Dover Root Canal Treatment

Dr. Amit Patel is a dentist who has answered some of the common questions Bizymoms visitors have about Root Canal Treatment.


Q. What is root canal treatment?

A: Root Canal treatment is necessary when the pulp, the soft tissue inside the root canal becomes inflamed or infected. The inflammation or infection can have variety of causes: deep decay, repeated dental procedures on the tooth, or a crack or chip in the tooth. In addition, an injury 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.  The treatment this ailment has evolved greatly over the last few decades and has become a routine procedure in our office and is treated with the same care and sensitivity as other simpler dental procedures.  More potent anesthetics and advanced instrumentation insure a comfortable visit, leaving my patients second guessing there impression of dentistry.


Q. What does treatment involve?

A: The first step in the procedure is to take an X-ray to see the shape of the root canals and determine if there are any signs of infection in a surrounding bone. Your dentist or endodontist will then use local anesthesia to numb the area near the tooth. Anesthesia may not be necessary, since the nerve is dead, but most dentists still anesthetize the area to make the patient more relaxed and at ease.  Modern anesthetics are much more effective and potent than the older "Novocaine".
Next, to keep the area dry and free of saliva during treatment, your dentist may place a rubber dam (a sheet of rubber) around the tooth.
An access hole will then be drilled into the tooth. The pulp, along with bacteria, the decayed nerve tissue, and related debris is removed from the tooth. The cleaning out process is accomplished using precision root canal files. A series of these files of increasing diameter are each subsequently placed into the access hole and worked down the full length of the tooth to scrape and scrub the sides of the root canals. Medicine including sodium hypochlorite may be used periodically to flush away the debris.
Once the tooth is thoroughly cleaned, it is sealed. Some dentists like to wait a week before sealing the tooth. For instance, if there is an infection, your dentist may put a medication inside the tooth to clear it up. Others may choose to seal the tooth the same day it is cleaned out. If the root canal is not completed on the same day, a temporary filling is placed in the exterior hole in the tooth to keep out contaminants -- like saliva and food -- out between appointments.
At the next appointment, to fill the interior of the tooth, a sealer paste and a rubber compound called gutta percha is placed into the tooth’s root canal. To fill the exterior access hole created at the beginning of treatment, a filling is placed.
The final step may involve further restoration of the tooth. Because a tooth that needs a root canal often is one that has a large filling or extensive decay or other weakness, a crown, crown and post, or other restoration often needs to be placed on the tooth to protect it, prevent it from breaking, and restore it to full function. Your dentist will discuss the need for any additional dental work with you.


Q. What are the signs of needing endodontic treatment?

A:  Signs to look for include pain, prolonged sensitivity to heat or cold, tenderness to touch and chewing, discoloration of the tooth, and swelling, drainage and tenderness in the lymph nodes as well as nearby bone and gingival tissues. Sometimes, however, there are no symptoms.


Q.  Are pain pills and antibiotics an acceptable substitute for root canal?

A: Pain pills and antibiotics simply cover up some of the symptoms. Until proper endodontic (root canal) treatment is performed, the tooth and your health are at risk. If you want to keep your tooth in the long run, you will need to have root canal treatment.

Q. Are there alternative treatments for root canal?

A:  If root canal therapy is indicated for a tooth there really is no alternative treatment other than an extraction. Root canal treatment deals with the inner aspects of a tooth unlike any other dental procedure. If it is required, no other dental work can suffice. If root canal treatment will not be a possibility for a tooth then it should be extracted. It is wise to consider all of the implications of losing a tooth before having it removed. The decision should not be made hastily or because the tooth is painful. If pain is present and the dentist thinks that the tooth can be saved, the discomfort can first be relieved and then the alternatives explored.

Q. How much will the procedure cost?

A:  There are many factors that affect the cost of root canal treatment. Each patient and tooth presents a different set of circumstances. Estimates range from $350-600 for a front tooth, which usually has one canal, to $500-$860 for a back molar, which can have three or more. Insurances commonly provide benefits for the procedure.  Prices are also based on difficulty, local cost of living and the dentist’s level of training and experience. An endodontist, specializing in tooth root problems, may charge up to 50 percent more for their expertise.  Keep in mind that the root canal treatment alone may not be the complete treatment for the tooth and that the cost of additional restorative work, like fabricating the crown, will also be provided during the consultation visit.


Q. Will the tooth need any special care or additional treatment?

You should not chew or bite on the treated tooth until you have had it restored by your dentist. The unrestored tooth is susceptible to fracture, so you should see your dentist for a full restoration as soon as possible. Otherwise, you need only practice good oral hygiene, including brushing, flossing, and regular checkups and cleanings.
Most endodontically treated teeth last as long as other natural teeth. In a few cases, a tooth that has undergone endodontic treatment does not heal or the pain continues. Occasionally, the tooth may become painful or diseased months or even years after successful treatment. Often when this occurs, redoing the endodontic procedure can save the tooth.

Q.  How to contact Dr. Patel if we have further questions?

You may contact Dr. Patel’s office at 302-734-7634 or you may e-mail him at adcdover@americandentalsmiles.com.  Dr. Patel values all of his patient’s questions and concerns and reviews every email or telephone request with his office staff.