What is endodontics?

Endodontics is a specialized branch of dentistry recognized by the American Dental Association concerned with the form, function, and disease of the human dental pulp and periradicular tissues. Its study and practice includes the basic and clinical sciences including the biology of the normal pulp and the cause, diagnosis, prevention and treatment of diseases and injuries of the pulp and associated periradicular conditions.

All dentists can do root canals why should I see a specialist?

Certainly, all dentists are trained in dental school to root canal therapy. Usually, dental school requirements include course work, root canal simulations on extracted teeth, and completion of 5-10 root canals on patients. An endodontist (root canal specialist) has to complete 2 additional years of training concentrating solely on endodontic therapy. Residents are exposed to a myriad of evidence- based techniques and the latest materials, which prepares us to handle all cases from simple to the most complex. Requirements to complete an Endodontic program usually include; additional course work, current and classic literature reviews, research projects and presentations and completion of over 200-250 non-surgical and surgical endodontic procedures.

The success of endodontic therapy depends upon successful examination, diagnosis, treatment planning and execution of appropriate therapy. The 90% success rate of root canal therapy that is often quoted requires that these steps be meticulously carried out. If by chance, root canal therapy has to be redone- the prognosis (chance of success) decreases approximately 10-15 percentage points.

As is often stated: A general surgeon is trained to do surgery from head to toe. A cardiac surgeon is trained to perform surgery specifically on the heart. If you needed open-heart surgery, which would you choose?

Should I save my tooth?

Root canal therapy is a procedure in which we attempt to treat a tooth that would otherwise require extraction. If root canal therapy is treatment planned there are treatment options, with their corresponding risks and benefits that will be explained to you. These most commonly include your right to refuse any and all treatment, and/or extraction of the offending tooth.

The loss of teeth can lead to shifting of the remaining teeth, biting and chewing complications, subsequent loss of adjacent or opposing teeth, esthetic facial changes (i.e. sunken facial features and loss of fullness to the lips and cheeks), etc.

The success of endodontic therapy depends upon successful examination, diagnosis, treatment planning and execution of appropriate therapy. The 90% success rate of root canal therapy that is often quoted requires that these steps be meticulously carried out. If by chance, root canal therapy has to be redone- the prognosis (chance of success) decreases approximately 10-15 percentage points.

As is often stated: A general surgeon is trained to do surgery from head to toe. A cardiac surgeon is trained to perform surgery specifically on the heart. If you needed open-heart surgery, which would you choose?

I'm worried about x-rays. Should I be?

No. While x-rays will be necessary during your endodontics treatment, we use an advanced non-film computerized system, called digital radiography that produces radiation levels up to 90 percent lower than those of already low dose conventional dental x-ray machinery. These digital images can be optimized, archived, printed and sent to co therapists via e-mail or diskette.

What about infection?

Again, there’s no need for concern. 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 and barrier techniques to eliminate any risk of infection.

Is the rubber dam necessary?

Not only is it necessary, but required. To render root canal therapy without a rubber dam in place is to render care that falls below the standard of care. The purpose of the rubber dam is to isolate the tooth to be treated so that foreign objects aren’t swallowed or aspirated, and to keep saliva – which is full of bacteria – from contaminating the root canal system. In addition, it allows for easier manipulation by retracting the cheeks and tongue.

Will I feel pain during the procedure?

With advanced anesthesia preparations and techniques, it is possible to complete endodontic therapy without any pain. We will ensure that the area and tooth that we are treating is indeed numb before proceeding with treatment. During the procedure you are totally in control. In the unlikely event that you feel discomfort at any time, you will have the ability to inform the doctor and anesthesia will be supplemented.

Will I feel pain after the procedure?

Post operative discomfort varies from patient to patient depending on how much inflammation/infection is present in your tooth and surrounding areas. Most individuals report no to slight discomfort. It is highly unlikely that you would need anything more than over-the-counter anti-inflammatory medications (i.e. Motrin, Advil, Aleve, Aspirin, Tylenol, etc) to control any discomfort.

How long will the procedure take?

The length of time per appointment depends on the procedure to be completed, as well as its complexity. Most root canals can be completed in a single visit. Treatment time can range from 30 minutes to slightly over an hour. Sometimes teeth have to be treated in multiple appointments. Often times these are teeth that are highly inflamed or those that are infected.

What happens after treatment?

When your root canal therapy has been completed, a record of your treatment will be sent to your restorative dentist. You should contact his/her office for a follow-up restoration within a few weeks of completion at our office. Your restorative dentist will decide on what type of restoration is necessary to protect your tooth. It is rare for endodontic patients to experience complications after routine endodontic treatment or microsurgery. If a problem does occur, however, we are available at all times to respond.

Will I be able to go back to work after procedure?

Conventional root canal therapy rarely requires time missed from work or school. Most procedures are completed under local anesthetic, which wears off approximately 2 ½ hours. There may be a few instances where the doctor will ask that you rest the remainder of the day or perhaps a couple of days post operatively. This would include patients who have had endodontic surgery and those whose infection and subsequent swelling requires medication and rest.

Will I need someone to drive me to and/or from my appointment?

Most often you will not need someone to drive you home, as most procedure are done using local anesthesia. If, however, our treatment is done using conscious sedation you will need someone to drive you home. This person will need to accompany you to the appointment and remain within the office until the procedure if completed.

What new technologies are being used?

Operating Microscopes:

In addition to digital radiography, we utilize special operating microscopes. Magnification and fiber optic illumination are helpful in aiding the doctor to see tiny details inside your tooth. Also, a tiny video camera on the operating microscope can record images of your tooth to further document the doctor’s findings.

Apex Locators:

An apex locator is an electronic method for measuring the working length of a root canal. The measurements made with an apex locator, combined with the experience and tactile sense of the endodontist, exceed the precision of measuring made only with classical radiography.

Ultrasonic:

Ultrasonic cleaning is state-of-the-art technology. It utilizes a digital generator powering transducers submerged in a tank of hot water. The transducers vibrate at a frequency of 40 KHz creating millions of tiny bubbles that form and implode. This repeated formation and implosion creates a gentle cleaning action known as Cavitation. Cavitation has the ability to not only clean the surface of items, but also penetrate into the difficult to clean internal and crevice areas. It is safe and gentle.

What are my options for sedation?

For some, the thought of even the most conservative form of dental treatment is frightening and we understand this. That is why we have arranged to have sedation available for dental procedures. It can help those with anxiety, gagging, or a difficulty in sitting through longer appointments.

The sedation is delivered by an anaesthesiologist qualified to perform sedation, and you can have the work done under comfortable conditions. This is not a general anesthetic, which means there is very little risk involved and you always maintain your breathing and protective reflexes.

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