FAQ’s Regarding Root Canal Treatment and other Endodontic Procedures

How is an endodontist different than a family dentist?

While there is some overlap between endodontists and dentists, endodontists are specialists in the dental pulp and nerves of the teeth. In addition to earning a dental degree that family dentists also have, endodontists complete at least two additional years of specialized, post-doctoral training to perform a wide variety of complex endodontic procedures to treat and save a patient’s natural teeth. These procedures include root canal treatment, root canal re-treatment, vital pulp therapy, apicoectomy, treatment for cracked teeth, and treatment for traumatic dental injuries.

Along with their advanced training in endodontic procedures, endodontists are also trained to utilize specialized equipment that make a patient’s care more efficient, safe, and comfortable. These state-of-the-art instruments include the dental operating surgical microscope, advanced equipment, and 3D CBCT imaging (cone beam computed tomography).

How would I know if I need root canal treatment?

Typically, your family dentist will refer you to an endodontist if he or she determines that root canal treatment is necessary in order to save or restore a diseased tooth. In many cases, patients go to their dentist when experiencing persistent tooth or gum pain — and x-rays reveal the need for endodontic treatment. There are also cases where a patient may not be experiencing any symptoms, but x-rays during a routine dental checkup reveal the tooth damage.

Do endodontists offer treatment for children in addition to adults?

While there are few endodontic practices that focus on children, our skilled, board-certified team at Upper East Side Endodontists in NYC is specially trained to provide exceptional endodontic care tailored to meet the needs of children of all ages (in addition to adults). Our years of experience give us unique insight into the physical and emotional needs of managing pediatric patients.

What is the root canal treatment process?

Performed by an endodontist, root canal treatment is a procedure that commonly involves local anesthesia for your comfort. However, you will be offered additional sedation dentistry options if you prefer, such as nitrous oxide and IV sedation. After sedation has been administered, the steps are as follows:

  • Your tooth is isolated to keep it dry, then a small opening is made through the crown of the tooth into the pulp chamber.
  • The pulp is removed from the chamber and the root canal (the space inside the root). The root canal is cleaned and shaped so it can be filled.
  • Sometimes, a root canal needs to be completed in multiple visits if it is infected. In that case, your endodontist may place medicine in the tooth to medicate the tooth in between appointments.
  • The root canal is filled with a special biocompatible material in order to seal it.
  • A temporary filling is placed in the tooth to prevent contamination of the canal. You will then return home with the temporary filling in place. An appointment will be set for your restorative dentist to remove the temporary filling and restore the tooth with a crown.
  • After restoration, the tooth should function and look like your other teeth – and you’ll be able to enjoy whatever food you like again without any discomfort.

What kind of sedation is offered to pediatric patients to make sure they’re calm and comfortable?

The sedation options for pediatric patients are similar to those offered to adult patients, of course with appropriate adjustments based on factors including age, weight and any special needs. At our office, we have a board-certified anesthesiologist available who will discuss with you the safest and most effective sedation options for your child, including:

  • Nitrous Oxide: More commonly known as “laughing gas,” nitrous oxide is a safe agent that is mixed with oxygen and breathed in and out through a mask that rests on the nose. Nitrous oxide is useful in reducing anxiety and helping patients relax while their dental treatment is being completed. Your child will remain awake during this procedure.
  • IV sedation: This method of sedation will also ensure that the patient’s endodontic care is given in a safe and stress-free environment. While under IV sedation, the patient will be unaware of the length of treatment time, helping to prevent the development of concerns and anxiety surrounding future dental and endodontic care.

What are the instructions to follow before endodontic treatment?

Prior to endodontic procedures, including root canal treatment, your endodontic team will give you a set of instructions to follow. The pre-treatment instructions commonly include:

  • Continue all medications prescribed by your physician for blood pressure, diabetes, thyroid problems and other health issues. With certain health-related cases, we may also prescribe pre-medication.
  • Unless instructed otherwise by your endodontist – and dependent on the sedation that will be administered – you’ll be able to eat a light breakfast or lunch. Drinking plenty of water is also important. Being that root canal treatment is typically performed with local anesthesia, it is not necessary to fast.
  • If necessary, we will call in a prescription for antibiotics for you.
  • We commonly recommend ibuprofen be taken pre-operatively to reduce inflammation.

What are the instructions to follow after endodontic treatment?

Follow-up appointment:

Once your endodontic treatment is completed, the root canal system will be permanently sealed, but the outer surface will be sealed with a temporary restoration. A follow-up restoration must be placed to protect your tooth against fracture or decay. We will make sure your records are sent to your restorative dentist for the follow-up appointment.

At-home instructions:

  • Your tooth may be tender for several days as a result of the manipulation during the treatment. Unless instructed otherwise, you may begin taking Ibuprofen, Advil or Motrin. We will provide you with a written list for doses and frequency before you leave our office.
  • Avoid eating, chewing or drinking hot foods or beverages until numbness has completely dissipated. In addition, do not drink alcohol or use recreational drugs while you’re taking pain medication for treatment of your tooth.
  • You may brush and floss your teeth as usual.
  • Post-operative infections are not very common. However, if one does occur we will prescribe an antibiotic.
  • Should pain become severe, swelling develop, or any other condition occurs that causes you concern, contact our office at your earliest convenience.

Why would root canal retreatment be necessary?

With appropriate care, a tooth that has had root canal treatment can last a lifetime. In fact, root canal treatment enjoys a 90% success rate. However, there are cases where a tooth that has received root canal treatment may fail to properly heal or an infection re-occurs. In those cases, root canal re-treatment may be necessary.

Are x-rays safe?

Thanks to advanced technology, digital x-rays  provide unprecedented precision with up to 90% less radiation exposure generated by conventional x-ray systems. At Upper East Side Endodontists in NYC, we use only digital x-rays for the safety of our patients.

Additional benefits of digital x-rays include:

  • Increased efficiency: Digital x-ray images can be viewed on a computer monitor within seconds, lessening the time you spend in the dental chair.
  • Improved outcomes: Digital x-rays also provide much sharper clarity, enhancing your dentist’s ability to diagnose and treat conditions with greater precision.
  • Post-processing manipulation: High resolution digital images can be easily magnified and manipulated to reveal additional anatomical features and angles, subsequently providing your dentist with enhanced detail and accuracy.
  • Greater convenience. Digital imaging can be easily transferred to different dentists via CD if and when needed.
  • More eco-friendly: Because digital x-rays do not require developing, they’re better for the environment.

What is vital pulp therapy?

Most commonly recommended for pediatric patients, vital pulp therapy is an effective endodontic procedure to treat, restore, and save a tooth affected by severe tooth decay or traumatic injury.  Vital pulp therapy also allows the tooth to remain alive so that the immature tooth and roots will continue to grow and develop.

What is an apicoectomy?

Usually, a tooth that has undergone a root canal can last for a very long time, even the rest of your life, and never need further endodontic treatment. However, in few cases, a tooth may not heal or may become re-infected. A tooth may become painful or diseased months or even years after successful treatment. If this is true for you, surgery may help save your tooth. The most common surgery used to save damaged teeth is an apicoectomy, also known as endodontic microsurgery.

What is pulp regeneration?

When an immature tooth suffers infection or damage, a safe, state-of-the-art treatment called pulp regeneration is a procedure we offer at Upper East Side Endodontists in NYC to regenerate the tooth’s natural tissue so the root can continue to grow. Studies have shown that even immature teeth that are considered “dead” are capable of regenerating pulp-like tissues that promote root development.

Can cracked teeth be saved?

If promptly and properly treated, cracked teeth can be saved through endodontic treatment. Treatment for a cracked tooth is dependent on the location, type, and size of the crack. The five types of tooth cracks and treatment options are:

  • Craze lines. Craze lines are tiny cracks that affect only the outer enamel of the tooth. More common in adults, craze lines are typically superficial and of no concern.
  • Fractured cusp. A fractured cusp rarely damages the pulp and the tooth can usually be restored with a full crown.
  • Cracked tooth. A tooth that is cracked from the chewing surface towards the root can sometimes extend below the gum line – and even extend further into the root. Damage to the pulp is also common. A cracked tooth that’s not properly and promptly treated will worsen, possibly leading the loss of the tooth. Root canal treatment may be necessary in this case.
  • Split tooth. Usually the result of an untreated cracked tooth, a split tooth – which can be identified by a crack with distinct segments — can rarely be saved intact. However, proper endodontic treatment and restoration can sometimes save a portion of the tooth.
  • Vertical root fracture. A vertical root fracture, which often shows minimal symptoms and may go unnoticed, begins at the root and extends towards the chewing surface of the tooth. Treatment may involve endodontic surgery if a portion of the tooth can be saved by removal of the fractured root. If not, the tooth may have to be extracted.

What happens in the event of traumatic injuries to teeth, such as sports accidents or falls?

Most traumatic tooth injuries occur in children and teenagers, but people of all ages can experience traumatic injuries to their teeth due to falls, sports mishaps, or auto accidents. No matter the cause, the type and severity of the injury will determine the treatment necessary. At Upper East Side Endodontists in NYC, our skilled, board-certified team is here to provide quality care to help save and restore the health of your teeth and smile.

Is there risk of infection in endodontic procedures?

The risk for infection is very minimal due to the rigorous standards of infection control advocated by OSHA, the Centers for Disease Control, and the American Dental Association – which we strictly adhere to at Upper East Side Endodontists in NYC.  For your added peace-of-mind, we employ the most advanced technology including autoclave sterilization and barrier techniques in order to minimize the risk of infection.

What other advanced technology is used today in endodontic procedures?

Some of the other state-of-the-art tools we utilize at Upper East Side Endodontists in NYC include:

  • High-speed digital x-rays for greater precision and up to 90% less radiation.
  • Dental operating surgical microscopes for unprecedented magnification and illumination in surgical procedures.
  • 3D imaging via CBCT (cone beam computed tomography) that provides invaluable images when planning endodontic procedures.
  • Biocompatible materials to maximize your body’s natural healing potential.
  • Ultrasonic hand pieces to increase precision during treatment.

You can always rest assured that our skilled and experienced endondontic team takes full advantage of innovations like these to provide our patients with exceptional, world-class care!