Frequently Asked Questions

Click to view answers to FAQs

General

What is your Privacy Policy?

We are very concerned about protecting the privacy of the information that you provide to us. See the Privacy Policy section of this website.

Why do I need a consultation?

When you come into your appointment, we will review both your medical and dental histories, discuss the reason for your visit, perform diagnostics tests or review x-rays, and evaluate any materials your primary dentist may have sent along for review. Depending on your situation, and the tooth in question, it may be necessary to take additional images in order to get a three dimensional view of the current situation.

What can I expect at my first appointment?

At this initial consultation the doctor will review any previous x-rays that you have brought with you, take any additional x-rays required to properly diagnose and treat your case, perform any necessary testing to determine a diagnosis of your condition, and review the treatment options with you. You have been referred to our office for extremely specialized dental care.

Worldwide, only approximately 20% of root canals are actually performed by Endodontists. The fact that you have been referred here shows that your dentist is very concerned about the complexities of your care. Each patient in our practice is a unique individual with specific treatment needs. Therefore, we do not typically schedule consultation and treatment for the same day. However, if in some cases it may possible to perform the consultation and treatment on the same day.

Different Dental Symptoms

The goals of an endodontic evaluation are:

  • Determine if you are in need of endodontic (root canal) treatment
  • Identify the source of the pain.*
  • Discuss your treatment options in easy to understand terms
  • Create an action plan for treatment

*Sometimes patients will experience a generalized pain, or “referred” pain might be felt in an area in another area altogether. It is important to note that not all oral pain implies that root canal treatment is necessary. A number of other situations may mimic the symptoms of a “toothache” which may be unrelated!

Your Endodontist will be able to take all of your information into account and determine what is the best course of action to get you feeling great again.

Why canʼt my general dentist perform the treatment?

All dentists receive basic training in root canal treatment in dental school. Although some general dentists perform root canal procedures, many refer their patients to endodontists. Endodontists have two or three years of specialized training beyond dental school in root canal treatment. Many have performed thousands of procedures and are familiar with all the potential complications that may arise. They have specialized training in the latest technology, including the use of the ultrasonic, apex locator, digital imaging, and the operating microscope. Endodontics is one of the nine specialties recognized by the American Dental Association. Because they limit their practice to endodontics, endodontists have lots of experience in handling difficult cases, such as teeth with narrow or blocked canals or unusual anatomy.

Myths about Root Canal Treatment

Myth #1: Root canal treatment is painful.
Truth—Root canal treatment doesn’t cause pain, it relieves it!

Myth #2: Root canal treatment causes illness.
Truth—Root canal treatment is a safe and effective procedure.

Myth #3: A good alternative to root canal treatment is extraction (pulling the tooth).
Truth—Saving your natural teeth, if possible, is the very best option.

(Source: American Association of Endodontists)

Do you extract / “pull” teeth?

Root canal (endodontic) treatment saves teeth that would otherwise be extracted. Although the pulp has been removed, the tooth is still anchored in the bone and can still be used for biting and chewing. With proper care, most teeth that have had root canal treatment can last as long as other natural teeth!

What do I do once the root canal is finished?

After treatment you will want to follow up with your general dentist. For more detailed information on what to expect after your procedure please read our AFTER TREATMENT BASICS or POST-SURGICAL INSTRUCTIONS.  And, as always, all patient’s will be given the doctor’s direct line to contact him with any questions, issues, or concerns.

How many appointments does a root canal take?

A root canal requires one or more office visits and can be performed by a dentist or endodontist. These visits are determined by the complexity of the procedure and will include a visit for consultation & evaluation.

How can you help me overcome being nervous about the treatment?

Dr. Grassin is known for his mad karaoke skills. (Aptly named “tone-deaf” by the Japanese creators of this fun activity.) He’ll both amuse and amaze you… please keep the chuckling to a minimum as he has work to do.


Endodontic Basics

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 are the signs of needing endodontic treatment?

Signs to look for include pain, prolonged sensitivity to heat or cold, tenderness to touch and chewing, discoloration of the tooth, and swelling, drainage and tenderness in the lymph nodes as well as nearby bone and gingival tissues. Sometimes, however, there are no symptoms.

Why would I need an endodontic procedure?

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.

Who performs endodontic treatment?

All dentists, including your general dentist, receive basic training in endodontic treatment in dental school. General dentists often refer patients needing more specialized endodontic treatment to an endodontist. An endodontist is a dentist with special training in diagnosing and treating problems associated with the inside of the tooth.

What is endodontics?

Endodontics (Root Canal) therapy is a branch of dentistry recognized by the American Dental Association involving treatment of the pulp (root canal) and surrounding tissues of the tooth. When you look at your tooth in the mirror, what you see is the crown. The rest of the tooth, the portion hidden beneath the gum line, is called the root. Though the outer portion of the root is a hard tissue called dentin, the inside channel or “root canal” contains a pulp of soft tissue, blood vessels and nerves. Bacteria that are introduced into the pulp as a result of tooth decay, periodontal disease, tooth fracture or other problems, can severely damage the pulp. When the pulp is damaged, an endodontic specialist removes the tissue to save the tooth and prevent further infection and inflammation. After successful endodontic treatment, the tooth continues to perform normally.

What is an endodontist?

An endodontist is a dentist with special training in diagnosing and treating problems associated with the inside of the tooth. They do only endodontic procedures in their practices because they are specialists. To become specialists, they complete dental school and an additional two or more years of advanced training in endodontics, one of the nine specialties recognized by the American Dental Association. They perform routine as well as very complex endodontic procedures, including retreatment of previous root canals that have not healed completely, as well as endodontic surgery. Endodontists are also experienced at finding the cause of oral and facial pain that has been difficult to diagnose.

The Specialty training allows an Endodontist to:

  • deal with diseases of the dental pulp and supporting structures.
  • diagnose facial pain and related problems. Your general dentist sometimes refers patients for consultation when the diagnosis is complicated or when treatment is more difficult than normal.
  • treat traumatic injuries to the teeth resulting from sports injuries or accidents.
  • manage pain and swelling resulting from infected teeth.

Why canʼt my general dentist perform the treatment?

All dentists receive basic training in root canal treatment in dental school. Although some general dentists perform root canal procedures, many refer their patients to endodontists. Endodontists have two or three years of specialized training beyond dental school in root canal treatment. Many have performed thousands of procedures and are familiar with all the potential complications that may arise. They have specialized training in the latest technology, including the use of the ultrasonic, apex locator, digital imaging, and the operating microscope. Endodontics is one of the nine specialties recognized by the American Dental Association. Because they limit their practice to endodontics, endodontists have lots of experience in handling difficult cases, such as teeth with narrow or blocked canals or unusual anatomy.


Endodontic Procedures

What is endodontic retreatment therapy?

With proper care, most teeth that have had root canal (endodontic) treatment can last as long as other natural teeth. In some cases, however, a tooth that has received endodontic treatment fails to heal. Occasionally, the tooth becomes painful or diseased months or even years after successful treatment. If your tooth has not healed or has developed new problems, you have a second chance. Another procedure, endodontic retreatment, may be able to save your tooth.

I’m worried about X-rays. Should I be?

The risks associated with radiation exposure from dental radiographs are very minimal. While x-rays will be necessary during your endodontic treatment, we use a system called computerized digital radiography. The radiation levels used by this system can be up to 90 percent lower than those of conventional dental x-ray systems.

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.

Will I feel pain during or after the procedure?

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. Your tooth may also continue to feel slightly different from your other teeth for some time after your endodontic treatment is completed. This discomfort can be relieved with over-the-counter or prescription medications. Follow your endodontist’s instructions carefully. However, if you have severe pain or pressure or pain that lasts more than a few days, call your endodontist.

How does endodontic treatment save the tooth?

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

What are the signs of needing endodontic treatment?

Signs to look for include pain, prolonged sensitivity to heat or cold, tenderness to touch and chewing, discoloration of the tooth, and swelling, drainage and tenderness in the lymph nodes as well as nearby bone and gingival tissues. Sometimes, however, there are no symptoms.

Why would I need an endodontic procedure?

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.

Can I drive myself home after my appointment?

Often you can, but you should ask our staff before your appointment so that you can make transportation arrangements if necessary.

What do I do once the root canal is finished?

After treatment you will want to follow up with your general dentist. For more detailed information on what to expect after your procedure please read our AFTER TREATMENT BASICS or POST-SURGICAL INSTRUCTIONS.  And, as always, all patient’s will be given the doctor’s direct line to contact him with any questions, issues, or concerns.


Cone Beam Computed Tomography

Should I have a Cone Beam Computed Tomography scan?

When you come into your appointment, we will review both your medical and dental histories, discuss the reason for your visit, perform diagnostics tests or review x-rays, and evaluate any materials your primary dentist may have sent along for review. Depending on your situation, and the tooth in question, it may be necessary to take additional images in order to get a three dimensional view of the current situation.

Click here for more information about Endodontic Evaluation & Consultation

What is a Cone Beam Computed Tomography scan?

Cone Beam Computed Tomography (CBCT) technology in dentistry is rapidly changing the diagnostic landscape, allowing dentists to now diagnose in three dimensions.

With this technology, implants and crowns can be placed with more ease and accuracy.  Impacted, hidden or missing teeth can be precisely located and ‘hopeless teeth’  can be saved by discovering untreated nerve canals. This power of perception can also help to identify bone and gum disease.

The use of CBCT makes taking diagnostic dental impressions an unnecessary, cumbersome task of the past. This minimizes the patient’s in-office work-up time, discomfort of dental impressions and the overall time it takes to formulate an accurate treatment plan.


Endodontic Retreatment Therapy

What are the alternatives to endodontic retreatment and/or endodontic surgery?

The only other alternative is extraction of the tooth. The extracted tooth must then be replaced with an implant, bridge or removable partial denture to restore chewing function and to prevent adjacent teeth from shifting. Because these options require extensive surgery or dental procedures on adjacent healthy teeth, they can be far more costly and time consuming than retreatment and restoration of the natural tooth. No matter how effective tooth replacements are, nothing is as good as your own natural tooth. You’ve already made an investment in saving your tooth. The payoff for choosing retreatment could be a healthy, functioning natural tooth for many years to come.

What are the alternatives to retreatment?

If nonsurgical retreatment is not an option, then endodontic surgery should be considered. This surgery involves making an incision to allow access to the tip of the root. Endodontic surgery may also be recommended in conjunction with retreatment or as an alternative. Your endodontist will discuss your options and recommend appropriate treatment.

How much will endodontic retreatment cost?

The cost varies depending on how complicated the procedure will be. The procedure will probably be more complex than your first root canal treatment, because your restoration and filling material may need to be removed to accomplish the new procedure. In addition, your endodontist may need to spend extra time searching for unusual canal anatomy. Therefore, you can generally expect retreatment to cost more than the initial endodontic treatment. While dental insurance may cover part or all of the cost for retreatment, some policies limit coverage to a single procedure on a tooth in a given period of time. Check with your employer or insurance company prior to retreatment to be sure of your coverage.

Is retreatment the best choice for me?

Whenever possible, it is best to save your natural tooth. Retreated teeth can function well for years, even for a lifetime. Advances in technology are constantly changing the way root canal treatment is performed, so your endodontist may use new techniques that were not available when you had your first procedure. Your endodontist may be able to resolve your problem with retreatment. As with any dental or medical procedure, there are no guarantees. Your endodontist will discuss your options and the chances of success before beginning retreatment.

What will happen during retreatment?

First, the endodontist will discuss your treatment options. If you and your endodontist choose retreatment, he will open your tooth to gain access to the root canal filling material. In many cases, complex restorative materials—crown, post and core material—must be disassembled and removed to permit access to the root canals. After removing the canal filling, your endodontist can clean the canals and carefully examine the inside of your tooth using magnification and illumination, searching for any additional canals or unusual anatomy that requires treatment. After cleaning the canals, he will fill and seal the canals and place a temporary filling in the tooth. If the canals are unusually narrow or blocked, your endodontist may recommend endodontic surgery. This surgery involves making an incision to allow the other end of the root to be sealed. After your retreatment is complete, you will need to return to your dentist as soon as possible to have a new crown or other restoration placed on the tooth to protect and restore it to its full function.

Why do I need another endodontic procedure?

As occasionally happens with any dental or medical procedure, a tooth may not heal as expected after initial treatment for a variety of reasons:

  • Narrow or curved canals were not treated during the initial procedure
  • Complicated canal anatomy went undetected in the first procedure
  • Placement of the crown or other restoration was delayed following the endodontic treatment
  • Restoration did not prevent salivary contamination to the inside of the tooth
  • Failure of the body’s immune system to resolve the infection

In other cases, a new problem can jeopardize a tooth that was successfully treated.

For example:

  • New decay can expose the root canal filling material to bacteria, causing a new infection in the tooth
  • A loose, cracked or broken crown or filling can expose the tooth to new infection
  • A tooth sustains a fracture

 

Who performs endodontic retreatment?

All dentists receive basic training in root canal treatment in dental school. However, because endodontic retreatment can be more challenging than providing first-time treatment, many dentists refer patients needing endodontic retreatment to endodontists. Endodontists are dentists with at least two additional years of advanced specialty education in diagnosis and root canal treatment. Because they limit their practices to endodontics, they treat these types of problems every day. Endodontists are experts in performing nonsurgical and surgical retreatment. They use their special training and experience in treating difficult cases, such as teeth with narrow or blocked canals or unusual anatomy. Endodontists may use advanced technology, such as operating microscopes, ultrasonics and digital imaging to perform these special services.

What is endodontic retreatment therapy?

With proper care, most teeth that have had root canal (endodontic) treatment can last as long as other natural teeth. In some cases, however, a tooth that has received endodontic treatment fails to heal. Occasionally, the tooth becomes painful or diseased months or even years after successful treatment. If your tooth has not healed or has developed new problems, you have a second chance. Another procedure, endodontic retreatment, may be able to save your tooth.

Can I drive myself home after my appointment?

Often you can, but you should ask our staff before your appointment so that you can make transportation arrangements if necessary.


Endodontic Surgery

What are the alternatives to endodontic surgery?

Often, the only alternative to surgery is extraction of the tooth. The extracted tooth must then be replaced with an implant, bridge, or removable partial denture to restore chewing function and to prevent adjacent teeth from shifting. Because these alternatives require surgery or dental procedures on adjacent healthy teeth, endodontic surgery is usually the most biologic and cost-effective option for maintaining your oral health. No matter how effective modern artificial tooth replacements are—and they can be very effective—nothing is as good as a natural tooth. You’ve already made an investment in saving your tooth. The pay-off for choosing endodontic surgery could be a healthy, functioning natural tooth for the rest of your life.

How do I know the surgery will be successful?

Your dentist or endodontist is suggesting endodontic surgery because he or she believes it is the best option for saving your own natural tooth. Of course, there are no guarantees with any surgical procedure. Your endodontist will discuss your chances for success so that you can make an informed decision.

Does insurance cover endodontic surgery?

Each insurance plan is different. Check with your employer or insurance company prior to treatment.

When can I return to my normal activities?

Most patients return to work or other routine activities the next day. Your endodontist will be happy to discuss your expected recovery time with you.

Will the endodontic surgery hurt?

Local anesthetics make the procedure comfortable. Of course, you may feel some discomfort or experience slight swelling while the incision heals. This is normal for any surgical procedure. Your endodontist will recommend appropriate pain medication to alleviate your discomfort. He will give you specific postoperative instructions to follow. If you have questions after your procedure, or if you have pain that does not respond to medication, call our office.

Are there other types of endodontic surgery?

Other surgeries your endodontist might perform include dividing a tooth in half, repairing an injured root, or even removing one or more roots. Gulf Coast Endodontics will be happy to discuss the specific type of surgery your tooth requires. In certain cases, a procedure called intentional replantation may be performed. In this procedure, a tooth is extracted, treated with an endodontic procedure while it is out of the mouth, and then replaced in its socket. Additionally, in some circumstances a procedure called an autotransplantation can be performed. A damaged tooth that cannot be saved is extracted and one of your natural teeth, such as a third molar, is used to replace the missing tooth. These procedures are designed to help you save your tooth.

What is an apicoectomy?

Removal of the very end of the root is called apicoectomy. In this procedure, your endodontist opens the gingival tissue near the tooth to examine the underlying bone and to remove any inflamed or infected tissue. A small filling may be placed in the root to seal the end of the root canal, and a few stitches or sutures are placed in the gingiva to help the tissue heal properly. Over a period of months, the bone heals around the end of the root.

Why would I need endodontic surgery?

Surgery can help save your tooth in a variety of situations:

  • Surgery may be used in diagnosis. If you have persistent symptoms but no problems appear on your x-ray, your tooth may have a tiny fracture or canal that could not be detected during nonsurgical treatment. In such a case, surgery allows your endodontist to examine the entire root of your tooth, find the problem, and provide treatment.
  • Sometimes calcium deposits make a canal too narrow for the instruments used in nonsurgical root canal treatment to reach the end of the root. If your tooth has this “calcification,” your endodontist may perform endodontic surgery to clean and seal the remainder of the canal.
  • Usually, a tooth that has undergone a root canal can last the rest of your life and never need further endodontic treatment. However, in a few cases, a tooth may not heal or become 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.
  • Surgery may also be performed to treat damaged root surfaces or surrounding bone, or aid the immune system in resolving an infection or problem outside the root canal.
  • Although there are many surgical procedures that can be performed to save a tooth, the most common is called apicoectomy or root-end resection. When inflammation or infection persists in the bony area around the end of your tooth after a root canal procedure, your endodontist may have to perform an apicoectomy.

 

Who performs endodontic surgery?

All dentists received training in endodontic treatment in dental school. However, because endodontic surgery can be more challenging than providing nonsurgical treatment, many dentists refer patients needing surgery to endodontists. Endodontists are dentists with at least two additional years of advanced education and training in root canal techniques and procedures. In addition to treating routine cases, they are experts in performing complicated procedures including surgery. They often treat difficult cases, such as teeth with unusual or complex root structure or small, narrow canals. This special training and experience can be very valuable when endodontic surgery is necessary.

Why do I need endodontic surgery?

To understand endodontic surgery, it helps first to know something about the nonsurgical endodontic procedure, or “root canal.” Root canal treatment is necessary when the soft inner tissue, or “pulp,” of the tooth becomes inflamed or infected. This may happen as a result of deep decay, repeated dental procedures on the tooth, or an injury to the tooth. Root canal (endodontic) treatment removes the damaged pulp. Then the tooth’s canals are cleaned and filled to help preserve the tooth. In a few cases, however, root canal (nonsurgical endodontic) treatment alone cannot save the tooth. In such a case, your dentist or endodontist may recommend surgery.

What are the alternatives to endodontic retreatment and/or endodontic surgery?

The only other alternative is extraction of the tooth. The extracted tooth must then be replaced with an implant, bridge or removable partial denture to restore chewing function and to prevent adjacent teeth from shifting. Because these options require extensive surgery or dental procedures on adjacent healthy teeth, they can be far more costly and time consuming than retreatment and restoration of the natural tooth. No matter how effective tooth replacements are, nothing is as good as your own natural tooth. You’ve already made an investment in saving your tooth. The payoff for choosing retreatment could be a healthy, functioning natural tooth for many years to come.

What are the alternatives to retreatment?

If nonsurgical retreatment is not an option, then endodontic surgery should be considered. This surgery involves making an incision to allow access to the tip of the root. Endodontic surgery may also be recommended in conjunction with retreatment or as an alternative. Your endodontist will discuss your options and recommend appropriate treatment.

Can I drive myself home after my appointment?

Often you can, but you should ask our staff before your appointment so that you can make transportation arrangements if necessary.


Cracked Teeth

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 mouth guard to protect your teeth.)
  • Wear a mouth guard or protective mask when playing contact sports.

 

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. He/She will advise you on how to keep your natural teeth and achieve optimum dental health.

How will my cracked tooth be treated?

There are many different types of cracked teeth. The treatment and outcome for your tooth depends 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 cusp (the pointed part of the chewing surface) becomes weakened, a fracture sometimes results. The weakened cusp may break off by itself or may have to be removed by the dentist. When this happens, the pain will usually be relieved. A fractured cusp rarely damages the pulp, so root canal treatment is seldom needed. Your tooth will usually be restored with a full crown by your dentist.

Cracked Tooth
This crack extends from the chewing surface of the tooth vertically towards the root. A cracked tooth is not completely separated into two distinct segments. Because of the position of the crack, damage to the pulp is common. Root canal treatment is frequently needed to treat the injured pulp. Your dentist will then restore your tooth with a crown to hold the pieces together and protect the cracked tooth. At times, the crack may extend below the gingival tissue line, requiring extraction. Even with high magnification and special lighting, it is sometimes difficult to determine the extent of a crack. 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 rare instances, endodontic treatment and a crown or other restoration by your dentist may be used to save a portion of the tooth. 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 portion of the tooth can be saved by removal of the fractured root.

Why have I been referred to an endodontist?

All dentists receive basic training in the diagnosis and treatment of cracked teeth in dental school. However, some cracked teeth can be especially difficult to diagnose, and treatment may involve root canal treatment. That’s why you have been referred to an endodontist. Endodontists are dentists with at least two additional years of education that include the diagnosis and treatment of unusual dental pain. Cracked tooth pain often comes from damage to the inner soft tissue of the tooth, the pulp. Endodontic treatment, also known as root canal treatment, can relieve that pain. Early diagnosis is extremely important. Like cracks in a windshield, cracks in teeth often start small and progress slowly. The sooner a crack is detected and treated, the better the chance of saving your tooth. The endodontist’s special training and experience can be valuable when a cracked tooth is suspected.

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 loose pulp is a connective tissue that contains cells, blood vessels and nerves. When the outer hard tissues of the tooth are cracked, chewing can cause movement of the pieces, and the pulp can become irritated. When biting pressure is released, the crack can close quickly, resulting in a momentary, sharp pain. Irritation of the dental pulp can be repeated many times by chewing. 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 tissue surrounding the tooth.

What makes a tooth susceptible to cracks?

With more sophisticated procedures, dentists are helping people keep their teeth longer. Because people are living longer and more stressful lives, they are exposing their teeth to many more years of crack-inducing habits, such as clenching, grinding, and chewing on hard objects. These habits make our teeth more susceptible to cracks.

How do I know if my tooth is cracked?

Cracked teeth show a variety of symptoms, including erratic pain when chewing, possibly with 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 do I need another endodontic procedure?

As occasionally happens with any dental or medical procedure, a tooth may not heal as expected after initial treatment for a variety of reasons:

  • Narrow or curved canals were not treated during the initial procedure
  • Complicated canal anatomy went undetected in the first procedure
  • Placement of the crown or other restoration was delayed following the endodontic treatment
  • Restoration did not prevent salivary contamination to the inside of the tooth
  • Failure of the body’s immune system to resolve the infection

In other cases, a new problem can jeopardize a tooth that was successfully treated.

For example:

  • New decay can expose the root canal filling material to bacteria, causing a new infection in the tooth
  • A loose, cracked or broken crown or filling can expose the tooth to new infection
  • A tooth sustains a fracture

 

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.


After Endodontic Care

When can I return to my normal activities?

Most patients return to work or other routine activities the next day. Your endodontist will be happy to discuss your expected recovery time with you.

Will the endodontic surgery hurt?

Local anesthetics make the procedure comfortable. Of course, you may feel some discomfort or experience slight swelling while the incision heals. This is normal for any surgical procedure. Your endodontist will recommend appropriate pain medication to alleviate your discomfort. He will give you specific postoperative instructions to follow. If you have questions after your procedure, or if you have pain that does not respond to medication, call our office.

What about infection?

We adhere to the rigorous standards of infection control advocated by Occupational Safety and Health Administration (OSHA), the Centers for Disease Control, and the American Dental Association. We use autoclave sterilization and disposable barrier techniques to help prevent infection.

What happens after treatment?

When your root canal therapy has been completed, a record of your treatment will be sent to your general dentist. You should contact your general dentist’s office for a follow-up restoration within one week of completion of your root canal therapy at our office. Your general dentist will decide what type of restoration is necessary to protect your tooth. It is rare for endodontic patients to experience complications after routine endodontic treatment or microsurgery. If a problem does occur, however, we are available at all times to respond.

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.

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, revising the original endodontic procedure can save the tooth.

Will I feel pain during or after the procedure?

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. Your tooth may also continue to feel slightly different from your other teeth for some time after your endodontic treatment is completed. This discomfort can be relieved with over-the-counter or prescription medications. Follow your endodontist’s instructions carefully. However, if you have severe pain or pressure or pain that lasts more than a few days, call your endodontist.


Payment & Insurance

Does insurance cover endodontic surgery?

Each insurance plan is different. Check with your employer or insurance company prior to treatment.

How much will endodontic retreatment cost?

The cost varies depending on how complicated the procedure will be. The procedure will probably be more complex than your first root canal treatment, because your restoration and filling material may need to be removed to accomplish the new procedure. In addition, your endodontist may need to spend extra time searching for unusual canal anatomy. Therefore, you can generally expect retreatment to cost more than the initial endodontic treatment. While dental insurance may cover part or all of the cost for retreatment, some policies limit coverage to a single procedure on a tooth in a given period of time. Check with your employer or insurance company prior to retreatment to be sure of your coverage.

How much does endodontic treatment cost?

The cost varies depending on how complex the problem is and which tooth is affected. Molars are more difficult to treat, so 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 a bridge or implant to restore chewing function and prevent adjacent teeth from shifting. These procedures tend to cost more than endodontic treatment and appropriate restoration. With root canal treatment you save your natural teeth and money.

Does my insurance pay for treatment?

Your dental plan is designed to share in your dental care costs. It will not cover the total cost of your treatment. Most plans cover between 20 to 80 percent of endodontic services. Sometimes, needed services are not covered at all.

Click here for more information on Gulf Coast Endodontic’s Financial Policy

Why doesnʼt my insurance pay for everything?

Your dental plan is designed to share in your dental care costs. It will not cover the total cost of your treatment. Most plans cover between 20 to 80 percent of endodontic services. Sometimes, needed services are not covered at all.

Click here for more information on Dental Insurance