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Q. My dentist does root canals, why can't he or she do this root canal?
A. Not all root canal treatments are of the same difficulty. Teeth vary in extremes of root curvatures, length, number of canals, and calcification of the canal system. Endodontists have extra education and exposure to a greater number of these types of cases so as to provide your general dentist with a place to refer difficult root canal cases and diagnosis.
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Q. The root canal is now finished is all the infection removed?
A. The cause of the infection is now removed. That is the bacteria and damaged pulp tissue in the tooth's canal system is gone. However, bacteria may or already have moved into tissue beyond the root canal space, namely the surrounding bone and possibly soft tissue. Antibiotics and your body's immune system help to heal the damage beyond the canal space.
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Q. Is endodontics a surgical procedure?
A. No. It involves no incision nor sutures. It does involve making a small opening through the crown of the tooth to gain access to the hollow space(s) inside the tooth known as the root canal system which under non-pathologic conditions contains the root forming organ of the tooth called pulp tissue.
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Q. What happens after the root is removed?
A. The root is not removed during root canal treatment. Only the contents of the canal space or spaces is removed. The canal may contain pulp remnants, gas, fluid, bacteria, or a combination of these. In some cases the pulp space may appear empty.
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Q. Since the nerve of my tooth is removed during root canal treatment why do I still feel the tooth?
A. The nerve either mandibular or maxillary actually runs horizontally under the roots of each tooth, and a nerve is not removed during endodontic treatment. See question #4. The periodontal ligament that connects the root surface to the bony socket is filled with nerve endings, and is still intact after root canal treatment.
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Q. How successful is root canal treatment?
A. Various clinical studies have been done over the last 30 years and in uncomplicated cases the range of success has been reported from 88-95%. treatment complications and very large, long standing chronic abscesses lower success rates. Not all teeth can be successfully treated.
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Q. Can all teeth be saved with a root canal?
A. No. Severe decay that prevents restoration, split teeth, external or internal resorption cases, incomplete root formation, unusual root shapes, and severely calcified canals are some of the complications that may prevent root canal treatment. In general, if the tooth cannot be restored there is no practicality in doing endodontics., This is where a consultation visit helps the patient and doctor decide what treatment is best.
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Q. Does my tooth need a crown after a root canal?
A. In general, posterior teeth, the chewing teeth should be fully covered with a crown after endodontic treatment. If the tooth has an old crown, and it needs canal treatment, then it is a good idea to place a new crown especially if there are signs of leakage or redecay. Front teeth that need root canal treatment and have no restorations do not need crowns in most cases.
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Q. After my tooth is root canaled and has a crown, I do not have to ever worry about anything happening to it, right?
A. No. Endodontic treatment only treats the current problem. It is a treatment option to extraction, but it does not prevent future problems. A tooth that has had root canal treatment is subjected to the potential of fracture, decay, periodontal disease, etc. just as all the rest of your teeth are.
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Q. My tooth has a crack in it, can it be saved?
A. Maybe. If the crack is closed and not separated and if the crack does not extend below the gum line there is a good chance that the tooth can remain functional with root canal treatment and a crown. However, cracked teeth are somewhat unpredictable in that the crack if not removed during the crown prep (sometimes not possible) may get worse over time.
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Q. Does my insurance cover endodontic treatment?
A. Most insurance companies cover a portion of endodontic costs. The amount varies with how your policy is underwritten for the company who takes out the policy. Our office manager will be happy to help you with your insurance coverage.
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Q. My tooth already had a root canal and it is reinfected. What are my options?
A. The basic options are extraction, apical surgery, or endodontic retreatment. We prefer to retreat the root canal rather than jump to the surgical option if possible. Apical surgery virtually eliminates the retreatment option, and apical surgery has a low chance of success if the canal space is recontaminated with bacteria and micro leakage.
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Q. Do I need a driver?
A. No. We use a local anesthetic. You will feel numb for most of the day, but you do not need a driver.
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Q. Is this going to hurt?
A. Most cases can be managed pain free except for the initial injection which is similar to having a filling or crown. We do use multiple injection techniques to achieve the best anesthesia possible. In cases of infected teeth we may treat you with antibiotics or in severely swollen cases use an incision and drainage procedure to control the infection before attempting root canal treatment.
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Q. Do you see children?
A. Yes. Root development varies with age especially between 6 and 14 years old so a consultation visit is recommended.
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Q. Do I need to pre-med for root canal treatment?
A. Sometimes. It depends on the condition that you have as antibiotic coverage then you should for endodontic treatment. Studies show a very low risk of blood born bacteria from endodontic procedures. Having your teeth cleaned is a much greater risk.
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Q. How long will the root canal procedure take?
A. Obviously the amount of time to do any work depends upon the complexity of the task. Teeth are like snowflakes. Each one is different, and each one presents its own set of hurdles including but not limited to root curvatures, calcifications, pulp stones, number of canals, tooth position, and type of restorations. Ideally we like to treat one patient at a time because our cases tend to be the most complex ones. We generally allow 2 to 1 and a half hours per patient. This gives us extra time to deal with complications that can not often be determined before the actual treatment starts. Since we allow a large block of chair time it is extremely important, and considerate, to confirm your appointment, and let us know if a certain time is inconvenient for you. Other patients in need of treatment will gladly fill an appointment that you cannot make.
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