What is endodontics?

Endodontics is one of the nine branches of dentistry recognized by the American Dental Association involving treatment of the pulp and surrounding tissues of the tooth. The word “endodontic” comes from “endo” which means inside and “odont” means tooth. Root canal therapy is the most common endodontic procedure.

Who are endodontists?

Endodontists are dentists who received two or more years of an advanced training in the field of endodontics. We specialize, thus limiting our practice to all aspects of endodontic treatment. We perform routine as well as difficult and complex endodontic procedures. Endodontists are also experienced at finding the cause of oral and facial pain that has been difficult to diagnose.

I’ve heard not so pleasant things about root canals. Will it hurt?

The goal of endodontics is to relieve pain caused by pulpal inflammation and infection. Therefore, root canal treatment doesn’t cause pain, but relieves it.  In the past, the procedures were performed differently and the quality of anesthetics wasn’t the best. With modern techniques and anesthetics, the majority of patients report being comfortable during the procedure. Many say that it is no different than having a filling placed.  A recent survey showed that patients who have experienced root canal treatment are six times more likely to describe it as “painless” than patients who have not had root canal treatment.

Will it hurt after treatment?

Generally for the first few days after treatment your tooth may be sensitive or sore, depending on the severity of the infection before the procedure. In most cases, over-the-counter pain medication will alleviate the discomfort, but we may prescribe additional medications for you.


Now that the root canal is finished, what do I do then?

After your treatment is finished, a report including digital images will be sent to your general dentist. We recommend seeing your general dentist within a month or less to restore your tooth. Your dentist will decide what type of final restoration will be placed. In certain cases, we will contact you for a follow-up exam to monitor healing.

Failure to see your general dentist within an appropriate time to restore your tooth can lead to possible failure of your treated tooth. See ” Retreatment, .improper healing, under the Procedures link”

I’m worried about having multiple x-rays taken. Should I be?

Because you are a 3-dimensional person, and x-rays are only 2-dimensional, we take our own x-ray(s) from different angles to allow for proper diagnosis and documentation. We also may take an additional x-ray(s) during the procedure to accomplish our goals. After treatment we take another to see the finished result as well as send a copy to your general dentist. X-ray radiation is minimal, but we take only as needed.

In our state-of-the-art office, we use an advanced non-film computerized system called digital radiography that produces radiation levels 90% lower than conventional film-based dental x-rays.

What is an operating microscope?

An operating microscope is what we use for every endodontic treatment. This modern technology allows us to magnify and illuminate with fiber optics deep into the root canals of the tooth, often visualizing the source of infection. Microfractures, extra canals, calcified and hard to find canals, as well as root anomalies can be detected with the microscope. We feel this is the most important factor in achieving the high success rate with endodontic procedures. A more appropriate term for microscope endodontic treatment is commonly called “Microendodontics” and “Microsurgery.”

Our microscopes can also display, capture, and record images of your tooth (inside and outside) to further document your records. They can be relayed to your general dentist if needed to help with proper restoration of your tooth.

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Low power magnification viewing inside a cleaned tooth.

How modern is your office?

Lehigh Valley Endodontics is dedicated in providing the most state-of-the-art endodontic practice in the Lehigh Valley.  In addition to digital radiography and the operating microscope, we now incorporate the latest cleaning and shaping techniques for root canal therapy, as well as various filling materials.  Lasers have revolutionized modern and natural dentistry, especially in the field of endodontics.  In our office, we apply laser dentistry to root canal treatments to enhance cleaning and shaping.  Please see the tab “Technology” for more info on Laser Endodontics.  Additional computerized units and ultrasonic instruments aid in the thoroughness of treatment.  For “Microsurgery,” the most up to date techniques as well as the most biocompatible root end filling materials are utilized in our office.

We are on the cutting edge of technology, incorporating 3-D imaging technology (commonly known as CBCT) that provides better imaging and diagnostics. Better diagnostics lead to better results. Please see the tab “Technology” for more info on CBCT.

How long can I expect to keep my treated tooth?

Root canal therapy ideally and properly treated has a success rate of 95%. You should expect to keep your tooth as long as you live. Poor hygiene as well as an improper restoration can also lead to failure of the tooth in the future.

What about infection control?

We follow the strict standards of infection control advocated by OSHA, the Centers for Disease Control and the American Dental Association. We use autoclave sterilization, barrier technique and disinfectants to eliminate any risk of infection. For root canal therapy, we utilize a rubber sheet over your tooth to prevent bacteria in saliva from invading the root canal system. This also eliminates debris from entering your mouth.

Wouldn’t extraction (pulling the tooth) be easier and a better alternative to root canal treatment?

Saving your natural teeth, if possible, is the very best option.

Nothing can completely replace your natural tooth. An artificial tooth can sometimes cause you to avoid certain foods. Keeping your own teeth is important so that you can continue to enjoy the wide variety of foods necessary to maintain the proper nutrient balance in your diet.  Losing teeth can also lead to changes in appearance, alteration of speech, movement of adjacent teeth, bone loss, and may further cause more stress on existing teeth.

Endodontic treatment, along with an appropriate restoration, is a cost-effective way to treat teeth with inflamed or infected pulp and is usually less expensive than extraction and placement of a bridge or an implant.  Placement of a bridge requires preparing and working on adjacent teeth that normally would not require treatment.  Implants can take significantly more time to complete as well as needing further procedures for supporting tissues.

Endodontic treatment also has a very high success rate. Most root canal treated teeth last a lifetime.

Millions of healthy endodontically treated teeth serve patients all over the world, years and years after treatment. Those healthy teeth are helping patients chew efficiently, maintain the natural appearance of their smiles and enhance their enjoyment of life. Through endodontic treatment, endodontists and dentists worldwide enable patients to keep their natural teeth for a lifetime.

Why is a root canal needed if I have no pain?

Pain does send many patients to the dentist or physician.  Many who do need root canals will have experienced some form of discomfort.  However, not feeling pain does not mean you don’t need to see a dentist or physician for regular checkups.  Sometimes diseases in the mouth or anywhere else in the body can be asymptomatic.

Root canals are an endodontic technique to preserve natural teeth that have irreversible pulpitis, and infection of the nerve pulp of the tooth.  If left untreated, the pulp tissue leads to necrosis and abscess.  Here are a few important reasons to look beyond pain to discover whether your tooth needs a root canal treatment.

Looking Beyond Pain – Root Canal Treatment 

1.  Your endodontist is looking for degeneration of pulp tissue as the cause of your troubles, not pain.  Pain can accompany inflammation or infection, but it is not a reliable guide to diagnosis.

2. Pain is one of a few symptoms of needing a root canal.  Other symptoms include sensitivity to heat or cold, swelling of the face or gums, or teeth that become gray or discolored.

3.  Your infection may be draining, which can temporarily reduce pain.  A pimple on the gum, commonly called a “fistula”, or other types of pus drainage from the tooth are signs of pulp tissue disease.  These conditions may temporarily reduce your pain, but the tooth will still need root canal treatment to save it.

4. Pain associated with inflamed or infected nerve pulp can be inconsistent.  If your dentist prescribes an antibiotic to deal with an infected tooth, your pain may be relieved.  Your pain may go away on its own, but this might be because the nerves in your tooth have necrosed, not because the tooth is healthy again.

5. Research is now finding more links between oral health disease to many health conditions, including diabetes, heart and kidney disease.  Newer studies are finding a possible link between Alzheimer’s, asthma, osteoporosis and oral cancer.  Often patients needing prosthetic joint replacement are required or being asked to have “dental clearance,” to avoid possible infection at the surgery site.

The 3-D image below shows a patient with an upper molar tooth infection.  The bacterial infection has not only eroded bone, but also perforated the maxillary sinus floor causing heavy mucositis.   Yet this patient never had any symptoms.

I’ve seen some unusual and negative stories about root canals on the web.
How much of this is true and why are there such stories?

There are misunderstandings and misinformation on any medical and dental procedure. It is important to be able to check the sources and know what is fact or fiction. There are over 15 million root canals performed every year, successfully and effectively. Root canal treatment is a procedure that can restore your tooth back to its healthy and natural state.