Frequently asked questions about root canal treatment
what is endodontics?
Endodontics is a specialty of dentistry that focuses on diseases of the dental pulp and its supporting structures. Although general dentists can perform endodontic treatment, patients are often referred to an Endodontist when the case is complicated or more difficult than usual.
what is an endodontist?
An Endodontist is a dentist who has undergone a minimum of 2 years of postgraduate training after completion of the traditional 4 year dental degree program. The specialty training allows an Endodontist to:
- deal with diseases of the dental pulp and supporting structures
- diagnose facial pain and associated issues
Aside from providing treatment, Dr. Mirucki understands the importance of making sure his patients understand why they require treatment, what treatment involves, and what they can do to ensure the best possible outcome. Dr. Mirucki believes that a properly informed patient has the greatest chance of achieving an optimal result.
what is endodontic treatment?
In order to understand endodontic treatment, it helps to know something about the anatomy of a tooth. Teeth have several layers. The outside layer of the tooth is composed of a hard layer called enamel. Enamel is supported by an inner layer called dentin, which has at its center a soft tissue known as the pulp. The pulp contains blood vessels, nerves, and connective tissue that are responsible for forming the surrounding dentin and enamel during tooth development. The pulp receives its nourishment supply from vessels which enter the end of the root. Although the pulp is important during development of the tooth, it is not necessary for function of the tooth. The tooth continues to be nourished by the tissues surrounding it even after the pulp is removed.
why would I need endodontic treatment?
Endodontic treatment is necessary when the pulp becomes inflamed or infected. The most common reasons for inflammation or infection are deep cavities (caries), repeated dental procedures, cracks or fractures in a tooth. Trauma can also cause inflammation and often shows up as discoloration of the tooth. If pulp inflammation or infection is left untreated, it can cause pain or lead to an abscess.
signs and symptoms
Indications for treatment include prolonged sensitivity to heat or cold, discoloration of the tooth, swelling or tenderness of the tooth or adjacent gum tissue. Sometimes there are no symptoms.
how can endodontic treatment help me?
The Endodontist removes the inflamed or infected pulp, carefully cleans and shapes the canal system and then seals the root of the tooth. Once treatment is completed, you will return to your dentist for a permanent restoration (dental filling and possible crown). The restoration of the tooth is an important part of treatment because it seals the cleaned canals from the oral environment, protects the tooth, and restores it to function.
what is re-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. When either of these situations occur, the tooth often can be maintained with a second endodontic treatment (retreatment).
what is an apicoectomy (endodontic root-end surgery)
In some cases it may be necessary to surgically remove the infection around the roots or the tooth. This is known as an apical surgery or an apicoectomy. Profound anesthesia is used to prevent any discomfort during treatment. Then, after a small incision on the gum, the infected area around the roots of the tooth is cleaned and sealed.
extended FAQ Information
A root canal is a treatment used to repair and save a tooth that is badly decayed or becomes infected. During a root canal procedure, the nerve and pulp are removed and the inside of the tooth is cleaned and sealed. Without treatment, the tissue surrounding the tooth will become infected and abscesses may form.
We will take every measure to ensure that your procedure is in no way uncomfortable or painful. If treatment is needed, we will inject a small amount of anesthesia to gently numb a concentrated area of your mouth. For most patients, the feeling of numbness usually subsides after 2-3 hours.
The roots of your tooth are not removed. The inside of the roots are cleaned and the rest of the root is left to support the tooth.
Your tooth will no longer be sensitive to hot or cold, but it will still have feeling due to the bone and ligament that hold your tooth in the jaw.
Teeth are often uncomfortable after a root canal, and discomfort usually peaks about two days after treatment. It is common for the tooth to still be a little uncomfortable for a week or so. It is important that the tooth is getting better over time.
Your jaw may be sore and your lip may be numb, but you should be in good shape to continue your regular schedule.
In most cases, you will be referred back to your general dentist who will assure the tooth has an adequate permanent restoration. Most back teeth will require a crown if there is not already one in place. In this office, a permanent filling is often placed (instead of a temporary) to assure the tooth is adequately sealed. We will assure that you are informed of the next step in your dental treatment. If you have received a temporary in our office, and your root canal is completed, I recommend getting the permanent filling within three weeks.
I do not recommend chewing on the tooth until it has received a permanent restoration. The risk of tooth fracture is very high in root canal treated teeth that have not been permanently restored.
If you already have a crown, most of the time the root canal will be done through a small opening in the top. Your dentist will need to repair the opening after your root canal is completed. A new crown may be indicated if there are imperfections that do not lead to predictable dental health. Crowns with porcelain (tooth colored crowns) are susceptible to fracture of the porcelain (happens less than 5% of the time). If the porcelain fractures in a way that the crown is no longer functional or esthetic, then replacing the crown may be necessary.
Many patients ask if they can come to me for all of their dental work. The answer is that I specialize in root canal therapy and limit my practice to that area of dentistry. Out of respect for your dentist, who has referred you to us, we will return you to their care. If you do not have a dentist, then we can help you find an appropriate match.
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 helps in predicting the outcome of treatment.
Use of a microscope adds superior lighting and magnification while treating your tooth. From the time I started my endodontic training, I have considered the microscope a necessary adjunct in providing top-quality care.
I acknowledge that you want to spend as little time in the dental chair as possible. The idea in dentistry that faster is better is false (in most cases). You would never tell your cardiologist to do your bypass as fast as possible. Rather, you would say “Please do your best.” 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. I re-treat many root canals that were done by a fast-paced practitioner oblivious to the nuances that make root canal therapy successful.
If you have not had your tooth permanently restored in a timely manner, the canal system may have become re-infected with bacteria. In this case a re-treatment may restore your tooth to health. In most cases you will need to pay for the cost of re-treatment, so getting the tooth restored early is a wise use of resources. The rate of fracture for an unrestored 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.
If you are unable to afford the restorative phase of treatment at this time, please discuss this with your dentist. At a minimum, the tooth should get a permanent filling and receive a temporary crown or be removed from occlusion (shaved down so you can’t bite down on it).
Yes, for most root canal treatments, we recommend that patients return to the office one year after the procedure is finished.