Your dentist has referred you to this office, because he is anxious to preserve your teeth, and wants to maintain your dental health and comfort for as long as possible. Root canal treatment is the only alternative to extraction when the pulp (nerves and blood vessels) of a tooth has become severely inflamed or infected. In some cases, this condition manifests itself by severe and/or prolonged sensitivity to heat or cold, in others the tooth becomes sensitive to touch or chewing pressure. Swelling may or may not be present. Occasionally, the deterioration process of the pulp progresses without any outward signs, but your dentist notices a shadow or ‘area’ on a routine x-ray check up, indicating the need for root canal treatment. In rare cases, a tooth with a healthy pulp may fracture, necessitating root canal treatment to provide for a post and crown.
Don’t be misled by symptoms that subside. Conditions requiring root canal treatment do not reverse themselves, once they have progressed beyond the point of momentary sensitivity to cold. Since the progressive breakdown may lessen your chances for successful treatment, delay may be harmful.
Now to answer a few questions, asked rather universally:
1. What does this work entail?
Endodontic therapy, or root canal treatment, consists of the removal of all the tissue found in the hollow core of the tooth. An opening is made, usually through an existing filling and all the canals in the root(s), as well as the chamber in the visible crown portion of the tooth, are thoroughly cleansed, shaped, and enlarged, so that they can be filled with a pliable rubber-like material called gutta percha.
2. Is there any pain connected with the treatment?
Regardless of what you may have been told by well meaning friends or relatives, this question can be answered with a “NO” in many of the cases. If the nerve tissue has died, causing an infection in the jawbone around the roots of the tooth, the pain you have been feeling is caused by movement (up and down or back and forth) of the tooth, but nerves in the jawbone, not the tooth, cause it. Thus, no injection may be necessary since insertion of a needle into an infected area may spread or aggravate the infection. If we suspect any live nerve tissue (teeth that are sensitive to heat or cold), a local anesthetic will be injected into the gum to numb the tooth to be treated.
What about those fewer than 5% of the cases that do not numb completely?
Well, first of all, they are limited to one particular location, so that we can anticipate the problem and control it to a great extent. We promise that we shall inform you if we expect you to have discomfort, and that it will be mild and of very short duration (less than two minutes).
3. How many visits will I have to make?
Usually two. Some cases may take more visits; occasionally, two visits will complete the treatment. The fee, once quoted, will not vary if either more or fewer visits are required.
4. How expensive is the treatment?
Much less expensive than extraction and replacement, usually. Besides, please keep in mind that any replacement places added strain on the teeth that anchor the bridge. Generally speaking, the fee per tooth will vary depending on the complexity of the problem.
5. Does the tooth require further attention, once endodontic treatment is completed?
Yes. You should return to your general dentist as soon as the tooth is comfortable after your treatment here has been completed. He will then place either a filling or a crown (cap) to protect the tooth against fracture. In the majority of cases, a crown is recommended, since an ordinary filling does not afford adequate protection. Please understand too, that an endodontically treated tooth can decay just like any other tooth, except that decay will not cause any sensitivity because the nerves have been removed, so you must continue your regular checkup visits to your general dentist.
In addition, we may send you a written notice to return to this office six months after completion of treatment, and in some instances, one or more times thereafter, to re-examine the treated tooth. These visits consist of taking a checkup x-ray and take but a few minutes. We urge you to avail yourself of this service.
6. What should I expect from this treatment?
If your tooth is sensitive to temperature changes, this sensitivity will usually disappear after the first visit. Swelling, pain to pressure or touch may take a bit longer, and may require some medication taken by mouth, as well as rinsing. You should avoid chewing on the tooth under treatment, so as not to bruise it.
Some soreness after any treatment visit (even the final one) is not uncommon. Resting the tooth will cause the discomfort to disappear, usually after a day or two.
Throughout your course of treatment at this office, our prime concern will be to make you feel as comfortable as possible in every respect. We schedule our patients in a manner that enables us to begin treatment within a few minutes of the appointed time, except in very rare cases of multiple emergencies. If, however, your visit is an unscheduled emergency, we will relieve your pain within 15 minutes or so.
7. What are my responsibilities?
We can conduct our practice in a calm, relaxed, efficient manner only with cooperation of our patients.
Here is what this means:
Punctuality: The time is set aside for you, and you alone, and is wasted if you are late or don’t show up. Therefore, we shall expect you to present yourself for your appointment s a few minutes ahead of time. If you must cancel, please try to give us at least 24 hours notice, so that we may schedule someone else in your stead.
Continuity of treatment: Occasionally, a patient will disappear, once the discomfort has been relieved, not to return for a month or more. We have found that in many of our so-called ‘failures’ occur in these cases. If the delay in continuing treatment is too prolonged, we may recommend to your dentist that he extract the tooth. Of course there will be a charge to the extent of the services rendered.
Payment arrangements: My secretaries will discuss modes of payment with you. Please do not be offended by the directness of our approach: our relationship will be a brief one. Frankly, our experience dictates that payment be completed promptly.
8. Insurance forms
We shall be happy to fill out all forms for insurance policies covering our specialty treatment. Except for extremely rare cases involving a surgical procedure, Blue Shield, Medicare, and insurance plans offering no dental coverage, are not applicable to endodontic treatment. Medicaid patients are not eligible for endodontics.
9. Will it Work?
No two cases are alike. Our rate of success is in the 95% range. If your case is not favorable, and you are likely to end up among the losing 5%, you will be so informed before the treatment. Then the choice to proceed will be yours.
We hope that this has been helpful in giving you a clearer understanding of our aims, procedures, and policies. We shall make every effort to establish a relationship with you that will be pleasant, free from stress, and mutually rewarding.