What is an Endodontist?

Endodontists are dental specialists; dentists who have undergone additional residency training after completing the normal 4-year post-graduate dental degree. This gives them unique training to become experts in one subset of procedures within the dental field. The average endodontist will have gone through 4 years of college for a bachelor’s degree, 4 years of dental school for a dental degree, and then 2-3 years of residency for a Certificate in Endodontics. Only after receiving a certificate can a dentist call themselves an endodontist.

What is the difference between a DDS and a DMD degree?

Not much except for what the abbreviations stand for! Both are professional doctorate degrees granted by universities in the US. A DDS degree stands for a Doctorate in Dental Surgery. A DMD degree is a latin degree that stands for Dentariae Medicinae Doctor, or a Doctor of Dental Medicine. The DMD degree was first given at the Harvard School of Dental Medicine because Harvard University confers degrees in Latin and there was not a favorable translation of DDS! Now, about half of dental schools in the US confer a DDS degree, and half confer a DMD. However, curriculum requirements are the same between both degrees.

What are common symptoms that a tooth that needs a root canal may present with?

Common symptoms that a tooth needs a root canal depend on the state of the dental pulp, casually known as the “dental nerve.” Nerves can be healthy, dying, or in a necrotic (dead) state. Generally, only teeth that have a dying or necrotic nerve would require root canal therapy. A tooth that has a dying nerve will frequently present with a tooth with TEMPERATURE sensitivity, BITING sensitivity, or a sudden, randomly onset toothache that can be worse at night time. A tooth that has a necrotic nerve and needs a root canal treatment can present with jaw SWELLING and radiating pain as the necrotic tissue begins to cause infection in the jaw bone. Believe it or not, some teeth in these states can present with NO symptoms at all!

If my tooth doesn’t hurt, or has never hurt, do I still need to get a root canal?

Yes, some teeth can have diseased nerves but the inflammation or infection isn’t bad enough, or active enough, to cause acute pain. That is why, even if you are not in pain, if your general dentist has given you a referral to see an endodontist then it is important to keep the appointment for a consultation. Your endodontist will review all findings and diagnoses with you and help explain why your tooth may need root canal therapy.

Will a root canal treatment hurt? I’ve heard horrible things!

Your tooth will be fully anesthetized (numbed) before we begin the root canal treatment. We have many different tests to ensure that you are numb before we start, and strategies to get even the most stubborn of teeth numbed up! Trust us, almost everyone who comes through our doors has angry nerves that require removal, we are experts at making sure you are numbed and comfortable. A root canal treatment should be just like a filling for you.

Will I need a tooth crown on the tooth after a root canal?

After root canals, most teeth will almost always benefit from dental crown placement. This is because most teeth that require a root canal therapy have suffered significant damage to the existing coronal tooth structure (the portion of the tooth that is functional and is above the gumline) from cavities, old fillings, and small cracks. This damage can make the tooth more susceptible to larger cracks or fractures in the future. If a tooth fractures, it frequently can’t be saved and requires extraction. Crowns for teeth are a protective covering placed on the tooth that is meant to minimize the risk of additional damage, and therefore protects the tooth and investment that you’ve already made in the tooth.

Why can’t you go over specific costs before I come in to see you?

Unfortunately, we cannot provide an accurate estimate of root canal therapy costs until we are able to take a look at the tooth in person. It’s important to complete testing and diagnostic procedures and examine your x-rays to determine the specific treatment needed. Each tooth is unique, and costs for root canal treatment are dependent on (1) the type of tooth, (2) if a tooth has had a previous root canal before, (3) and if there are additional procedures that are required to successfully treat the tooth. Once the initial evaluation is completed, we will go over all anticipated costs and estimated insurance benefits with you BEFORE we start any treatment to make sure that you are comfortable with your out-of-pocket expenses.

Are there alternatives to root canal therapy? Can’t I just take antibiotics to fix my infection?

Generally, the only alternative to treat a tooth that needs root canal therapy is to extract the tooth. Sometimes extraction is the best and most predictable option, however, saving a tooth with root canal therapy is often less drastic, less time consuming, and often significantly less expensive than extraction. If extraction is necessary, we generally recommend replacing an extracted tooth with something highly functional such as a dental implant or bridge which adds to the overall costs. Delaying recommended treatment, even when the tooth does not hurt, is never a good option as severe pain can develop very rapidly or infection can spread and put overall health in danger.

Unfortunately, antibiotics will never permanently fix a dental infection. Antibiotics can sometimes temporarily calm down active infections that cause intense swelling and pain, but only some form of physical dental treatment can fully resolve and remove the infection.

I’ve already had a root canal on this tooth! My nerves should be gone! Why does it still hurt?

There can be many reasons that a tooth that has already had a root canal treatment can hurt. When a tooth is treated with a root canal, it means that the tooth has had the center nerve already removed from it and replaced with a filling. However, there are still millions upon millions of nerve endings in the bone around the tooth, the gum tissue around the tooth, and very importantly, the ligament that attaches the tooth to the surrounding bone. These nerve endings can transmit pain signals if there is inflammation also present in the area.

Therefore, common causes of pain on a root canal treated tooth include:

  • A tooth that recently underwent a dental procedure, including recently after a root canal treatment. It can be normal for the surrounding area to get a little inflamed, which can cause pain to pressure. This pain should be temporary and resolve itself with time.
  • The root canal filling is infected and a possible abscess has formed! This abscess can cause pain.
  • Sometimes, another tooth in the area of a root canal treated tooth is causing your pain. This is called ‘referred pain’ and can make it feel like a different tooth is actually causing your problem.
Can I drive myself to my appointments?

Yes, absolutely! Just like a basic filling, we only use local anesthetics which do not typically impair your ability to drive to and from the appointment. Some exceptions to this are if you are also undergoing further dental sedation with oral medicine or IV anesthesia (being ‘put to sleep’). You CAN often still drive yourself to and from the appointment if you are receiving light dental sedation using nitrous oxide (laughing gas). If you have any questions or concerns, feel free to contact us before your appointment for further clarification!

My old dentist used to do all my root canal treatments! Why did my new dentist send me to you?

All general dentists can perform any dental procedure they choose! This includes root canal therapy, extractions, braces, etc. However, for any specialized procedures that they choose to perform, they are still held to the same standards as a specialist. For various reasons, different dentists have unique preferences about which procedures they are comfortable and confident in doing. Often, they send you to a specialist for your benefit and comfort! As endodontic specialists, our office performs root canals all day long. This means we are experts on challenging teeth, with odd and unique anatomy, and difficult variables to manage. We have specialized equipment that aids in our ability to perform root canal therapy quickly and efficiently. This means that a typical root canal treatment at our office will take less than an hour to complete. Just know that if your dentist is sending you to a specialist for root canal treatment, they have your absolute best interest in mind!


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