Root Canal

What is a root canal?

A root canal is the process of removing inflamed or dead tissue from space within the root. During this process the roots are cleaned and disinfected to remove bacteria as much as possible. After the canal space is cleaned and dried, it is filled with a root canal filling material to prevent the re-entry of bacteria.

Will the treatment be painful?

We will take every measure to ensure that your procedure is not uncomfortable or painful. If treatment is needed, we will use local anesthesia to carefully numb the area of your tooth/mouth.

Will it take more than one visit?

About half of the root canals done in this office are done in one visit. Most are done in two visits due to swelling, persistent drainage or complex anatomy. If your tooth needs more than one visit you will not need to pay more. It just means that we want to give you the best quality root canal regardless of the number of visits it will require.

What pain medication is best?

I recommend 600mg of ibuprofen (Advil, Motrin, or generic) about every 4-6 hours. If you are still uncomfortable despite the ibuprofen, you can take about 650mg of Tylenol (acetaminophen) along with the ibuprofen. If you have been given a prescription for Norco (Vicodin) then you may take that with the ibuprofen instead of the Tylenol. Do NOT mix Tylenol and Vicodin!

The tooth is still uncomfortable. Is that normal?

Teeth are usually uncomfortable after a root canal for approximately 3-7 days after treatment. Usually the soreness is greatly reduced by the third day and is usually gone at day seven. It can be possible that soreness lasts for several weeks, but will usually get better every day.

Can I go back to work after my root canal?

Yes you can. You will be numb for 2-3 hours after your appointment, but you should be in good shape to continue your regular schedule. You should not eat until the numbness is gone. You may unknowingly bite your lip or cheek.

Am I awake for the root canal?

Yes you are. Most, if not all root canals, are like getting a filling at your dental office. If you feel that you need something to calm your anxiety, an oral sedative can be prescribed – If you take this medication, then you will need someone to drive you to and from your appointment. Nitrous oxide sedation is available for an additional charge.

Is the tooth dead?

The center of the tooth no longer has nerve tissue in it; therefore your tooth will no longer be sensitive to hot or cold. Your tooth will still have feeling due to other tissue and ligaments that hold your tooth in your jaw.

Will I need more dental work after my root canal?

In most cases, you will be referred back to your dentist who will determine if the tooth  needs a permanent restoration. Most root canalled teeth will require a crown if there is not already one. If you have received a temporary in our office, and your root canal is completed, I recommend getting the permanent filling within 30 days or sometimes sooner. We will assure that you are informed of the next step in your dental treatment.

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

Yes, for most root canal treatments, we recommend that patients return to the office 1 year after the procedure was finished. Our office will send a reminder notice to you when you are due for a recall appointment. There is usually no charge for this visit.

Can I chew on my tooth after a root canal?

I do not recommend chewing on the tooth until it has received a permanent restoration. First of all, the tooth is sore and you can make it more sore if you do. Secondly, you could break the tooth if it has a temporary filling. The risk of tooth fracture is very high in root canal treated teeth that have not been permanently restored.

Why do root canals cost so much?

The fees in our office are on par with those throughout the East Bay. The cost of treatment is due to the high cost of having an excellent, well-trained staff, dental supplies, highly specialized equipment, continuing education and the years of training it took to gain a mastery of our specialty.

Why don’t you take the same insurance my dentist does?

We will help you by submitting claims to your insurance company. We do not participate in most capitation plans, but you will find that your out of pocket expense for an out-of-network provider may be close to that of an in-network provider. Call us so that we can help you determine the cost of your care.

One reason for not participating in many insurance plans is that they simply will not reimburse at an acceptable rate. Some companies reimburse specialists and generalists the same amount. This is unacceptable when you consider that the complexity (and therefore the time required) of cases treated by a specialist is much greater than those treated by general practitioners. Some reimburse at rates close to what I experienced in dental school!

Though the care you receive in our office is not affected by the type of insurance you have (or don’t have), we have had to limit ourselves to those companies that recognize and reimburse for the quality care we render.

I’ve heard of implants. Are they better than root canals?

Maintaining your natural teeth is one of our priorities, but if we feel that root canal treatment is not predictable then a dental implant may be indicated. Implants are great for replacing missing teeth, and will be recommended if it is believed that they will be a better long-term investment in your health. The use of the dental operating microscope and our cone beam computed tomography helps in predicting the outcome of treatment.

Do you take out teeth?

We only take teeth out if we are placing an implant for you in the near future. Since an implant may be an option in the site where the tooth is being removed, I often recommend that the person placing the implant should be the one removing the tooth. This way the site will be prepared in a way that is familiar to the person placing the implant.

Why do you use a microscope?

I have used a microscope for endodontics since 1995. The Surgical Operating Microscope (SOM) has enhanced my endodontic practice and improved the success rate of root canals. It allows for magnification and a high intensity Xenon light source to see all of the root canal anatomy.

The root canal in your office seemed to take longer than the last root canal I had.

We acknowledge that you want to spend as little time in the dental chair as possible, but we strive to give you our personal best for each and every patient. The idea in dentistry that faster is better is false (in most cases). If your root canal is taking longer than expected, it is because we care about the quality of care you are receiving, and we are trying to treat the entire anatomy present in your tooth. We re-treat many root canals that were done by fast-paced offices oblivious to the nuances that make root canal therapy successful.

I was supposed to get my temporary 6 months ago and now my tooth hurts. Now what?

If you did not see your dentist for a final restoration after your root canal, chances are that the tooth may be fractured or has become re-infected. The rate of fracture for an un-restored root canal treated tooth is very high. If the tooth has cracked, then it may not be restorable, and you will lose what you have invested. A re-infected tooth can be retreated.

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