Frequently Asked Questions (FAQs)

Root Canal FAQs

• Do you have to take another x-ray, even if I’ve just had one taken at my dentist’s office?

  Yes, we require our own radiographic image prior to evaluation or treatment at our office. Our office utilizes a specific Rinn system to capture undistorted images needed to provide proper endodontic therapy. As such, we cannot medically/legally diagnose from another dental office’s images.

• How long will I be numb?

  Your lips, teeth, cheek, and/or tongue may be numb for several hours after the procedure. To avoid injury, you should avoid any chewing and hot beverages until the numbness has completely worn off. It is very easy to bite or burn your tongue, cheek, or lip while you are numb.

• Is it normal for my gums or jaw to be sore?

  Irritation to the gum tissue can occur from dental work and use of the rubber dam. Rinsing your mouth 2-3 times per day with warm salt water (1/2 tsp salt in 1 cup of warm water) can help to alleviate discomfort. Injection sites can be sore for several days after your appointment. Over-the-counter pain medications work well to alleviate the tenderness.

• Why do you use the rubber dam?

  The rubber dam isolates the tooth we are treating and prevents any instruments or fluids we use from reaching the back of your throat while we work. The rubber dam also prevents any saliva from entering the tooth while we are working, which can lead to issues with infection. Use of the rubber dam is the standard of care for endodontics and treatment cannot be performed without it.

• Will my tooth be sensitive after treatment?

  It is not uncommon for a tooth to feel tender or even exhibit a dull ache (bruise sensation) over the next few days as your body undergoes the natural healing process. These symptoms are temporary (usually last less than one week) and usually respond well to over-the-counter medications. This is a normal response and is no cause for alarm.

• Is my tooth open after treatment?

  The tooth is sealed with a temporary filling following the root canal procedure. It is important to return to your general dentist to have the temporary filling removed and replaced with a permanent restoration within the next 2 weeks following treatment.

• Why does my tooth feel different?

  You may feel a slight indentation or rough area on the back of a “front tooth” or the top of a “back tooth.” This is where a temporary material was placed into the access that was made on the tooth to permit treatment. It is not unusual for a thin layer of the temporary material to wear off between appointments. However, if you think the entire temporary filling has come out, please contact our office.

• My bite feels off, is this normal?

  If your bite feels uneven and is causing soreness, please call our office. A short office visit to adjust the problem area of the tooth usually leads to a quick and dramatic improvement.

• How soon can I eat and/or drink following the root canal procedure?

  We ask that you allow 30-40 minutes after the root canal before eating or drinking. This allows the temporary filling we place to harden.

• Is it okay to eat on the tooth with the root canal?

  Please avoid chewing on the tooth that had the root canal. Whenever possible, try to chew on the opposite side of the treated tooth until the final restoration has been placed. The temporary filling will not permanently protect your tooth from reinfection or fracture.

• Do I need any other treatment after a root canal?

  A permanent restoration is required after a root canal is performed on a tooth. The location of the tooth will determine what restoration will be recommended. Most teeth will require some type of crown, although there are exceptions where just a filling may be placed. This permanent restoration is used to avoid future tooth fractures and to prevent recontamination of the root canal.

• Am I finished with your office following the root canal procedure?

  We monitor you every 6 months for 2 years following root canal treatment. There is no charge for this service. You will be given a reminder card in our office once treatment is completed to contact our office in 6 months for a digital image to assess healing. It is your responsibility to call for this appointment. A reminder card will be given to you at each subsequent visit.

• When do I need to see my general dentist for the permanent restoration?

  The temporary filling we place can last up to 2 weeks if you are gentle on it. We recommend you return to your general dentist for final restoration as soon as possible following the root canal to avoid issues resulting from reinfection or fracture that could jeopardize your tooth’s prognosis.

• Will I be able to go back to work after the root canal?

  Most people return to work the same day following root canal treatment. Your lips, teeth, cheek, and/or tongue may be numb for several hours after the procedure. Please avoid any chewing and hot beverages until the numbness has completely worn off.

• Any restrictions after my root canal?

  Please do not eat or drink anything for 30-45 minutes to allow the temporary access filling to harden. After that, please be gentle on the tooth until you return to your referring dentist. Avoid sticky or hard food that could break the temporary.

• Do I have to see my dentist today?

  No. But, we do recommend seeing your dentist ASAP to ensure the temporary does not break down and allow re-infection of the root canal system. We recommend seeing your referring dentist within 2 weeks.

• When do I have to see my Dentist?

  We recommend seeing your dentist within 2 weeks to place the permanent restoration.

• Is my tooth covered or open?

  Your tooth is covered with a temporary filling.

• Does the root grow back?

  No. The soft pulp tissue has been infected, both of which is removed during the root canal process. The hard structure of the root remains and was fully “grown” years ago.

• Why do root canals have to be redone?

  There are many reasons, but the most common are missed anatomy during the original root canal process or re-infection from recurrent cavities or restorative work that has begun to deteriorate.

• Can you do a root canal after the crown has been placed?

  Yes. We make a small access opening through the biting surface of the tooth that does not affect the structural integrity of the crown.

• What exactly do you do when you do a root canal?

  After a small access opening is made through the biting surface of the tooth, the soft pulp tissue and infection is removed and the canal system is disinfected. Fillings are placed in the root canal spaces to help prevent re-infection.

• Can I drive myself?

  Yes. However, you will need to have a driver if you have elected for conscious sedation during the root canal process. A conscious sedation evaluation is needed first before treatment.

• How long will I be in pain?

  Most patients have little to no pain post-operatively. Ibuprofen and Tylenol regiments are recommend for 1-2 days after the procedure to help achieve this goal.

• I took one antibiotic pill this morning, do I need take 4 now for my prosthetic joint?

  Yes. However in this situation we may need to place you on a different antibiotic to ensure proper antibiotic coverage for your prosthetic joint. Please call our office for further details.

• Will I leave here with a hole in my tooth?

  No. A temporary access filling has been placed that lasts approximately 2 weeks until you see your referring dentist for final restoration.

• I have dual insurances, why do I have a co-payment?

  It depends on whether your insurance companies have a coordination of benefits. If not, then your secondary insurance company will likely not cover your co-payment. It is important for you to understand how your insurance companies work before scheduling for treatment.

• My dentist told me that I may have a root fracture which may result in me losing my tooth. If you find that, why can't it be fixed?

  Unfortunately once a fracture extends down into the root, there is no “super glue” in the world yet that has the ability hold broken root segments together for a predictable long term prognosis. The fracture will continue to spread, even if the tooth is treated with a root canal, and allow bacteria to re-enter the root canal system and cause re-infection. In a broken root scenario, its best to have the tooth removed and replaced with a different prosthetic solution such as a bridge or single tooth implant.

• Why do we have to use a rubber dam? I have had root canals without them before.

  The rubber dam is the standard of care for all endodontic procedures. It isolates the tooth like a surgical gown to prevent oral bacteria from entering the tooth during the procedure. If bacteria enters the tooth during the procedure, which is aiming to remove all bacteria, the procedure has a high risk of failure. Additionally, the rubber dam prevents any of our small tools from accidentally being dropped into your mouth where they could unfortunately be inhaled directly into your lungs or swallowed and go into your digestive system. Both possibilities would require immediate medical attention at a hospital with likely surgery to retrieve the instrument. The rubber dam ensures the patient remains safe throughout the procedure.

• Is it okay to brush and floss my teeth?

  Yes. You may return to normal hygiene routines after your appointment. It will not affect the temporary as long as the temporary has the normal 30-40 minutes of curing after the procedure.

• How long will I be numb for after the treatment?

  Anesthesia times vary depending on the type of anesthetic used and a person’s physiology. The average time a person is generally numb after an endodontic procedure ranges between 1 and 3 hours.

• We do not provide general anesthesia or IV anesthesia due to the risk involved with this type of anesthesia and the costs that would burden a patient. We do provide conscious sedation in the forms of nitrous oxide or pills (triazolam). In the past 40+ years, we have found that these methods combined with profound local anesthesia allow us to provide the patient care most require for the 35-40 minute root canal procedure.

• Is it alright to exercise after the procedure?

  Yes, as long as you feel well. However, we would recommend waiting until after the local anesthesia has worn off to ensure you do not bite any tissues in your mouth and to give the temporary access filling a chance to cure so that it does not become dislodged.

• Is nitrous oxide available and why does it cost more here than at my dentist's office?

  Yes, nitrous oxide is available. It costs more at an endodontic office as our working procedure can be 2-3 times the length of a filling appointment, necessitating a larger amount of nitrous oxide. Additionally, it makes the root canal process more challenging for the clinician as the nose cannula for the nitrous oxide rests directly between the microscope and rubber dam making visibility and access very challenging to provide optimal endodontic results.

• Why does my tooth have to be extracted if it is cracked?

  Once a tooth has cracked or broken, there is no way to glue or mend the 2 pieces back together so that the tooth can endure normal chewing forces again. Even with the strongest glues in tests, previously cracked teeth quickly crack open again and allow infection to continue its course. Hopefully one day a strong biologic glue will be developed that will allow teeth to function again and prevent extraction.

• Will you relay everything you told me about the treatment of my tooth to my dentist?

  Yes. The doctors forward a detailed report about your root canal treatment to your referring dentist, and it includes the digital images we took during treatment to include into their records.

• Why won't my insurance company pay for the retreatment of my old root canal that has now become a problem?

  Unfortunately, many insurance companies are deciding they will only pay for 1 root canal procedure per tooth per lifetime, no matter when the past root canal procedure was done or by whom. Additional information as to why this occurs with your insurance may be best acquired by directly contacting your insurance representative.

• Why can't you place the final filling in my tooth if the crown is in good shape?

  Every referring dentist has a filling type preference based on what they think works best given a tooth’s current status and clinical studies that they have read. Stocking all the different types of filling materials would be cost ineffective to our practice as they would never be used completely before their expiration dates. Your referring dentist also likes to check and see how you are doing after the root canal experience!

• What is the main advantage of using nitrous oxide versus a pill for conscious sedation?

  As nitrous oxide is an inhaled drug, it has the ability to be titrated to maximize its effect. More importantly, nitrous oxide can be quickly removed from the body by breathing oxygen through the nose cannula at the end of the appointment. Due to this ability to remove the drug quickly, a patient does not require an escort and they can safely drive home from the appointment or return to work.