Endodontic FAQ

What is endodontics?

Endodontics is a speciality of dentistry recognized by the American Dental Association involving treatment of the pulp (aka "the nerve" or the "root canal") and surrounding tissues of the tooth. Underneath your tooth, the portion hidden beneath the gum line, is called the root. Inside the root, there are inside channels or the “root canal” which contains the pulp (aka “the nerve”). The pulp is composed of both blood vessels and nerves.

Endodontic procedures include, but are not limited to, root canal treatment, root canal retreatment, surgical endodontic treatment (aka apicoectomy or root end resection), treatment of tooth resorption, cracks fractures, and traumatic dental injuries. Other endodontic procedures that Dr. McIntyre enjoys also include apexogenesis, apexification, internal bleaching, autotransplantation, pulp regeneration, decoronation, instrument and/or post removal, pulp capping, perforation repairs, vital pulp therapy, and more. Some endodontists also place implants.

What is an endodontist? Why should I see an endodontist for my root canal treatment?

An endodontist is a dentist who has completed a 2 or 3 year specialty program beyond dental school that focuses on endodontic (root canal) therapy. This additional training expands extensively on the dental school endodontic curriculum. As specialists, endodontists specifically perform root canal treatment and associated procedures. These include complex root canal therapy, retreatments of existing root canals, root-end surgeries, whitening of root canal treated teeth and treatment of traumatic injuries in children and adults.

Why are endodontists called specialists?

While all endodontists are dentists, less than 3% percent of dentists are endodontists! Just like a doctor in any other field, endodontists are specialists because they’ve completed an additional two or more years of training beyond dental school. Their additional training focuses on diagnosing tooth pain and performing root canal treatment and other procedures relating to the interior of the tooth. In many cases, a diseased tooth can be saved with endodontic treatment. For this reason, endodontists proudly refer to themselves as Specialists in Saving Teeth.

Why do I need endodontic (root canal) treatment, and what does it entail?

Root canal treatment is a way to help you save your natural tooth: http://www.hopkintonendo.com/page.aspx?n=Endodontic-Procedures. You may need root canal treatment for a variety of reasons, sometimes even for more than one reason. Usually, a root canal is necessary because of a cavity (tooth decay), periodontal disease, a tooth fracture or cracks, or a large filling or crown that has ultimately had a nice run has ultimately annoyed the nerve inside your tooth. Or, you might have an abscess at the end of the tooth roots inside your jaw bone. In a few circumstances, your dentist might advise root canal treatment before restoring a tooth just in case the new crown or restoration is too close to the nerve.

During root canal treatment, an endodontic specialist treats the nerve/pulp by removing it and cleaning the "canals" to prevent further infection and inflammation. After successful endodontic treatment, the tooth is allowed to continue to function normally, after a final restoration by your dentist.

Will endodontic (root canal) treatment hurt?

This is the question that we are asked most frequently. The procedure should not be uncomfortable. Modern dentistry has created wonderful options for anesthesia and pain management. Dr. McIntyre’s main goal is for your treatment to be a pleasant experience; she will do everything she can to keep you comfortable and calm.

What happens after endodontic (root canal) treatment?

You may experience some discomfort following root canal treatment. You may notice this if you tap on the tooth or push on it with your tongue or finger. This sensitivity can usually be managed by over-the-counter medications such as Advil/Aleve and/or Tylenol. Dr. McIntyre provides all patients with a sheet of written post-treatment instructions (link: http://www.hopkintonendo.com/page.aspx?n=after-treatment) and she is available by phone should you have further questions.

She will place a temporary filling in the tooth after the root canal treatment is completed. This temporary can seal the opening for approximately 4 – 6 weeks. We recommend that you make an appointment with your dentist for a final (non-temporary) filling or crown within this time period, or as soon as possible. If you are still experiencing symptoms, we request that you contact our office prior to seeing your dentist. Without a final filling placed by your dentist, re-contamination of the root canal system may occur, and the need for a root canal retreatment to be performed resulting in additional time and expense for you.

When your root canal therapy has been completed, a record of your treatment and the final X-ray will be sent to your restorative dentist and your dentist will plan for your final restoration to make the tooth fully functional again.

Are endodontic (root canal) procedures and materials safe?

Research on root canal therapy done as early as the 1930s and 40s shows no correlation between root canal therapy and general physical illness. The presence of bacteria in the mouth has been proven, even in individuals who do not have any dental disease (cavities, gum disease, etc.). Additional references and information can be found at http://www.aae.org/patients/mythsrootcanal/. Dr. McIntyre would be happy to answer any additional questions you may have.

What happens if I don’t have endodontic (root canal) treatment?

If you choose to delay or decline treatment, several things may happen. You may develop pain or the tooth may abscess, creating a swelling of the gums, face or jaw that may be dangerous and could require hospitalization. The other concern is that bone may be lost around the roots of the tooth in response to the chronic infection. This can lead to mobility of the tooth and ultimately, the loss of the tooth.

Why can’t I just take antibiotics for my toothache or dental infection?

Taking antibiotics (instead of receiving endodontic – root canal – treatment) will only “mask” the problem. An example would be like putting a lid on a trash can. The trash can (the inside of the tooth) is still inflamed or infected; in other words, the trash can is still dirty. The best thing to do would be to clean out the canals (the trash can) so that the symptoms do not recur, and so that other complications do not develop (abscess, swelling, pain). Unfortunately, teeth DO NOT heal, like the rest of our body does. Because the tooth is a hard structure, it is not capable of healing, and that is why the root canal should be performed. The root canal treatment is the only thing that will save the tooth and treat the inflammation and/or infection.

I’m really worried about radiation. Do I need more X-rays?

In communication with your general dentist, often times we can use your dentist's recent X-ray. However, occasionally, it might not be available or the x-ray your dentist sends us might be different from what might exist in your mouth at the time of your visit. In those instances, we use an advanced non-film computerized system, called digital radiography, which provides significantly lower radiation levels – up to 90 percent lower – than those of already low dose conventional dental x-rays. We then send back to your dentist via mail or e-mail our digital images. Nevertheless, Dr. McIntyre cannot perform her treatment without x-rays, as they are the standard of care during endodontic treatment; at least one X-ray will be necessary during your root canal treatment.

What are my other options?

It is prudent, and we encourage you, to have all possible information prior to making any decisions about your dental care. Other options include extraction of the tooth and replacement with either a dental implant (screw placed in the bone with a false tooth to replace the missing one), a bridge (two crowns cemented on the teeth on either side with a false tooth in the center), or a removable partial denture (a false tooth / teeth to replace the missing tooth / teeth that can be removed from the mouth)

Despite all of the advancements in dentistry, there is no real replacement for your natural teeth. The loss of even one tooth can cause shifting and changes in the bite (occlusion) that may require extensive treatment to correct.

Dr. McIntyre is happy to extensively discuss your treatment options with you at your visit. Of course, your dentist is a wonderful resource as well.

How much will the endodontic (root canal) treatment cost?

The fees depend on several things, including root canal anatomy, location of the tooth in the mouth, the need for medications inside the tooth, what type of filling materials are used and if the procedure is a retreatment of previous root canal therapy or a surgical procedure.

Our staff is happy to provide you with a cost range based on the treatment that you require. A more specific fee can be provided at your evaluation or treatment appointment following the doctor’s evaluation of your specific tooth; it is difficult to accurately discuss fees without a consultation and/or review of your insurance benefits, if you have them. http://www.hopkintonendo.com/page.aspx?n=financial-policy

Should I be concerned about infection?

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, weekly spore testing, and barrier techniques to eliminate any risk of infection.