What will happen when I am brought back to the treatment room?
The dental assistant will begin by taking 1 or 2 x-rays. The doctor will review your medical history and will ask questions about the current tooth problem. The doctor may perform an exam, such as palpating for tender or swollen areas, or other diagnostic tests to determine the need for a root canal. Once a diagnosis is reached, the doctor will explain treatment options and expectations. You will be given the opportunity to ask any questions before any treatment begins.

My dentist gave me an x-ray to bring, do I still need more?
Although the x-ray your dentist may have given to you will be helpful to us, we will likely want to take a different angle to get the best visualization of the tooth. If your dentist gave you an x-ray and a referral slip, please remember to bring these with you to your appointment. In other cases, your dentist may have made the referral over the phone and will not have given you anything to bring us.

How is the root canal done?
With local anesthetics, your tooth is rendered “numb”. The tooth is isolated with a rubber shield that keeps the bacteria of your mouth out of the tooth, and removes the risk of accidentally swallowing small instruments or disinfecting solutions. A small access cavity is prepared in the tooth to expose the canals. Using small instruments, the canals are measured, cleaned and enlarged. When shaping of the canals is complete, the canals are filled with a warm rubber material that seals the empty space.

How many appointments will it take?
Many root canals can be treated in one visit, but the number of visits required may be dictated by the presence of infection or other complications, and can vary from one to three. Root canal re-treatments often require two visits. Most appointments are from 60 to 90 minutes.

Will the procedure be painful?
The majority of root canals are treated without any discomfort to the patient. Endodontists are specialists trained in a variety of local anesthetic techniques. Many times the “nerve” of the tooth is “dead” and does not even require anesthetic for the work to proceed. Your dentist may have determined that you need a root canal even though you are not having any symptoms. This is the best time to have a root canal done. Left untreated, the condition can progress to a painful toothache or abscess.

Will I have pain after the root canal?
Because there is usually an underlying inflammatory condition when you need a root canal, it is normal for there to be some discomfort afterwards. Usually this is noticed while chewing. For most cases, the discomfort is managed with over the counter anti-inflammatory medications such as ibuprofen, Advil, or Aleve. We usually recommend that you take one of these medications before your anesthetic wears off. Tylenol is not an anti-inflammatory, but is recommended if you cannot tolerate the other medications. In some cases we may prescribe stronger medications. Occasionally, a “flare-up” can occur several days after your root canal therapy. These can sometimes occur in teeth that were not causing any pain prior to the treatment, but suddenly become symptomatic two or three days later. This can sometimes be accompanied by swelling of the gum or face. If this occurs, please call our office. We will evaluate your circumstance and recommend how to best manage the condition.

Should I take pain medication before coming in?
Taking an anti-inflammatory prior to your appointment could mask the symptoms that we are trying to diagnose. If your symptoms are mild or vague, it might be best not to take anything for several hours prior to your appointment. If your symptoms are stronger or well localized, do not try to suffer through it. Make sure to tell your endodontists what medications you are taking. Please call us if your symptoms are severe, we will make every effort to get you in and relieve your pain. If you are taking narcotic medications, please have someone else drive you to your appointment.

What about my other medications?
You should take all your normal daily medications at your normal time. If you take many medications, please bring a list of them with you to the office. Please tell your endodontist of all the medications that you take, including over the counter and herbal medications.

Will I need antibiotics?
In most cases, antibiotics are not required after endodontic therapy. You will be given a prescription for antibiotics if we feel it is necessary. Some medical conditions, such as a heart murmur and prosthetic hip joints, require special doses of antibiotics an hour before treatment. If you have been told by your physician to pre-medicate with an antibiotic for dental treatment, make sure to fill your antibiotic prescription before your appointment date and take the antibiotic as it is prescribed. This special pre-medication dose is still needed even if you have been taking a daily regime of antibiotics for several days already. If you have any questions about this, please call our office.

Will I be able to drive home or go to work after he appointment?
In most cases, you should consider this appointment no more involved than a routine dental filling. Unless we prescribe anti-anxiety medications to take during the appointment, or you have been taking narcotic pain medications, then you should be able to drive yourself to and from the appointment. If you felt well enough to work prior to your appointment, then you should feel well enough to return to work afterwards.

Will I need to see my dentist after the treatment is completed?
Most teeth need some type of restorative procedure after a root canal is completed. For back teeth, this is usually a crown. This is a procedure that is done by your general dentist and is not a part of endodontic therapy. In some cases, you may already have a crown on your tooth prior to the root canal treatment. In these cases, we will cut a small hole to gain access into the crown, without removing the crown. When the root canal is completed, we may be able to place a filling in the access hole so that you do not have to make a special trip back to your dentist for that. Some general dentists prefer that we not place the final restoration. Because they are responsible for the longevity of your dental restorations, your dentist may prefer to place the filling with a material they are familiar with.

How should I take care of my tooth after the appointment?
If we placed a temporary filling, avoid drinking hot beverages or chewing on the tooth for several hours until it has had time to harden up. To avoid cracking the tooth, it is best to avoid heavy chewing until you get the permanent crown placed. Expect that the tooth will be tender to biting for several days after your treatment. Temporary restorations cannot be expected to last for more than 30 days. Failure to return to your dentist for final restoration could result in recontamination or fracture of the tooth, which could result in loss of the tooth. Please make sure you understand what type of restoration was placed in your tooth at the time of root canal treatment, and whether you need to contact your dentist for further restoration.

I had my root canal but it is still sore to chew on, how can that be if the nerve is gone?
Root canal therapy removes the nerves within the pulp of the tooth, the nerves that are a part of the tissue that formed the tooth. There are still millions of nerve fibers in the ligament that lines the socket of the tooth. The inflammation that began in the pulp of the tooth is a chemical cascade that spreads outside the tooth through the natural openings at the ends of the roots where the blood vessels enter. This inflammation is similar to a sunburn, where touch now becomes painful instead of just touch. As with a sunburn, time will heal the inflammation and the tooth will return to feeling normal.

I have extreme anxiety about this procedure!
Relax. Most people relate some anxiety about having dental work done and many people fear the reputation of the words “root canal”. Most bad experiences surrounding root canal therapy are related to the pain or infection that occurs prior to root canal therapy. A severe toothache can come on in the middle of the night with no warning and is not a pleasant experience. Please tell us of your anxieties at your appointment and we will make the experience as positive as possible. For some people, dental anxiety is a serious obstacle to their seeking treatment. We do offer nitrous oxide gas for those patients that prefer a conscious sedative. The effects of nitrous oxide last only while the gas is administered so you can still drive yourself home afterwards. For patients in which anxiety requires stronger medication, we request that you schedule a consultation appointment. At the consultation, we can review your treatment needs, answer questions, obtain your consent, and evaluate your medical history. We can then prescribe a medication tailored to your needs that you can pick up at a pharmacy and take before your treatment appointment. For these cases, you will need someone to drive you to and from the treatment appointment.

I was told I would need my root canal retreated, what is that?
The canals of some roots are more complicated than others. Sometimes the infection of the canal is not eliminated following root canal therapy. This may not be known immediately after treatment is done, and in some cases several years after treatment. In other cases, a treated root canal can become contaminated if it is not properly restored afterwards, or if decay develops around the edges of the crown. In these cases, we remove the rubber canal filling, and then proceed to clean and disinfect the canals again. Since these procedures are more complicated and time consuming, they are often done in two visits.

I was told I would need root canal surgery, what is that?
Most root canals are treated non-surgically. In some cases, there may be some reason why non- surgical treatment or retreatment cannot be performed. In these cases, we can still save some of these teeth by surgically operating on the ends of the roots. This is considered minor oral surgery, and can be done in our office with local anesthetics. We will usually want to provide a consultation appointment prior to scheduling a surgical treatment appointment.

Do you do root canals on baby teeth?
Baby teeth can become infected. Usually they are extracted, but sometimes the retention of the baby tooth is critical for maintaining the proper space in the arch for the adult tooth. Occasionally root canals are done on these teeth so that they do not need to be extracted before the adult tooth is ready to erupt.