WHAT TO EXPECT
So what should you expect on the day you come to see us? Well, a lot of friendly smiles, for one. But beyond that, if you haven’t already filled out your paperwork online, we will give you the chance to do that in our comfy greeting room. One of our friendly dental assistants will then review your chart, chat with you about your problem, and take some x-rays of your teeth. Easy peasy, right?
After that, your endodontist Dr. Bryan Eslinger, will look everything over and sit down with you to explain what is going on. Once you know the diagnosis and your options, we’ll decide whether to begin treatment right away or to schedule another visit. The entire process depends on several things, but usually takes about an hour and a half, but don’t worry: Once we get going, we’ll give you local anesthesia to keep everything nice and numb while we’re working. We can even give you nitrous, if you’re feeling especially anxious. Either way, most procedures are just about painless.
Unless you opt for other sedation methods, you should be able to drive yourself home as soon as your procedure is over – in fact, you could even return to work if you really want to. Some folks have mild discomfort for a few days after the procedure, but over-the-counter pain medications are usually enough to take care of it. If you’re having a surgical treatment, you’ll still be able to drive but should plan on a few days of recovery time before getting back into your normal routine.
If you want the nitty-gritty on the procedures we’ll do, or the advanced technology we’ll use, you can read about all of that stuff here. But know that our job is to find the best option for you and to make sure you understand what we’re doing every step of the way. And the vast majority of the time, we’re able to complete your treatment in a single appointment so you don’t have to come back to see us any more than necessary (unless you really just miss us and want to say hello – hey, we’re pretty nice people).
Once your regular dentist has referred you to our wonderful office, we’ll go about figuring out what’s wrong with you and whether endodontic treatment is actually the answer. We’ll review your medical and dental history, perform diagnostic tests, take some x-rays, and figure out the best course of action to get you all fixed up.
Some of the things we might use during this part of your visit:
• Our eyes. Yup – a visual examination goes a long way.
• Radiographs. That’s a fancy word for x-rays. In some cases, we might even take a 3D one to get a clear picture of what’s causing the problem. If it’s a re-treat of a previously treated tooth, we will always take that 3D x-ray.
• Thermal testing. We’ll evaluate how your tooth responds to hot or cold.
• Palpation. We’ll see how your tooth responds to pressure near the tip of its root.
• Percussion. No, we won’t break out the bongos (unless you really want us to…) – we’ll just check out how your tooth responds to tapping.
• Electric pulp tester. We’ll apply some gentle electric stimulation to your tooth to see how it responds to that.
• Magnification, illumination, and sometimes a surgical microscope. Those tools all can help us get a better look at the area that’s bothering you to see what’s going on.
Sometimes, the pain you’re feeling can actually be coming from a different area than you might think – a weird phenomenon known as “referred pain.” We’ll look for that too, to make sure we’re going after the correct source of your discomfort.
Pain that seems like it might need a root canal can also be related to a host of other issues – anything from a sinus infection to a blocked salivary gland. If we see that something like that is going on, we’ll refer you to the proper medical professional for the problem, since a root canal wouldn’t help.
Okay – let’s start with a quick lesson on teeth. From the outside, our teeth look hard and solid, right? But inside every tooth, beneath the shiny enamel and a hard layer called the dentin, is a soft tissue called the pulp. It’s made up of blood vessels, nerves and connective tissue.
You need a root canal when the pulp becomes inflamed or infected. That can happen because of deep decay or fillings, a crack or chip in the tooth, or some sort of trauma. If any of those things are left untreated, they can cause serious pain or swelling – even a not-so-fun-build-up of pus and debris.
That’s where we come in. During a root canal, Dr. Eslinger will use a series of super-small instruments along with special medicines to remove the infected pulp. He will then carefully clean and reshape the inside of the tooth’s root. Last but not least, he will fill and seal up the space with a rubbery filling known as gutta percha.
Once all that’s finished, you’ll go back to your regular dentist, who will put a crown on the tooth to protect it and get it back in business for you. After that, the tooth should work and feel fine – just like any other pearly white in your beautiful mouth. (On occasion, we’ll have to retreat a root canal later on – if there are new fractures, for instance, or infections that come up in the tooth after your initial visit – but that’s more the exception than the rule.)
Some of the tools we’ll use for a root canal include a dental operating microscope, which lets us zoom way in to see the inside of your tooth and look for fractures or extra canals, and an electronic apex locator, which helps us make sure we treat the entire canal from top to bottom.
Before you receive your permanent crown/bridge you will first receive a temporary restoration. This is not as sturdy as the permanent version, so you should be careful when cleaning and eating. You should brush the area gently and should not pull up on the tooth when flossing because it could become dislodged. The same goes for eating. You should avoid sticky or chewy foods while you have the temporary in.
There may be some sensitivity and irritation after the temporary or permanent is placed. This is normal and will subside after the soft tissue heals. A warm salt water rinse will help, and you can also take Advil or Tylenol if the pain does not go away.
When the permanent crown or bridge is placed it may feel a little awkward for a few days. Your mouth needs to adjust to the new tooth, and it should feel like one of your natural tooth in less than a week. If your bite feels abnormal in any way, you should let your dentist know. Caring for your bridge or crown is just like caring for your own teeth. You should brush and floss regularly.
After the anesthesia wears off your teeth will likely be sensitive. You should avoid hot and cold food or drink for the next few days. After that initial period, your treated teeth will feel as good as new. Continue your normal hygiene plan to ensure that your fillings last for a long time.
Most of the time, the regular root canal procedure described above is all we need to do. Every now and then, though, a tooth can become infected months or even years after a successful treatment. In those cases, endodontic surgery may be able to save the tooth.
It sounds a little icky, but it works: What we do is open up the gum tissue near the tooth to get at the underlying bone and take away the infected tissue. We also take out the very end of the tooth’s root while we’re there, then put in a small filling and then a few stitches to help seal everything up and make sure it heals properly. In the months after that’s done, the bone heals around the end of the root – and in most cases, the tooth is then healthy and fine from there on out.
Other procedures we’ll sometimes do include vital pulp therapy, in which we remove unhealthy tissue in a tooth that isn’t fully developed and thus allow the body to keep developing a healthy root on its own; pulpal regeneration, in which we stimulate an undeveloped tooth to make it start growing again (yes, effectively bringing it back from the dead – but don’t worry: It won’t become a zombie!); and trauma management. We are here to help your dentist get your mouth feeling happy and healthy again.