Endodontic Associates, Treatment

Endodontic Procedure

Endodontic treatment can often be performed in one or two visits and involves the following steps:


		The endodontist examines and x-rays the tooth, 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.

		After the space is cleaned and shaped, the endodontist fills the root canals with a biocompatible material, usually a rubber-like material called “guttapercha”. 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.

		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 mstore 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.

Post Root Canal Care

Please do not chew on the area of your root canal treatment until your treatment is completed. You may eat only after the anesthesia has worn off completely as to prevent from chewing on your lip or your tongue while the area is numb. Again, be careful not to chew on that tooth.

As soon as possible after your appointment take some over the counter pain medication (Advil or Tylenol) to stay one step ahead of any potential pain that you may have. Although most patients experience some minor pain after the start of the treatment it is possible and could be normal to experience higher levels of pain. This will depend on many factors, one being the conditions of the tooth or infection prior to the start of your procedure.

Here are some recommendations on how to take the medications described above:

Advil: (same as Ibuprofen and Motrin) Take 800 mg (that would be 4 over the counter tablets) immediately after your appointment and continue to take 800 mg every 6 hours as needed for pain. Children under 16 years old should take 200 mg to 400 mg every 6 hours.

If you are allergic to or cannot tolerate the above please take the following:

Tylenol: Take 1000mg immediately then repeat every 4 hours as needed for pain.

Do not be concerned if your tooth is sensitive or sore for up to one week and possibly longer after the procedure. This can be a normal response. In the unlikely event, that the pain should become severe or swelling develops, please call our office.

Your tooth may continue to feel slightly sensitive or slightly different from your other after your endodontic treatment is completed. This may take a few weeks to settle down.

You may brush your teeth as usual but try to avoid flossing around that tooth as the temporary filling may dislodge.

The temporary filling may sink in slightly giving the impression that it has come out. Unless this leads to the complete dislodgement of the temporary filling there is no cause for alarm.

As always, if there are any questions or concerns please contact our office.
Please note that in most cases a two visit root canal procedure is required . If you have been scheduled for this second visit please be aware that you will be anesthetized locally as you were in your first appointment.

Post Surgery Instructions

What to do following Endodontic surgery:

After leaving the office, rest and avoid strenuous activity for the remainder of the day.

Apply an ice bag or cold compress to the outside of your face, over the operated area. Apply for 20 minutes, and then remove for 20 minutes. Continue the application for the first day during normal waking hours. This will help reduce swelling. You have been provided with an extra ice pack in your care package. Once this has been used you will have to discard and use crushed ice in a plastic bag wrapped in a towel.

Avoid chewing in the operated area until the sutures are removed. You should eat soft foods for the first few days. You have been provided with Ensure. This is a nutrition drink that will be easy to take following your surgery. Take this before your medications as medication on an empty stomach may make you feel nauseated.

Do NOT smoke as this will delay healing.

You should keep well hydrated. Drink plenty of water.

Avoid manipulation of area unnecessarily. It is possible to accidentally tear the sutures, open the incision and delay healing.

After 24 hours gently rinse mouth using warm salt water following meals. Use one teaspoon of salt with 8 oz. of water.

You should keep your mouth as clean as possible by brushing all areas other than the surgical site. You may start this 24 hours after your surgery.

Your follow up appointment will be to remove the sutures and to check the healing.

Sleep with your head slightly elevated.

Take pain medication as follows:

Advil: (same as Ibuprofen and Motrin): Take 800 mg (that would be 4 over the counter
tablets) immediately after your surgery and continue to take 800 mg every 6 hours regardless of pain for 2 days. You have been provided with an 800mg dosage in your care pack. This will help reduce inflammation and swelling. After the initial 2 days you may reduce intake of this medication and reserve it for controlling pain.

If you are allergic to or cannot take the above for any reason take the following:

Tylenol: Take 1000mg every 6 hours as needed for pain. Tylenol is not an anti-inflammatory medication so it will have little affect on swelling. You may have to rely simply on the ice to help with swelling if you cannot take ibuprofen.

What to expect following surgery:

Some pain will usually be present. Severe pain seldom occurs. If the Advil or Tylenol does not restore comfort please take your prescription pain medication.

There may be swelling and discoloration for three to seven days following surgery. This is normal and part of the healing process. You may exhibit more swelling in the mornings as compared to the evenings. This is as a result of laying down flat for an extended period of time. Throughout the day it should decrease.

There is often temporary loss of feeling in the operated area. This will return back to normal with time.

The operated tooth may feel sore and loose following the procedure. This is expected and should return to normal with time.

*As always should there be any questions please feel free to call our office.

Frequently Asked Questions


		What is endodontic treatment?
		Why would I need an endodontic procedure?
		How does endodontic treatment save the tooth?
		Will I feel pain during or after the procedure?
		What is endodontic surgery?
		What are the alternatives endodontic treatment?


		What is endodontic treatment? “Endo” is the Greek word for “inside” and “odont” is Greek for “tooth.” Endodontic treatment treats the inside of the tooth. 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.

		Why would I need an endodontic procedure? Endodontic treatment is necessary when the pulp 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, a blow 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. Signs of pulp damage include pain, prolonged sensitivity to heat or cold, discoloration of the tooth and swelling and tenderness in the nearby gums. Sometimes, there are no symptoms.

		How does endodontic treatment save the tooth? The endodontist removes the inflamed or infected pulp, carefully cleans and shapes the inside of the tooth, 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. Turn to pages six and seven for a step-by-step explanation of the 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. This discomfort can be relieved with over-the-counter or prescription medications. Follow your endodontist’s instrnctions 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.

		What is endodontic surgery? The most common endodontic surgical procedure is called an apicoectomy or root-end resection: When inflammation or infection persists in the bony area around the end of your tooth after endodontic treatment, your endodontist may perform an apicoectomy. In this procedure, the endodontist opens the gum tissue near the tooth to expose the underlying bone and the infected tissue is removed. The very end of the root is also removed and a small filling may be placed to seal the root canal. Local anesthetics make the procedure comfortable and most patients retum to their normal activities the next day.

		What are the alternatives endodontic treatment? When the pulp of a tooth is damaged, the only altemative to endodontic treatment is extraction of the tooth. To restore chewing function and to prevent adjacent teeth from shifting, the extracted tooth must be replaced with an implant or bridge. This requires surgery or dental procedures on adjacent healthy teeth and can be far more costly and tilne- consuming than endodontic treatment and restoration of the natural tooth. No matter how effective modem tooth replacements are—and they can be very effective--nothing is as good as a natural tooth.