Understanding what's ahead

 

No one wants to go to the dentist. We get that. But we're here to make your experience as stress-free and positive as possible, and remember: When we're all done, you'll leave our office feeling a million times better.

So how's this whole thing work? Glad you asked. Here's a detailed look at the procedures we perform and the tools we use to do them.

 
417-endodontics-root-canal-therapy.jpg

The consultation (aka the easy part)

 

Once your regular dentist has referred you to our office, we'll go about figuring out what's wrong with you and whether endodontic treatment is actually the answer. We'll review your medical and dental history, perform diagnostic tests, take some x-rays, and figure out the best course of action to get you all fixed up.

Some of the things we might use during this part of your visit:

  • Our eyes. Yup -- a visual examination goes a long way.
  • Radiographs. That's a fancy word for x-rays. In some cases, we might even take a 3D one to get a clear picture of what's causing the problem.
  • Thermal testing. We'll evaluate how your tooth responds to hot or cold.
  • Palpation. We'll see how your tooth responds to pressure near the tip of its root.
  • Percussion. No, we won't break out the bongos (unless you really want us to...) -- we'll just check out how your tooth responds to tapping.
  • Electric pulp tester. We'll apply some gentle electric stimulation to your tooth to see how it responds to that.
  • Magnification, illumination, and sometimes a surgical microscope. Those tools all can help us get a better look at the area that's bothering you to see what's going on. 

Sometimes, the pain you're feeling can actually be coming from a different area than you might think -- a weird phenomenon known as "referred pain." We'll look for that, too, to make sure we're going after the correct source of your discomfort.

Pain that seems like it might need a root canal can also be related to a host of other issues -- anything from a sinus infection to a blocked salivary gland. If we see that something like that is going on, we'll refer you to the proper medical professional for the problem, since a root canal wouldn't help.

 

Root canal therapy

 

Okay -- let's start with a quick lesson on teeth. From the outside, our teeth look hard and solid, right? But inside every tooth, beneath that shiny enamel and a hard layer called the dentin, is a soft tissue called the pulp. It's made up of blood vessels, nerves, and connective tissue.

You need a root canal when the pulp becomes inflamed or infected. That can happen because of deep decay or fillings, a crack or chip in the tooth, or some sort of trauma. If any of those things are left untreated, they can cause serious pain or swelling -- even a not-so-fun build-up of pus and debris.

That's where we come in. During a root canal, our endodontists use a series of super-small instruments along with special medicines to remove the infected pulp. They then carefully clean and reshape the inside of the tooth's root. Last but not least, they fill and seal up the space with a rubbery filling known as gutta percha.

Once all that's finished, you'll go back to your regular dentist, who will put a crown on the tooth to protect it and get it back in business for you. After that, the tooth should work and feel fine -- just like any other pearly white in your beautiful mouth. (On occasion, we'll have to retreat a root canal later on -- if there are new fractures, for instance, or infections that come up in the tooth after your initial visit -- but that's more the exception than the rule.) 

Some of the tools we'll use for a root canal include a dental operating microscope, which lets us zoom way in to see the inside of your tooth and look for fractures or extra canals, and an electronic apex locator, which helps us make sure we treat the entire canal from top to bottom. 

 
filler.jpg

Endodontic surgery and other therapies

 

Most of the time, the regular root canal procedure described above is all we need to do. Every now and then, though, a tooth can become infected months or even years after a successful treatment. In those cases, endodontic surgery may be able to save the tooth.

It sounds a little icky, but it works: What we do is open up the gum tissue near the tooth to get at the underlying bone and take away the infected tissue. We also take out the very end of the tooth's root while we're there, then put in a small filling and/or a few stitches to help seal everything up and make sure it heals properly. In the months after that's done, the bone heals around the end of the root -- and in most cases, the tooth is then healthy and fine from there on out.

Other procedures we'll sometimes do include vital pulp therapy, in which we remove unhealthy tissue in a tooth that isn't fully developed and thus allow the body to keep developing a healthy root on its own; pulpal regeneration, in which we stimulate an undeveloped tooth to make it start growing again (yes, effectively bringing it back from the dead -- but don't worry: It won't become a zombie!); and trauma management, in which we'll work with teeth that have been damaged -- splinting loose teeth or replanting teeth that have become detached, for instance -- to get your mouth feeling happy and healthy again.