unique and sometimes uniquely complex. On average, a typical root canal treatment may take between 45 and 90 minutes. However, it’s very important that our patients understand that “fast” is not always “best” or “most successful.” We seek to be efficient, but we also want to do our very best for you, and rarely should one’s best be measured by one’s speed unless one’s on a racetrack!
While it is good to be cognizant of radiation exposure, x-rays are an important part of all dental treatment, and they are integral to endodontic diagnosis and treatment. We use advanced digital radiography, which reduces radiation exposure by up to 90% compared to those of already low-dose conventional radiography. We also use limited (small) field of view cone-beam computed tomography to evaluate a small region 3-dimensionally. The images we capture can be optimized, archived, printed, and delivered to referring doctors via e-mail.
When your root canal treatment has been completed, a record of your treatment will be sent to your referring dentist via email. You should contact your referring dentist’s office for a follow-up appointment if a definitive/final restoration/filling is necessary 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. Sometimes, we can place this final filling in our office at the time we complete your root canal treatment, but it is dependent on your referring dentist’s preference, to which we try to adhere. It is rare for endodontic patients to experience complications after routine endodontic treatment or microsurgery. If a problem arises, however, we are available on an emergency basis.