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Common Questions

What is an Endodontist?

Endodontists are dentists who specialize in maintaining teeth through endodontic therapy -- procedures, involving the soft inner tissue of the teeth, called the pulp.  The word "endodontic" comes from "endo" meaning inside and "odont" meaning tooth.  Like many medical terms, it's Greek.  All dentists are trained in diagnosis and endodontic therapy, however, some teeth can be especially difficult to diagnose and treat.  That's why you may have been referred to an endodontic specialist.

In addition to dental school, endodontists receive two or more years of advanced education in this kind of treatment. They study root canal techniques and procedures in greater depth, for diagnosis and treatment of more difficult cases. For this reason, many dentists choose to refer their patients to endodontists.

What is Root Canal Therapy?

 "Endo" is the Greek work for "inside" and "odont" is Greek for tooth.  Endodontic treatment treats the inside of the tooth. 

To understand endodontic treatment, it helps to know about the anatomy of the tooth.  Inside the tooth, under the white enamel and a hard layer called the dentin, is a soft tissue called the pulp.  The pulp contains blood vessels, nerves, and connective tissue.
The pulp extends from the crown of the tooth to the tip of the roots where it connects to tissues surrounding the root.  The pulp is important during a tooth's growth and development.  However, once a tooth is fully mature it can survive without the pulp, because the tooth continues to be nourished by the tissue surrounding it. 
Root Canal Therapy (Endodontics) involves the removal of all bacterial infection from the root canal.  During the treatment, the endodontist removes the inflamed or infected pulp, carefully cleans and shapes the inside of the canal, then fills and seals the space.  Afterwards, you will return to your dentist, who will place a crown or other restoration on the tooth to protect and restore it to full function.  After restoration, the tooth continues to function like any other tooth.

Why is Root Canal Therapy needed?

The nerve may become damaged by bacteria associated with past or present decay, or by a traumatic blow.  Endodontic treatment is necessary when the pulp, the soft tissue inside the root canal, becomes inflamed or infected.  The inflammation or infection can have a variety of causes: deep decay, repeated dental procedures on the tooth, or a crack or chip in the tooth.  In addition, an injury to a tooth may cause pulp damage even if the tooth has no visible chips or cracks. If pulp inflammation or infection is left untreated, it can cause pain or lead to an abscess.  Root canal therapy allows you to keep the natural tooth in a healthy state rather than substituting it with an artificial tooth.

What are signs of needing endodontic treatment?

Signs to look for include pain, prolonged sensitivity to heat or cold, tenderness to touch and chewing, discoloration of the tooth, and swelling, drainage and tenderness in the lymph nodes as well as nearby bone and gingival tissues.  Sometimes, however, there are no symptoms.

Will I feel pain during or after the procedure?

Many endodontic procedures are performed to relieve the pain of toothaches caused by the pulp inflammation or infection.  With modern techniques and anesthetics, most patients report that they are comfortable during the procedure. For most patients, the feeling of numbness usually subsides after 2-3 hours. For those patients who are especially anxious about dental procedures, we provide a prescription for orally administered Valium. 

For the first few days after treatment, your tooth may feel sensitive, especially if there was a pain or infection before the procedure.  This discomfort can be relieved with over-the-counter or prescription medications.  Follow your endodontist's instructions carefully.
Your tooth may continue to feel slightly different from your other teeth for some time after your endodontic treatment is complete.  However, if you have severe pain or pressure that lasts more than a few days, call your endodontist.

Will I need to return to your office for follow-ups after the procedure is finished?

Yes, for most root canal treatments, especially if there is a large lesion in the bone, we recommend that patients return to the office 6-12 months after the procedure was finished.   This allows us to make sure the tooth has healed or is healing properly.  Our office will notify you when it is time for you to return for an evaluation of healing.  Since an abscess may take 2 years to heal, our office will reevaluate the tooth for at least 2 years.

Will I need retreatment?

Occasionally a tooth that has undergone endodontic, treatment fails to heal or pain continues despite therapy. Although rare, sometimes a tooth initially responds to root canal therapy but becomes painful or diseased months or years later. When either of these situations occur, the tooth often can be maintained with a second endodontic treatment.

How many visits are required to complete a root canal?

The treatment consists of three or four basic steps, but the number of visits will depend on your particular case.  Some treatments take 2 visits but most are just a single visit.  Occasionally 3 appointments are needed. You should allow 2 to 2.5 hours for endodontic treatment of a molar.

In any case, it depends on the degree of infection/inflammation and degree of treatment difficulty.  To me, it's more important to do it the very best we can than to meet a specific time criteria.  Let's look at the basic steps for nonsurgical endodontic therapy.

Will I need retreatment?

Occasionally a tooth that has undergone endodontic, treatment fails to heal or pain continues despite therapy. Although rare, sometimes a tooth initially responds to root canal therapy but becomes painful or diseased months or years later. When either of these situations occur, the tooth often can be maintained with a second endodontic treatment.

Will the tooth need any special care or additional treatment after endodontic treatment?

You should not chew or bite on the treated tooth until you have had it restored by your dentist.  The unrestored tooth is susceptible to fracture and possible leakinage around temporary fillings, so you should see your dentist for a full restoration as soon as possible.  Otherwise, you need only practice good oral hygiene, including brushing, flossing and regular check-ups and cleanings.

Most endodontically treated teeth last as long as other natural teeth.  In a few cases, a tooth that has undergone endodontic treatment does not heal or the pain continues.  Occasionally, the tooth may become painful or diseases months or even years after successful treatment.  Often, when this occurs, redoing the endodontic procedure can save the tooth.

What causes an endodontically treated tooth to need additional treatment?

Occasionally a tooth that has undergone endodontic, treatment fails to heal or pain continues despite therapy. Although rare, sometimes a tooth initially responds to root canal therapy but becomes painful or diseased months or years later. New trauma, deep decay or a loose, cracked or broken filling can cause new infection in your tooth.  In some cases, the endodontist may discover additional very narrow or curved canals that could not be treated during the initial procedure. These situations can usually be successfully treated with a second endodontic procedure.

Can all teeth be treated endodontically?

Most teeth can be treated.  Occasionally, a tooth can't be saved because the root canals are not accessible, the root is severely fractured, the tooth doesn't have adequate bone support or the tooth cannot be restored.  However, advances in endodontics are making it possible to save teeth that even a few years ago would have been lost.  When endodontic treatment is not effective, endodontic surgery may be able to save the tooth.

How much will the procedure cost?

The cost varies depending on how complex the problem is and which tooth is affected.  Molars are more difficult to treat, the fee is usually more.  Most dental insurance policies provide some coverage for endodontic treatment.

Generally, endodontic treatment and restoration of the natural tooth are less than the alternative of having the tooth extracted.  An extracted tooth must be replaced with a bridge or implant to restore chewing function and prevent adjacent teeth from shifting.  These procedures tend to cost more than endodontic treatment and appropriate restoration.  With root canal treatment you save your natural teeth and money.

I am Worried About X-rays. Should I be?

No. While X-rays will be necessary during your endodontic 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 other treating dentists via email 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 are meticulous in our use of barrier techniques, disinfection, and autoclave sterilization to eliminate any risk of infection. In addition, we are a “Sterilox office”. This is a proprietary fluid that prevents any bacterial biofilms from developing inside the dental unit waterlines. Sterilox dental offices exceed the biofilms standards as proposed by the government’s Center for Disease Control.

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.  

Apex Locators: These devices measure the length of the tooth electronically and reduce the need for radiographs during treatment.
 Ultrasonics: Ultrasonic energy can be used to "drill" away tiny portions of a tooth to locate small canals or remove obstructions in the tooth.  We also use ultrasonic devices to aid in endodontic microsurgery.
Sonic Activators:   This device removes the “smear layer” from the inside walls of the root canal. This enables the dentist to remove bacterial substrate and ensure a better seal of the root canal.

2021 Geer Rd.
Turlock, CA 95382