For patients

Your Office Visit

Endodontists’ specialized training will put you at ease and keep you comfortable.
As with a first visit to many new medical practices, on your initial visit to an endodontist you’ll complete paperwork, which will include your medical history and consent forms. Prepare for your visit with a list of all prescription and over-the-counter medications you take, information on your medical history including any prior dental health issues, and the contact information for a referring dentist.

Completed forms will be reviewed by an assistant who will take X-rays of your teeth before the endodontist sees you. Your endodontist will review your X-rays and paperwork and talk with you about your symptoms before examining the tooth in question along with adjacent teeth. Once the exam and any required tests are completed you’ll discuss treatment options and the benefits and risks associated with each so that you can make an informed decision on how to proceed.

If you decide to receive treatment, it will be scheduled or may start immediately depending upon the severity of the problem with your tooth. Several visits may be necessary to complete the prescribed treatment. Once the procedure is completed X-rays will be taken again to determine the success of the treatment. Before, during and after your procedure you should feel free to address questions or concerns with your endodontist and the office staff.

Dental Insurance

Your endodontist wants you to understand how dental insurances work and how to maximize your benefit.
Your endodontist will also inform you how your dental plan covers the treatment you receive.
The contract your employer negotiated with your insurance carrier defines your dental benefits. Please read the insurance plan booklet provided by your employer so that you better understand your benefits. Various dental plans cover the cost of endodontic procedures at different percentages causing your payment portion to vary.
If you do not find answers to your questions, contact your employer’s benefit administrator. They can further explain your dental coverage.

Pain Management

Root canal treatment means the end of pain, not the beginning of it. Anyone who’s ever suffered from pulp inflammation or infection knows the hurt of toothache, which only gets worse the longer it goes untreated. Even taking a sip of water can be a painful experience to someone in need of root canal treatment.

An endodontist is well aware of the painful plight of toothache, and they are experts in pain management. An endodontist makes patient comfort a priority and strives to keep procedures pain free, with advanced numbing techniques and a gentle bedside manner.
With modern techniques and anesthetics, most patients report that they are comfortable during the procedure.

For the first few days after treatment, your tooth may feel sensitive, especially if there was an infection before the procedure. This discomfort can be relieved with over-the-counter or prescription medications. Follow your endodontist’s instructions carefully.
When is it time to see an endodontist?
No one enjoys having work done on their teeth and some even delay their bi-annual cleanings out of fear or reluctance to visit the dentist. But when it comes to real tooth pain, it’s important to take care of it as soon as possible. You’ll feel better and likely save your tooth.

If you’re experiencing tooth pain, have injured your tooth, feel sensitivity to hot or cold, and/or there is swelling around the teeth, gums or your face, make an appointment with an endodontist or pay a visit to your dentist, first.

Your dentist may refer you to an endodontist — an expert at saving teeth with two or more years of specialized training above and beyond dental school.Always keep in mind that beginning your root canal procedure means ending your tooth pain.

Post Treatment Care

After your procedure, your endodontist will send you home with instructions for pain management and how to care for your tooth while recovering from treatment and until a follow-up visit. Following guidelines for care is especially important if a temporary filling or crown is in place.
As the medication used to numb your mouth during the procedure wears off, you may feel some tenderness in the area for a few days as everything heals and some mild soreness in your jaw from keeping your mouth open for an extended period during the procedure.

These temporary symptoms usually respond well to over-the-counter medication but your doctor may prescribe stronger, narcotic medication as well. It’s important to carefully follow the instructions for medications and that narcotics can make you drowsy so you should exercise caution when taking them and driving a car or operating dangerous machinery.

Though you may experience a slightly different sensation from your treated tooth than your other teeth for some time, you should contact your endodontist immediately if you experience any of the following symptoms:

• Severe pain or pressure lasting more than a few days
• Visible swelling inside or outside your mouth
• An allergic reaction to medication (rash, hives or itching)
• Your bite feels uneven
• The temporary crown or filling, if one was put in place, comes out (losing a thin layer is normal)
• Symptoms you experienced prior to treatment return

Reasons for Root Canal Treatment

Root canal treatment is necessary when the pulp, the soft tissue inside the root canal, becomes inflamed or infected. There are a whole host of reasons why you might need root canal treatment:

• Deep decay
• Repeated dental procedures on the tooth
• Faulty crown
• 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.

There are many clinical reasons for needing root canal treatment, but there are also countless practical reasons why saving the natural tooth is a wise choice. Endodontic treatment helps you maintain your natural smile, continue eating the foods you love and limits the need for ongoing dental work. With proper care, most teeth that have had root canal treatment can last a lifetime.

Benefits of Root Canal Treatment

Root canal treatment is virtually painless and often leaves you with less discomfort during recovery than if you have your natural tooth extracted. Thanks to modern techniques and effective anesthesia, patients who experience root canals are six times more likely to describe it as painless than patients who have a tooth extracted!

When you undergo a root canal or other endodontic treatment, the inflamed or infected pulp is removed and the inside of the tooth is carefully cleaned and disinfected, then filled and sealed with a rubber-like material called gutta-percha. Afterwards, the tooth is restored with a crown or filling for protection and will continue to function like any other tooth.

Benefits of Saving the Natural Tooth

There are many clinical reasons for needing root canal treatment, but there are also countless practical reasons why saving the natural tooth is a wise choice. Endodontic treatment helps you maintain your natural smile, continue eating the foods you love and limits the need for ongoing dental work. With proper care, most teeth that have had root canal treatment can last a lifetime.

Virtually Pain-Free Procedure

Root canal treatment is virtually painless and often leaves you with less discomfort during recovery than if you have your natural tooth extracted. Thanks to modern techniques and effective anesthesia, patients who experience root canals are six times more likely to describe it as painless than patients who have a tooth extracted.

Efficient & Cost-Effective

Tooth extraction can take longer than root canal treatment due to follow-up appointments required for a denture, bridge or implant; plus the cost may be higher. Most dental insurance plans cover endodontic treatment.

Visually Appealing Result

Crowns not only function like natural teeth; they look great, too. Improve your smile and laugh out loud again with root canal treatment.
Take the time to learn more about root canal treatment and some of the common misconceptions about it and then take the first step to a pain-free, healthy mouth by visiting an endodontist near you.

Root Canal vs Extraction

When the nerve of a tooth becomes irreversibly damaged or infected, you have two main options: root canal treatment or extraction. Both procedures prevent the spread of infection and pain, but they are quite different in how they go about it.
Root canal, or endodontic therapy, is a procedure that involves removing the diseased pulp from inside your tooth, cleaning and disinfecting it, then filling and sealing it. This helps to save the natural tooth structure while providing relief from any pain or discomfort caused by infection. The major advantage of a root canal is that it preserves the existing natural tooth and avoids extensive and costly restorative treatment (such as a bridge or implant) to replace it.
An extraction is just what it sounds like: the complete removal of a tooth and its periodontal attachment from its bony socket. While extraction effectively eliminates pain and infection, there are marked downsides to consider:
The first is that you will need to fill in the missing space in order to maintain proper alignment of your bite. Spaces left by extracted teeth can cause other teeth to shift, affecting your ability to properly chew and impacting your smile. The replacement of the missing tooth will require additional visits, possibly with multiple dental specialties, and potentially other dental procedures (bone grafts, sinus lifts, etc.).
Secondly, an extraction can be more costly than an endodontic procedure followed by a single tooth restoration. When presented with both options of Root Canal vs Extraction, more often than not, opting for a root canal will be less expensive and allow you to keep your tooth. Nothing looks, feels or functions like a natural tooth.
Finally, an extraction is a larger procedure and often is more uncomfortable than a root canal.
Ultimately, when presented with both options of Root Canal vs Extraction, more often than not, opting for a root canal will be less expensive and allow you to keep your original tooth intact rather than replacing it with a prosthetic device. And remember: Nothing looks, feels or functions like your natural tooth. Don’t get a tooth pulled because you think it’s easier or more cost-effective. Tooth extraction often is more painful than the infection itself, and replacing an extracted tooth with an artificial one requires additional dental visits that can quickly add up.
Other Endodontic Treatment Options
In many cases of root canal treatment, your saved tooth will last a lifetime; but not every case is cut and dry. If you’ve already had endodontic treatment and you’re experiencing issues again, or if you’ve been told that a root canal procedure is no longer an option for you, know that there are endodontic treatment alternatives.

Endodontic Retreatment

During retreatment, the endodontist will reopen your tooth and remove the filling materials that were placed in the root canals during the first procedure. The endodontist then carefully examines the tooth, looking for additional canals or new infection. The endodontist then removes any infection, cleans and shapes the canals, and places new filling materials. The opening is then sealed with a temporary filling. The tooth should then be restored with a more permanent restoration to seal and protect it. In some cases the endodontist may be the one to seal the tooth more permanently in preparation for the general dentist to place a crown.

Endodontic Surgery

Endodontic surgery can be used to locate small fractures or hidden canals previously undetected on X-rays during the initial treatment. Surgery may also be needed to remove calcium deposits in root canals, or to treat damaged root surfaces or the surrounding bone of the tooth.
There’s no need to worry about surgery if your endodontist prescribes this additional measure. Advanced technologies like digital imaging and operating microscopes allow these procedures to be performed quickly, comfortably and successfully. There are many surgical procedures that can be performed to save a tooth. The most common is called an apicoectomy, or root-end resection, which may be needed when inflammation or infection persists in the bony area around the end of your tooth after a root canal procedure.

Dental Implants

Do everything possible to save your teeth before considering extraction – it should always be a last resort!
If an endodontic procedure can’t save your tooth and it must be extracted, you should consider a dental implant that will enable you to bite and chew properly, keep healthy teeth from shifting, and help you maintain a natural appearance. Carefully discuss your options for treatment with your dental team to ensure you pick the treatment that is best for your overall health.

Saving Your Natural Tooth

Nothing looks, feels or functions like your natural tooth. Regular brushing and flossing, along with six-month check-ups from your dentist, can help you keep your teeth for a lifetime.

Sometimes your teeth may have infection or disease and will need additional care. When possible, you should always consider treatments to save your teeth. You may think, why not have a tooth pulled, especially if no one can see it, but you will know your tooth is missing and it will negatively impact your quality of life.
Don’t get a tooth pulled because you think its easier or more cost-effective. Missing teeth can cause other teeth to shift, affect your ability to properly chew and ruin your smile. Tooth extraction often is more painful than the infection itself, and replacing an extracted tooth with an artificial one requires additional dental visits that can quickly add up.

Modern endodontics offers advancements in technologies, procedures and materials, giving you many treatment options to save your natural teeth. It’s important to understand your choices and how they’ll impact both your tooth and your future dental health. It’s always best to retain your natural teeth whenever possible and endodontic treatment should be your first choice for the best health and cosmetic results. Endodontists are specialists in saving teeth. They can evaluate your condition and provide the best treatment plan to help you save your teeth for a lifetime.

Here are some tips for saving your teeth:

When given a choice between tooth extraction and root canal treatment, always opt for a root canal. No denture, bridge or implant will look, feel and function as well as a natural tooth.
Act immediately when you experience symptoms of swelling or pain. Most endodontists can accommodate emergency cases, even on weekends, ensuring you’ll be seen quickly.
If your dentist recommends tooth extraction, ask whether the root canal is an option.
If you’re told root canal is not an option, ask why and request a referral to an endodontist
Root canals treatment from an endodontist is virtually painless and often leaves you with less discomfort during recovery than if you have your natural tooth extracted. Thanks to modern techniques and effective anesthesia, patients who experience root canals are six times more likely to describe it as painless than patients who have a tooth extracted! Take the time to learn more about root canal treatment and some of the common misconceptions about it and then take the first step to a pain-free, healthy mouth by visiting an endodontist near you.

How does endodontic treatment save the tooth?

It’s necessary to have endodontic or root canal treatment when the inside of your tooth (the pulp) becomes inflamed or infected as a result of deep decay, repeated dental procedures, faulty crowns or a crack or chip in the tooth. Trauma to your tooth may also 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.
When you undergo a root canal or other endodontic treatment, the inflamed or infected pulp is removed and the inside of the tooth is carefully cleaned and disinfected, then filled and sealed with a rubber-like material called gutta-percha. Afterward, the tooth is restored with a crown or filling for protection and will continue to function like any other tooth.
Endodontic treatment helps you maintain your natural smile, continue eating the foods you love and limits the need for ongoing dental work. With proper care, most teeth that have had root canal treatment can last a lifetime.

Myths About Root Canals

The thought of a root canal may make you fearful or uneasy if you aren’t familiar with the procedure. There are common misconceptions that endodontic treatments such as root canals, cause pain and/or illness and should be avoided at all costs. The exact opposite is true. The pain, inconvenience and cost of avoiding endodontic treatment in favor of tooth extraction or a wait-and-see approach can be easily avoided. The longer you postpone treatment the more you risk the chance to save your tooth. Take the time to read the information on our website to find out what endodontists do to save teeth with minimal time and discomfort. Then address any remaining concerns or questions with your dentist or endodontist.
Put your mind at ease as we dispel three common myths about root canals:

Myth 1: Root canal treatment is painful.
That may have been the case decades ago, but with modern technology and anesthetics, you won’t experience any more pain than if you went to have a cavity filled. The pain from a severe toothache, often caused by damaged tissues in the tooth, can be easily remedied when an endodontist removes the damaged tissue through root canal treatment. In addition, endodontists are experts in pain management, and most cases can be treated quickly and comfortably.

Myth 2: Root canal treatment causes illness.
Information you may find on the Internet or elsewhere, claiming that if you receive a root canal treatment that you’re more likely to become ill or contract a systemic disease in the future simply isn’t true. This false claim was based on long-debunked and poorly designed research conducted nearly a century ago, long before modern medicine understood the actual causes of many diseases. There is no valid, scientific evidence linking root canal treatment to cancer or disease elsewhere in the body. In fact, modern research has shown that patients with multiple endodontic treatments had a 45 percent reduced risk of cancer.(Tezal M, et al. Dental Caries and Head and Neck Cancers. JAMA Otolaryngol Head Neck Surg 139(10):1054-60, Oct. 2013.).

Myth 3: It’s better to pull a tooth than have root canal treatment.
Saving your natural teeth, if possible, is always the best option. Nothing artificial can replace the look or function of a natural tooth so it’s important to always consider root canal treatment as an option. Endodontic treatment has a high success rate and many root canal-treated teeth last a lifetime. Replacing an extracted tooth with a bridge or implant requires more time in treatment and may result in further procedures to neighboring teeth and supporting tissue.

Myth 4: Root Canals Involve Removing the Roots of the Tooth.
When a root canal treatment is performed, the pulp from inside of the tooth is removed. The roots of the tooth are not removed.
Myth 5: If My Tooth Doesn’t Hurt, There is No Need for a Root Canal.
While a throbbing toothache typically is a telltale sign of a need for root canal treatment, there are times a tooth can require root canal treatment when there is no pain present. Endodontists are specially trained to test a tooth to see if the pulp has been infected or damaged. If this is the case, a root canal would be necessary to save the tooth. And remember, when it comes to teeth: There is no pain that is normal, so be sure to see an endodontist if you have a toothache.

Patient FAQs

Can you refer me to an endodontist?

You can self-refer to an endodontist.

Is a root canal painful?

Many endodontic procedures are performed to relieve the pain of toothaches caused by pulp inflammation or infection. Today, Endodontists understand a great deal about pain management. With modern techniques and anesthetics, the vast majority of patients report that they are comfortable during the procedure. For the first few days after treatment, your tooth may feel sensitive, especially if there was pain or infection before the procedure. Over-the-counter medications, such as Advil® or Tylenol®, are usually enough to manage this sensitivity. In some cases, prescription medications may be necessary and are available from your endodontist. 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 completed. Of course, if you experience pressure or pain that lasts more than a few days, call your endodontist.

Dental Symptoms
Tooth pain can keep you up at night. Rest easy when you get care from an endodontist.
It’s possible for dental problems to arise, even with proper brushing and flossing and regular visits to the dentist. Teeth can be damaged at any age, from decay, an injury or an infection. Regardless of the cause, if you have ongoing pain or discomfort, contact your dentist or use our Find an Endodontist search tool to find a practice near you.

Endodontists can diagnose and treat oral and facial pain resulting from abscessed, cracked, dislodged or knocked-out teeth. The earlier you address the symptoms and treat your dental problem, the better the outcome. Learn more about potential causes of tooth pain and different injuries to teeth that need to be treated.

Endodontists are skilled specialists in finding the cause of oral and facial pain that has been difficult to diagnose. Click the links below to learn more about some common dental symptoms.

• Tooth Pain
• Cracked Teeth
• Abscessed Teeth
• Traumatic Dental Injuries
• Knocked-Out Teeth
• Root Canal Explained

While endodontists are specialists in saving teeth — meaning they are trained in performing root canal treatment and other procedures to save the tooth — they will look at all treatment options to determine the best course of action for each individual patient and case.

Tooth Pain
If you’re experiencing tooth pain, whether sharp and throbbing or dull and achy, it can be difficult to bite and chew, concentrate, get through the day, even sleep at night, no matter what over-the-counter medication you take for some relief.
The source of tooth pain may be dental decay, a cracked tooth, or an infection. Regardless of the cause, if you have ongoing pain it’s time to see a dentist or endodontist for treatment. In the meantime, read on for information on common pain symptoms, possible causes and some steps you can take to ease the discomfort.

Tooth Pain Symptoms and Possible Problems

Symptom: Momentary sensitivity to hot or cold foods.

Possible problem: This generally does not signal a serious problem, unless the sensitivity remains for an extended period of time. It may be caused by minor decay, a loose filling or by minimal gum recession that exposes small areas of the root surface.

What to do: Try using toothpaste made for sensitive teeth and brush with a soft or extra-soft brush, using an up-and-down motion, never side-to-side, which wears away exposed root surfaces. If the issue persists, it’s time to see a dental health practitioner.

Symptom: Sensitivity to hot or cold foods after dental treatment.

Possible problem: It’s possible that recent dental work has inflamed the pulp inside the tooth, causing this temporary symptom.
What to do: Wait two to four weeks and if the pain persists or worsens, have your dentist or endodontist check for a more serious problem.

Symptom: Sharp pain when biting down on food.

Possible problem: This jarring symptom may be caused by decay, a loose filling or a crack in the tooth. It’s also possible there is damage to the pulp tissue inside the tooth.

What to do: Get the matter evaluated by a dentist, who may refer you to an endodontist if there is pulp tissue damage. These specialists perform pulp-related procedures, such as root canals, which involve cleaning out the damaged pulp and filling and sealing the remaining space.

Symptom: Lingering pain, typically lasting more than 30 seconds, after eating hot or cold foods.

Possible problem: It’s likely that the pulp has been irreversibly damaged by deep decay or physical trauma.
What to do: See your dentist or endodontist as soon as possible to save the tooth with root canal treatment.

Symptom: Constant and severe pain and pressure, swelling of gum and sensitivity to touch.

Possible problem: A tooth may be abscessed, causing an infection in the surrounding tissue and bone.
What to do: See your endodontist for evaluation and treatment to relieve the pain and save the tooth. Take over-the-counter medications until you see the endodontist.

Symptom: Dull ache and pressure in upper teeth and jaw.

Possible problem: Grinding of teeth, known as bruxism, can cause this type of ache. The pain of a sinus headache may also be felt in the face and teeth.
What to do: For bruxism, consult your dentist. For a sinus headache, try over-the-counter medication. If the pain is severe and chronic, see your endodontist or physician for evaluation.

Cracked Teeth
Whether your tooth cracks from an injury or general wear and tear, you can experience a variety of symptoms ranging from erratic pain when you chew your food to sudden pain when your tooth is exposed to very hot or cold temperatures. In many cases, the pain may come and go and your dentist may have difficulty locating the tooth causing the discomfort. If you experience these symptoms or suspect a cracked tooth, it’s best to see an endodontist as soon as possible.
Endodontists specialize in saving cracked teeth and will cater treatment to the type, location, and extent of the crack. The sooner your tooth is treated, the better the outcome. Once treated, most cracked teeth continue to function as they should, for many years of pain-free biting and chewing.
Explore more about the symptoms, causes, and treatments for cracked teeth.

How do I know if my tooth is cracked?

Cracked teeth show a variety of symptoms, including erratic pain when chewing, possibly with the release of biting pressure, or pain when your tooth is exposed to temperature extremes. In many cases, the pain may come and go, and your dentist may have difficulty locating which tooth is causing the discomfort.

Why does a cracked tooth hurt?

To understand why a cracked tooth hurts, it helps to know something about the anatomy of the tooth. Inside the tooth, under the white enamel and a hard layer called the dentin, is the inner soft tissue called the pulp. The pulp contains the tooth’s nerves and blood vessels.
When the outer hard tissues of the tooth are cracked, chewing can cause movement of the pieces, and the pulp can become irritated. Eventually, the pulp will become damaged to the point that it can no longer heal itself.
The tooth will not only hurt when chewing but may also become sensitive to temperature extremes. In time, a cracked tooth may begin to hurt all by itself. Extensive cracks can lead to infection of the pulp tissue, which can spread to the bone and gum surrounding the tooth.

What if my tooth is chipped?

Chipped teeth account for the majority of dental injuries. Most chipped teeth can be repaired either by reattaching the broken piece of tooth enamel or by bonding a tooth-colored filling or crown in place. See your dentist as soon as possible after the injury to treat your chipped tooth and keep it from worsening.

How will my cracked tooth be treated?

There are many different types of cracked teeth. The treatment and outcome for your tooth depend on the type, location, and extent of the crack.

Craze Lines
Craze lines are tiny cracks that affect only the outer enamel. These cracks are extremely common in adult teeth. Craze lines are very shallow, cause no pain, and are of no concern beyond appearances.

Fractured Cusp
When a piece of a tooth’s chewing surface breaks off, often around a filling, it’s called a fractured cusp. A fractured cusp rarely damages the pulp, and usually doesn’t cause much pain. Your dentist can place a new filling or crown over the damaged tooth to protect it.
If you’ve cracked a tooth and breathing through your mouth or drinking cold fluids is painful, bite on clean, moist gauze or cloth to help relieve symptoms until reaching your dentist’s office. Never use topical oral pain medications (such as Anbesol®) or ointments, or place aspirin on the affected areas to eliminate pain symptoms.

Cracked Tooth
A cracked tooth means a crack extends from the chewing surface of your tooth vertically toward the root. The tooth is not yet separated into pieces, though the crack may gradually spread. Early diagnosis is important in order to save the tooth. If the crack has extended into the pulp, the tooth can be treated with a root canal procedure and a crown to protect the crack from spreading.
However, if the crack extends below the gum line, it is no longer treatable, and the tooth cannot be saved and will need to be extracted. That’s why early treatment is so important. A cracked tooth that is not treated will progressively worsen, eventually resulting in the loss of the tooth. Early diagnosis and treatment are essential in saving these teeth.

Split Tooth
A split tooth is often the result of the long-term progression of a cracked tooth. The split tooth is identified by a crack with distinct segments that can be separated. A split tooth cannot be saved intact. The position and extent of the crack, however, will determine whether any portion of the tooth can be saved. In some cases, endodontic treatmentmay be performed to save a portion of the tooth.

Vertical Root Fracture
Vertical root fractures are cracks that begin in the root of the tooth and extend toward the chewing surface. They often show minimal signs and symptoms and may, therefore, go unnoticed for some time. Vertical root fractures are often discovered when the surrounding bone and gum become infected. Treatment may involve extraction of the tooth. However, endodontic surgery is sometimes appropriate if a tooth can be saved by removal of the fractured portion.

After treatment for a cracked tooth, will my tooth completely heal?

Unlike a broken bone, the fracture in a cracked tooth will not heal. In spite of treatment, some cracks may continue to progress and separate, resulting in loss of the tooth. Placement of a crown on a cracked tooth provides maximum protection but does not guarantee success in all cases.
The treatment you receive for your cracked tooth is important because it will relieve pain and reduce the likelihood that the crack will worsen. Once treated, most cracked teeth continue to function and provide years of comfortable chewing. Talk to your endodontist about your particular diagnosis and treatment recommendations.

What can I do to prevent my teeth from cracking?

While cracked teeth are not completely preventable, you can take some steps to make your teeth less susceptible to cracks.

• Don’t chew on hard objects such as ice, unpopped popcorn kernels or pens.
• Don’t clench or grind your teeth.
• If you clench or grind your teeth while you sleep, talk to your dentist about getting a retainer or other mouthguard to protect your teeth.
• Wear a mouthguard or protective mask when playing contact sports.
Abscessed Teeth

If your mouth or jaw is aching, you experience pain while chewing or you have swollen gums, you may have an abscessed tooth. These are just a few of the symptoms that can occur when the pulp (the soft tissue inside the root canal of a tooth) dies, becomes inflamed and goes untreated. The resulting infection in or around the root of the tooth may or may not be painful but any ongoing symptoms should be tended by an endodontist who specializes in treating infected teeth and pulp.
An endodontist will typically treat your abscess with a root canal procedure or endodontic surgery. This involves removing the bacteria from the empty canals within your tooth, cleaning, shaping and filing the root canals, and sealing the empty space. Then, after some time to be certain the treatment was successful, you’ll visit your dentist who will put a crown or other restoration on the tooth to protect and restore it to full function. After the dentist restores it the tooth will continue to function like your natural teeth.

Traumatic Dental Injuries
Traumatic dental injuries often occur as a result of an accident or sports injury. The majority of these injuries are minor – chipped teeth. It’s less common to dislodge your tooth or have it knocked completely out but these injuries are more severe. Treatment depends on the type, location and severity of each injury. Regardless of the extent of the injury, your tooth requires immediate examination by a dentist or an endodontist. Sometimes, your neighboring teeth suffer an additional, unnoticed injury that can only be detected by a thorough dental exam.
Endodontists are dentists who specialize in treating traumatic dental injuries. With their advanced skills, techniques and technologies they often can save injured teeth. If you have a cracked or injured tooth, find an endodontist near you right away. Most endodontists offer tremendous flexibility in accommodating emergency cases, including weekends in some instances. You’ll have relief from your pain and likely save your tooth, so act as quickly as possible.

FAQs about Traumatic Dental Injuries

What is endodontic treatment?

“Endo” is the Greek word for “inside” and “odont” is Greek for “tooth.” Endodontic treatment involves the inside of your tooth. Inside your tooth, under the white enamel and a hard layer called the dentin, is a soft tissue called pulp. It contains blood vessels, nerves, and connective tissue, and creates the surrounding hard tissues of the tooth during its development.
The pulp extends from the crown of your tooth to the tip of the roots, where it connects to the tissues surrounding the root. It’s vitally important to your tooth’s growth and development, however, once your tooth is fully mature it can survive without the pulp; your tooth continues to be nourished by the tissues surrounding it.

Who performs endodontic treatment?

All dentists, including your general dentist, received training in endodontic treatment in dental school. General dentists can perform endodontic procedures along with other dental procedures, but often they refer patients needing endodontic treatment to endodontists.
Endodontists are dentists with special training in these procedures, providing only endodontic services in their practices because they are specialists. They’ve completed dental school and an additional two or more years of advanced training in endodontics. You can feel confident visiting an endodontist for anything from routine to difficult and very complex endodontic procedures, including endodontic surgery. Endodontists also are experienced at finding the cause of oral and facial pain that has been difficult to diagnose.

How will my injury be treated?

CHIPPED OR FRACTURED TEETH
If you’ve chipped or fractured your tooth’s crown, it’s likely it can be repaired either by reattaching the broken piece or by putting a tooth-colored filling in place. If a significant part of your tooth crown is broken off, an artificial crown or “cap” may be needed to restore it.
When the pulp is exposed or damaged after a crown fracture, root canal treatment may be needed. These injuries require special attention. If breathing through your mouth or drinking cold fluids is painful, bite on clean, moist gauze or cloth to help relieve symptoms until reaching your dentist’s office. Never use topical oral pain medication (such as Anbesol®) or ointments, or place aspirin on the affected areas to eliminate pain symptoms.
Injuries in the back teeth, such as fractured cusps, cracked teeth require root canal treatment and a full coverage crown to restore function your tooth if the crack extends into the root. More seriously injured split teeth may require extraction.

DISLODGED (LUXATED) TEETH
During an injury, a tooth may be pushed sideways, out of or into its socket. Your endodontist or general dentist will reposition and stabilize your tooth. Root canal treatment is usually needed for permanent teeth that have been dislodged and should be started several days following the injury. Medication may be put inside your tooth as part of the root canal treatment; once treatment is complete and has been deemed successful a permanent root canal filling or crown will be put in place at a later date.
Children ages 12 and under may not need root canal treatment since their teeth are still developing. New research indicates that stem cells present in the pulps of children can be stimulated to complete root growth and heal the pulp following injuries or infection. When a child’s tooth is injured, an endodontist or dentist will monitor the healing carefully and intervene immediately if any unfavorable changes appear. Multiple follow-up appointments are likely to be needed.

KNOCKED-OUT (AVULSED) TEETH
If one of your teeth is completely knocked out of your mouth, see an endodontist or dentist immediately! Time is of the essence and if you receive treatment quickly, preferably within 30 minutes, there is a chance to save your tooth.
Handle a knocked-out tooth very carefully and don’t touch the root surface. Following a few important steps will help increase the likelihood of saving your tooth. Your endodontist or dentist will evaluate the tooth, place it back in its socket and examine you for any other dental and facial injuries. A stabilizing splint will be placed for the next few weeks. Depending on the stage of root development, your dentist or endodontist may start root canal treatment a week or two later.
Depending on the length of time your tooth was out of your mouth and how it was stored before receiving treatment it may be necessary to discuss other treatment options with your dentist or endodontist.

ROOT FRACTURES
A traumatic injury to your tooth may also result in a horizontal root fracture. The location of the fracture determines the long-term health of your tooth. The closer a fracture is to the root tip, the better the chances of success and long-term health; fractures closer to the gum line are more debilitating for your tooth. Sometimes, stabilization with a splint is required while the tooth heals.

Do traumatic dental injuries differ in children?

Chipped primary (baby) teeth can be esthetically restored. Dislodged primary teeth can, in rare cases, be repositioned. However, primary teeth that have been knocked out typically should not be replanted because it may cause further and permanent damage to the underlying permanent tooth that is growing inside the bone.
Children’s permanent teeth that are not fully developed at the time of the injury need special attention and careful follow up, but not all of them will need root canal treatment. In an immature permanent tooth, blood supply to the tooth and stem cells in the region may enable your dentist or endodontist to stimulate continued root growth.
Endodontists will do all that is possible to save the natural tooth and have the knowledge and skill to treat incompletely formed roots in children so that, in some instances, the roots can continue to develop. Look to these specialists for information and their expertise when your child is the victim of dental trauma.

Will the tooth need any special care or additional treatment?

Factors that affect the long-term health of your tooth after an injury include: the nature of the injury, the length of time from injury to treatment, how your tooth was cared for after the injury and your body’s response. Getting treatment as soon as possible is very important with dislodged or knocked-out teeth in particular, in order to prevent root resorption.
Resorption occurs when your body, through its own defense mechanisms, begins to reject your own tooth in response to the traumatic injury. Following an injury, you should return to your dentist or endodontist to have the tooth examined and/or treated on a regular basis for up to five years to ensure that root resorption is not occurring and that surrounding tissues continue to heal. Unfortunately, some types of resorption are untreatable.

Knocked Out Teeth
More than five million teeth are knocked out every year in children and adults but if this happens to you due to an injury or accident it doesn’t necessarily mean it’s lost for good. Proper emergency action can save the tooth so that it can be replanted successfully and last for years to come.

Act quickly, within 30 minutes, and visit the nearest dentist or endodontist.

Review and remember these tooth-saving steps that take you and your tooth from the time it falls out until you reach medical support:

1. Pick up the tooth by the crown (the chewing surface) NOT the root.
Locate the tooth immediately; don’t leave it at the site of the accident. Handle the tooth carefully when you pick it up, and never touch the root of the tooth, only the crown (chewing surface).
2. If dirty, gently rinse the tooth with water.
Use only water to gently rinse off any dirt. Do not use soap or chemicals. Don’t scrub or dry the tooth, and don’t wrap the tooth in a tissue or cloth.
3. Reposition the tooth in the socket immediately, if possible.
Try to put the tooth back into its socket right away. Gently push it in with your fingers, by handling the crown, or position it above the socket and close your mouth slowly. Hold the tooth in place with your fingers or by gently biting down on it.
4. Keep the tooth moist at all times.
The tooth must stay moist at all times, either in your mouth or, if it can’t be replaced in the socket, put it in milk, in your mouth next to your cheek, or in an emergency tooth preservation kit (such as Save-a-Tooth®). Don’t use regular tap water; root surface cells can’t tolerate that for extended periods of time.
5. See an endodontist or dentist within 30 minutes of the injury.
Bring the tooth with you to your emergency appointment ideally. It’s best to see the doctor within 30 minutes; however, it is possible to save a tooth even if it has been outside the mouth for an hour or more.

Root Canal Explained

Has your dentist or endodontist told you that you need root canal? If so, you’re not alone. More than 15 million teeth are treated and saved each year with the root canal, or endodontic, treatment. This page explains root canal treatment in detail and how it can relieve your tooth pain and save your smile.

What is a root canal?

“Endo” is the Greek word for “inside” and “odont” is Greek for “tooth.” Endodontic treatment treats the inside of the tooth. Root canal treatment is one type of endodontic treatment.
To understand endodontic treatment, it helps to know something 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 and creates the surrounding hard tissues of the tooth during development.
The pulp extends from the crown of the tooth to the tip of the roots where it connects to the 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 tissues surrounding it.

How to know if you need a root canal?

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.

What are the signs of needing a root canal?

There are a few symptoms that mean you might need a root canal—

• Severe pain while chewing or biting
• Pimples on the gums
• A chipped or cracked tooth
• Lingering sensitivity to hot or cold, even after the sensation has been removed
• Swollen or tender gums
• Deep decay or darkening of the gums

How does endodontic treatment save the tooth?

The endodontist removes the inflamed or infected pulp, carefully cleans and shapes the inside of the root canal, then fills and seals the space. Afterward, 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.

Will I feel pain during or after the root canal?

Many endodontic procedures are performed to relieve the pain of toothaches caused by pulp inflammation or infection. With modern techniques and anesthetics, most patients report that they are comfortable during the procedure.
For the first few days after treatment, your tooth may feel sensitive, especially if there was 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 completed. However, if you have severe pain or pressure or pain that lasts more than a few days, call your endodontist.

Step-by-Step Endodontic Procedure

Endodontic treatment can often be performed in one or two visits and involves the following steps:
1. The endodontist examines and takes a radiograph of the tooth using x-rays, then administers local anesthetic. After the tooth is numb, the endodontist places a small protective sheet called a “dental dam” over the area to isolate the tooth and keep it clean and free of saliva during the procedure.
2. The endodontist makes an opening in the crown of the tooth. Very small instruments are used to clean the pulp from the pulp chamber and root canals and to shape the space for filling.
3. After space is cleaned and shaped, the endodontist fills the root canals with a biocompatible material, usually a rubber-like material called gutta-percha. The gutta-percha is placed with an adhesive cement to ensure complete sealing of the root canals. In most cases, a temporary filling is placed to close the opening. The temporary filling will be removed by your dentist before the tooth is restored.
4. After the final visit with your endodontist, you must return to your dentist to have a crown or other restoration placed on the tooth to protect and restore it to full function.
If the tooth lacks sufficient structure to hold the restoration in place, your dentist or endodontist may place a post inside the tooth. Ask your dentist or endodontist for more details about the specific restoration planned for your tooth.

How much will the root canal 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 expensive than the alternative of having the tooth extracted. An extracted tooth must be replaced with an implant or bridge to restore chewing function and prevent adjacent teeth from shifting. These procedures tend to cost more than endodontic treatment and appropriate restoration.

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, 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 checkups 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 diseased 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?

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.

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.

What can I eat after a root canal? 

After a root canal, try to eat soft foods that require very little chewing, like applesauce, yogurt, eggs, and fish. Avoid hard or hot foods that might hurt your teeth. Some dentists suggest to not eat for a few hours until the numbness in your mouth wears off so you don’t bite your cheek or tongue.

How is a root canal done? 

A root canal is performed when the endodontist removes the infected pulp and nerve in the root of the tooth, cleans and shapes the inside of the root canal, then fills and seals the space. Afterward, your dentist will place a crown on the tooth to protect and restore it to its original function.

What to expect after a root canal?

For the first few days after a root canal, some patients experience sensitivity, swelling, or inflammation, while others experience an uneven bite or a reaction to the medication provided by the endodontist. Regardless of symptoms, a follow-up appointment is almost always needed.

Does a root canal kill the tooth?

A root canal does not kill the tooth, and after a root canal is complete, the tooth will be able to function as it normally does. However, root canals do remove the nerves inside the tooth, but these nerves serve very little function in a fully formed tooth.

Do you need a crown after a root canal?

Needing a crown after a root canal depends highly on the location of the tooth in the mouth—teeth towards the back of the mouth like molars and premolars are needed more for chewing, and generally require crowns, where incisors or canines which aren’t needed for chewing don’t always require crowns.

Can a root canal fail? 

Root canals can fail for a variety of reasons, including a procedure that didn’t clean the canals to begin with, a breakdown of the crown or its inner sealant, or essentially anything that allows the tooth that previously had a root canal treatment to become infected at the root and affect other teeth.

What happens if you don’t get a root canal?

If left untreated, the infection in the tooth can spread to other parts of the body, and in some cases can even be life threatening. If you are in need of a root canal, the infected pulp in the tooth needs to be removed.

Do root canals cause cancer?

There is absolutely no evidence that a root canal can cause cancer. In fact, a root canal is the only way to remove an infected tooth that could spread and cause serious disease or illness. All claims that root canals cause cancer or other illnesses are complete myths.

Can I brush my teeth after a root canal? 

Unless told otherwise by your dentist or endodontist, brush and floss as you regularly would after a root canal treatment.

Will a tooth turn black after a root canal?

Sometimes after a root canal, the tooth can become slightly discolored or develop spots called intrinsic stains, where the tooth bleeds internally and the inner part of the tooth turns yellow or dark. Luckily, the tooth can be whitened afterward through internal (non-vital) bleaching.

How many visits does a root canal take? 

Most root canals can be done in one to two appointments. The first appointment is the procedure itself when the infected pulp is removed. The second (and maybe third) appointment is when the root canal gets cleaned and filled with a crown or other filling to prevent infections. Each appointment lasts roughly 90 minutes each.

Can you smoke after a root canal?

While you can smoke after a root canal it is not recommended as smoking increases the risk of needing another procedure. In fact, smokers are nearly twice as likely to need root canals than non-smokers, and that number increases with more years of smoking.

Can I drive after a root canal?

Most root canal procedures are done using local anesthesia, meaning only the areas that are being operated on will be numb during the course of the procedure. This means you are awake and aware during the process and can drive and operate machinery as you normally would immediately after the procedure is over.

What kind of dentist does root canals?

While all general dentists have been trained in root canals, more often than not the procedure is done by an endodontist. Generally speaking, a dentist specializes in exterior teeth and gum health, an endodontist specializes in the health of the inside of the tooth.

When is it too late to get a root canal?

Waiting too long to get a root canal can oftentimes result in tooth loss. This generally occurs when the root of an infected tooth has gone untreated for so long that results in bone loss. Many times with severe furcation, it might be too late for a root canal and the tooth would need to be extracted.

Can you eat before a root canal? 

You can eat normally before a root canal treatment, and most endodontists even allow patients to eat up to 1 hour before a procedure. However, as with all oral procedures, most endodontists prefer that you brush your teeth prior to the appointment.

Is it better to have a root canal or extraction?

It is always better to maintain a healthy, natural smile whenever possible, and root canals allow for just that. Extracting and then replacing a tooth results in more treatments and procedures, and could even impact neighboring teeth and supporting gums.

Can you be put to sleep for a root canal? 

Generally speaking, most endodontists choose local anesthesia for a root canal, meaning they are only numbing the area that needs to be operated upon. However, the option for general anesthesia varies from endodontist to endodontist, and it’s best to consult your local office about their policies.

Can you drink alcohol after a root canal? 

After a root canal procedure, you can eat and drink normally, including alcohol, once the numbness wears off.

What not to do after a root canal? 

After a root canal, make sure to follow all of your endodontist’s instructions, which most often include avoiding hard or especially chewy foods, brushing twice a day, and being very cautious around the area where the root canal procedure was completed.

Source: https://www.aae.org/patients/root-canal-treatment/what-is-a-root-canal/root-canal-explained/