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How do I know I need a root canal?
See the information under the heading of What is Endodontics (click on this link)
My tooth quit hurting. Do I still need a root canal?
There are certain key symptoms (spontaneous pain, lingering cold and chewing sensitivity, and usually heat sensitivity) that indicate the nerve tissue has undergone irreversible change and once these symptoms have been present, the tooth will ultimately need root canal treatment. Even if the symptoms temporarily resolve. So if you have had one of these key symptoms, the answer is unfortunately yes, you will still need a root canal. Similarly, many teeth we treat have had no symptoms at all and are diagnosed solely on the basis of radiographic changes.
Why can't my regular dentist do the root canal?
Many dentists do the majority of root canal procedures needed by their patients and refer the more difficult cases to an endodontist. Other dentists refer the majority of their root canal cases believing that their patients will benefit from treatment in a specialty practice.
Why do I need to schedule an evaluation/consultation? My dentist said I need a root canal. Why can't I just schedule treatment?
For some teeth, we can tell from the x-ray of your tooth if a root canal is needed and what type of treatment appointment to schedule. In these cases we will your first appointment to start treatment (unless you prefer a consultation anyway). For other teeth, it is not possible to tell which tooth is causing the pain or what type of treatment appointment is needed. And in more than a few cases it has turned out that the problem tooth was not the one initially believed to be cause of the pain. And in some instances, root canal treatment is simply not the best option. This cannot always be determined from an x-ray alone.
So although, like you, we'd prefer to simply schedule treatment whenever possible, there are often situations that require an evaluation and/or consultation. From a cost/time point of view, our fee for an evaluation does not even cover our overhead costs. Likewise, it may mean lost time and money for you if you need to take time off from work. So is it a lose-lose situation for both you and us in terms of time and cost. But it is a win-win in terms of us providing and you receiving, the best possible care.
How many visits are required for root canal treatment?
Some teeth require one visit. Others require two (and occasionally more) visits. You should not use as a guide to what is normal, the number of visits required for your last root canal or that of a friend who recently had root canal treatment.
The need for one or several visits depends on many factors. The type and presence of symptoms, the presence of an abscess, the length, shape and number of roots, the difficulty of the case, whether the canals are calcified, swelling, and the presence of fractures are just some of the factors that determine this.
These factors can sometimes be evaluated from an x-ray but can sometimes only be determined by an in office evaluation. Trying to schedule every root canal in one visit in a set amount of time is simply poor treatment.
If the problem is infection, why not treat it with antibiotics instead of a root canal?
The logic of this common question makes perfect sense. The answer lies in the fact that once the nerve (and blood supply accompanying it) dies, there is a dead space left behind that becomes a perfect place for bacteria to hide and grow in. Antibiotics can only go where the blood supply takes them. Since the blood supply dies along with the dying nerve, an antibiotic is unable to get to the source of the infection deep inside the root.
The purpose of a root canal procedure is to remove these bacteria that antibiotics cannot get to and to then seal the space to prevent bacteria from ever taking up residence inside the root again.
Is there any alternative to root canal treatment?
The only alternative to root canal treatment is extraction. Assuming the tooth will be replaced, the replacement options are a removable appliance (not usually done for a single tooth), a bridge, or an implant. The usual method of replacing a single tooth is a bridge or implant--both of which are more costly than keeping the tooth with root canal treatment.
Replacing the tooth with a removable appliance is a less expensive alternative but one that most patients find objectionable. Not replacing the tooth is of course the least expensive option but usually has adverse effects on the adjacent teeth.
We will always discuss and explain fully your other options, their pros and cons, and their associated costs. In some situations root canal treatment is not the best option and we will always advise you in that instance.
Is root canal treatment painful?
The answer is no 99% of the time. In addition to taking great care to anesthetize slowly and gently, we anesthetize the tooth much more heavily than your dentist would for routine dentistry. For the vast majority of root canal procedures treated in our office, it is truly a non painful experience. Most patients who have never had a root canal before are pleasantly surprised to find it is not the dreaded procedure they anticipated.
If you have had difficulty getting numb in the past or have had any bad past dental experience, please let us know so that we can ensure your treatment is comfortable. Please also refer to the section on Oral Sedation under About Your Visit (click on link).
Why do I need a crown after root canal treatment? Is it really necessary?
Although front teeth do not usually require a crown after root canal treatment, all back teeth need to be crowned ("capped") or run a high risk of fracture and tooth loss. A tooth that has had root canal treatment is usually already weakened due to large fillings or fractures and the root canal procedure adds to the weakened state if not followed up with a crown.
Should I expect pain after my root canal treatment?
Over many years, we have found that about half of our patients tell us they felt little to nothing the day after treatment. The other half of the time we hear that the tooth was achy and sore to chewing for several days to a week. When it is sore, the discomfort most commonly peaks at about 48-72 hours then gradually subsides over the next several days. The use of an anti-inflammatory medication such as Ibuprofen (Motrin) helps to minimize this.
Occasionally a tooth can be significantly sore following treatment and take a week or two to subside. Fortunately, this is a minority of cases.
A High Tooth: It is important to note whether your tooth is "high" following treatment. Inflammation sometimes causes your tooth to raise up just enough following treatment that when you bite on your back teeth the treated tooth hits harder than the other teeth resulting in pain every time you bring your teeth together. While it can be normal to have the tooth be sensitive to pressure while eating the first week or so, when you are not chewing food, you should be able to bring your back teeth together without the treated tooth hitting harder than the others. If your tooth is high be sure to call us so that we may lower it and take it out of the bite. If high, adjusting it will greatly speed up the healing process.
Do I need an antibiotic after root canal treatment?
Although antibiotics cannot take the place of root canal treatment, they are sometimes used during treatment to help your body more quickly resolve acute infection.
Antibiotics are only indicated when swelling or fever is present. Just as antibiotics are of no value for a cold, they are of no value for a tooth ache without swelling or fever. The majority of tooth aches are due to inflammation of the nerve tissue. Antibiotics have no effect upon inflammation just as they have no effect upon the viruses that cause the common cold.
Will I be able to return to work after my appointment or the next day?
If you use oral sedation you would not be able to return to work that day as you would still be groggy. Without sedation, many people return to work after their appointment. With or without sedation, it would be very unusual not to be able to return to work the next day.
Can I make payments over several months or more?
We offer the services of a company called "Care Credit" that allows payments over 90 days without interest. They will finance over a longer period of time with interest.
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