What is a root canal?

A root canal is one of the most common dental procedures with well over 14 million performed every year. This simple treatment can save your natural teeth and prevent the need for dental implants or bridges.

A root canal is a treatment used to repair and save a tooth that is badly decayed or becomes infected. During a root canal procedure, the nerve and inflamed or dead tissue are removed and the inside of the tooth is cleaned, disinfected, and sealed. After the canal space is cleaned and dried, it is filled with a root canal filling material to prevent the re-entry of bacteria. Without treatment, the tissue surrounding the tooth will become infected and abscesses may form.

“Root canal” is the term used to describe the natural cavity within the center of the tooth. The pulp or pulp chamber is the soft area within the root canal. The tooth’s nerve lies within the root canal.

A tooth’s nerve is not vitally important to a tooth’s health and function after the tooth has emerged through the gums. Its only function is sensory — to provide the sensation of hot or cold. The presence or absence of a nerve will not affect the day-to-day functioning of the tooth.

Will the treatment be painful?

We will take every measure to ensure that your procedure is in no way uncomfortable or painful. If treatment is needed, we will inject a small amount of anesthesia to gently numb a concentrated area of your mouth. For most patients, the feeling of numbness usually subsides after 2-3 hours. Nitrous oxide (“laughing gas”) is available to use.

Will it take more than one visit?

About half of the root canals done in this office are done in one visit. Most are done in two visits due to swelling, persistent drainage, or complex anatomy. If your tooth needs additional visits, you will not need to pay more. It just means that we want to give you the best quality root canal regardless of the number of visits it will require.

Is the tooth dead?

The center of the tooth no longer has nerve tissue in it; therefore your tooth will no longer be sensitive to hot or cold. Your tooth will still have feeling due to other tissue and ligaments that hold your tooth in your jaw.

What pain medication is best?

I recommend ibuprofen (Advil, Motrin, or generic) about every 4-6 hours. The over the counter pills are 200mg. You may be given a prescription for 600mg or 800mg with the corresponding instructions. If you are still uncomfortable despite the ibuprofen, you can take 650mg of Tylenol (acetaminophen) along with the ibuprofen. If you have been given a prescription for Vicodin, then you may take that with the ibuprofen instead of the Tylenol. Do NOT mix Tylenol and Vicodin!

Will I need more dental work after my root canal?

In most cases, you will be referred back to your dentist who will determine what kind of permanent restoration is needed. Most root canalled teeth will require a crown if there is not already one. If you received a temporary filling in our office, and your root canal is completed, I recommend getting the permanent restoration within 30 days or sometimes sooner. We will send a completed treatment report to your dentist with a copy of your radiographs.

Will I need to return to your office for follow-ups after the procedure is finished?

Yes, for most root canal treatments, we recommend that patients return to the office 6 months after the procedure was finished. Our office will send a reminder notice to you when you are due for a recall appointment. There is usually no charge for the exam at this appointment but there is a minimal charge for the radiograph. A new report with the current xray will be sent to your dentist.

Can I chew on my tooth after a root canal?

I do not recommend chewing on the tooth until it has received a permanent restoration. First of all, if the tooth is sore you can make it more sore with chewing. Healing is similar to a sprained ankle, the more you use it, the longer it will take to heal. Secondly, you could break the tooth if it has a temporary filling. The risk of tooth fracture is very high in root canal treated teeth that have not been permanently restored.

The tooth is still uncomfortable. Is that normal?

Teeth are usually uncomfortable after a root canal for approximately 3-7 days after treatment. Usually the soreness is greatly reduced by the third day and is usually gone at day seven. It can be possible that soreness lasts for several weeks, but will usually get better every day. I recommend taking the ibuprofen for the first 3 days after the root canal procedure. It will help with the discomfort as well as keeping the inflammation down.

I was supposed to get my temporary filling replaced 6 months ago and now my tooth hurts. Now what?

If you did not see your dentist for a final restoration after your root canal, chances are that the tooth may be fractured or has become re-infected. The rate of fracture for an un-restored 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. A re-infected tooth can usually be retreated.

Why do you use a microscope?

I have used a microscope for endodontics since 2003. The Surgical Operating Microscope (SOM) has enhanced my endodontic practice and improved the success rate of root canals. It allows for magnification and a high intensity Xenon light source to see all of the root canal anatomy. Canals are often the width of a human hair making magnification a must needed

Do you perform emergency treatment?

Endodontic treatment can occasionally involve unscheduled emergency visits. While we do our best to run on time, these unforeseen interruptions can sometimes result in delays. Every effort will be made to see you as promptly as possible. Should you find yourself in a similar emergency situation, we hope that patients made to wait due to your emergency will understand as well.

Do you take out teeth?

We only take teeth out if we are placing an implant for you in the near future. Since an implant may be an option in the site where the tooth is being removed, a bone graft may be suggested at this time. 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’ve heard of implants. Are they better than root canals?

Maintaining your natural teeth is one of our priorities, but if root canal treatment is not predictable then a dental implant may be indicated. Root canal therapy may not be ideal treatment if the tooth has a fracture below the gumline or there is not enough remaining tooth structure to support a crown. 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 and our cone beam computed tomography (CBCT) helps in predicting the outcome of treatment.

My dentist referred me for a Cone Beam scan. What is that and how much radiation is involved?

The CBCT systems used by dental professionals rotate around the patient, capturing data using a cone-shaped X-ray beam. This data is used to reconstruct a three-dimensional (3D) image of the following regions of the patient’s anatomy: dental (teeth); oral and maxillofacial region (mouth, jaw, and neck); and ears, nose, and throat (“ENT”).

X-ray imaging, including dental CBCT, provides a fast, non-invasive way of answering a number of clinical questions. Dental CBCT images provide three-dimensional (3-D) information, rather than the two-dimensional (2-D) information provided by a conventional X-ray image. This may help with the diagnosis, treatment planning and evaluation of certain conditions. In our office, it is especially useful in finding missed canals in a previously root canalled tooth, or showing patterns of bone loss that could indicate a fracture in the tooth. While oral health professionals have long relied on 2D imaging for diagnosis and treatment planning, this technology typically requires multiple exposures and, with them, multiple doses of radiation. With a properly prescribed 3D scan, practitioners have gained the ability to collect much more data – often with a single scan and potentially with a lower effective patient dose.

Although the radiation doses from dental CBCT exams are generally lower than other CT exams, dental CBCT exams typically deliver more radiation than conventional dental X-ray exams.

Why don’t you take the same insurance my dentist does?

Your dentist has referred you to our office because of their trust in our clinical and professional ability. Most restorative dentists may not be aware of which insurance companies we are in or out of network with. We will help you by reviewing your benefits and submitting claims to your insurance company. Dental insurance is an agreement between you, your employer and your insurance carrier. We will do our best to give you an accurate estimate of your coverage. Most patients find that their out of pocket expense for an out-of-network provider may be close to that of an in-network provider.

The care you receive in our office is not affected by the type of insurance you have, or don’t have. We have limited ourselves to those companies that recognize and reimburse for the quality care we render. The companies we are in network with are: Anthem BC/BS of CT, Delta Dental of New Jersey (and corresponding USA network plans), Mashantucket Pequot Plan, United Concordia National Fee for Service, and Cigna PPO.

We ARE NOT in network with the Medicare and Husky plans. Medicare has extremely limited dental coverage. Patients with Husky insurance must go to an in network provider to receive benefits.