The information below is intended to answer some questions that you will likely have. However, please feel free to ask any questions or to express any concerns you might have – prior to, during, or after treatment – either by phone, email, or at the time of appointment(s).
It is our goal to provide the highest quality of care while delivering treatment in a comfortable manner and minimizing time spent in the office. A microscope is used for almost all procedures. It is a fantastic aid in helping to locate canals and cracks that otherwise would be very difficult to impossible to see. We have a small field-of-view CBCT machine in-office for 3D imagery when indicated.
What is an endodontist?
An endodontist, commonly referred to as a ‘root canal specialist’, is a dentist who treats inflammation and disease of the tooth pulp, including infections in the jawbone caused by such disease. The pulp consists of blood vessels and nerves that are located inside a tooth; that is, inside the canals which exist within a tooth’s roots (see diagram below). Not many years ago, these teeth were extracted. Today, with modern dental techniques and root canal therapy, most of these teeth can be saved.
Why have you been referred to an endodontist?
Your dentist, after reviewing your x-rays and/or starting the root canal treatment, has decided that your needs would best be met by referring you to an endodontist due to the complexity of your particular problem.
Sometimes an initial consultation visit is required to gather necessary information and to answer some questions. For example: What treatment is needed and what options are there? Does the long-term prognosis of the tooth/teeth warrant investing the time and cost of treatment? How much time and how many appointments are required to complete treatment? How much will treatment cost?
About your tooth (see diagram left)
Your tooth can be divided into two main parts: the crown which is the part of the tooth above the gum line and is visible in your mouth, and the root(s) which is (are) the part of the tooth that is beneath the gum and is surrounded by bone. Inside each root is (are) the canal(s) that contains the pulp (blood vessels and nerves) which is often simply referred to as the nerve in the tooth.
When is root canal treatment necessary?
Root canal treatment is generally necessary when the pulp has been irreversibly damaged by bacteria associated with decay, very deep fillings, cracks, or trauma. In order to preserve a tooth in which this has occurred, it is necessary to remove the inflamed or infected pulp tissue. This procedure is known as ‘a root canal’ or ‘endodontic therapy’.
What is involved in root canal treatment?
Having a ‘root canal’ means treatment of a tooth’s root canal system. This involves finding the canal(s), enlarging and cleaning them to remove bacteria and the pulp, and then filling the root canal system with an inert rubber-like material. This procedure is usually done in one or two appointments. The prognosis for the overwhelming majority of teeth is favourable.
Will it hurt?
With some people, root canals unfortunately have a bad reputation. Comedians often get a laugh by making some kind of comparison to a root canal. Dentists are continually trying to change this image. We have two priorities: one is to do an excellent job for every case, the other is not to hurt people. To do an excellent job, the patient must be comfortable.
The goal of root canal treatment is to eliminate pain and/or infection. After treatment, there is sometimes inflammation of the tissues surrounding the tooth. Taking an anti-inflammatory/pain reliever such as Ibuprofen (Advil or Motrin) usually controls discomfort from this. Extra Strength Tylenol or Tylenol 3 can also be taken in between the times that Ibuprofen is taken. If this is insufficient, then you should call the office or the after hours number. Occasionally an antibiotic prescription is given, but this is not common.
If the tooth is dead, then won’t it fall out?
No. Firstly, a tooth that has had root canal treatment is not dead. The tooth still receives nourishment and support from the tissues around it and does not fall out. It remains held in place by surrounding ligaments.
Will the tooth turn black?
No. Not with modern treatment. And those that have become discoloured prior to or after root canal treatment can usually be corrected with a simple bleaching procedure.
Will the treatment be expensive?
The cost of root canal treatment is nearly always less than the cost of removing the tooth and replacing it with an artificial one.
What are the alternatives to root canal treatment?
There are two alternatives: (1) Continuing with the existing problem (this would not be recommended as it would likely become more serious), or (2) Extraction. If a tooth is extracted, there are two or three ways to replace it: a removable partial denture, a bridge, or an implant. It is best to speak with your dentist about these options.
What happens after the root canal treatment?
Sometimes a permanent filling is placed in our office. Sometimes a temporary filling is placed in which case it is important for you to contact your dentist for a follow-up restoration (filling or crown) within 4-6 weeks. All back teeth (molars and premolars) and some front teeth should usually be restored with a crown (often referred to as a ‘cap’) soon after root canal treatment to prevent breakage in the future. This is done by your dentist and the fee is not included in the cost of root canal treatment. (It should be noted that the combined cost of root canal treatment and a crown is nearly almost always less than the cost to extract and replace the tooth with a bridge or implant.)
X-rays are taken as an integral part of quality root canal treatment. Let us know if you have reservations about this. It might interest you to know that we use digital technology which uses an exposure time that is up to 5 times lower than with conventional film. We have a small field-of-view CBCT machine in-office for 3D imagery when indicated.