Root canal treatment is performed when the pulp of the tooth has been infected or inflamed.
Here at Omega Dental, we offer all type of endodontic treatments including root canal treatment, root canal retreatment, and endodontic surgery or apical surgery. This page will discuss these treatments and other related procedures.
Your first visit will include an examination and a review of your treatment options. In most cases, your root canal treatment will be started that day. However, if you have a complicated medical history, or you require specialized dental services, we may schedule a second appointment to begin the treatment.
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The interior of the tooth is made up of pulp, and this pulp can become infected. When this occurs, an Endodontist often performs a root canal to take the pulp out of the tooth and seal up that tooth to end the pain and infection.
The interior of a molar can be harder to treat than the front teeth, and an endodontist is often called on to perform root canals on molars as well as on teeth that have extremely infected pulp. This specialist can treat an infection inside a tooth as well as drain pus from infected teeth.
Root canal treatment is necessary when there is infection or inflammation in the pulp. Many things can cause infection inside the root canal, including big decay, dental procedures, and dental trauma.
An Endodontist will remove pulp that is infected. Then, he or she cleans out the inside of the root canal and fills space before sealing it. After the root canal, you should return to the dentist who places a crown or restoration on the tooth to protect it. Afterward, the repaired tooth will function like a brand new tooth!
How Much Does Endodontic Procedure Cost?
The cost of a root canal or other related procedure will vary depending on the complexity of the situation and which tooth is affected. Molars, for instance, are harder to treat. Many dental insurance policies provide some coverage for this type of treatment. As a general rule, treatment and restoration cost less than the option of extraction and replacement with an implant or bridge.
WHAT IS ROOT CANAL?
Root Canal is a dental procedure done to relieve the pain and save a patient’s tooth. The patient is a candidate for the treatment if the tooth has infections in the root, and there is swelling. An endodontist who specializes in root canal procedure will remove the pulp and tissues, clean inside the tooth, and have it sealed. The pulp contains blood vessels and connective tissues that surround the root. The pulp is only important when the teeth are developing and is not needed when they reach maturity. Endodontist will remove the pulp to stop the decay that causes an abscess in the roots of the tooth. An abscess can cause swelling which can spread to the face and neck, and cause bone loss around the root tip.
WHEN DO YOU NEED ROOT CANAL?
To determine if you are a candidate for a root canal is not always automatic. The endodontist will have to know the symptoms and characteristics of the infected tooth. These will include clinical testing and x-ray evaluation of the tooth. First, are the clinical signs that only a dentist’s eye will know if there is a problem in the nerve space. Signs of an existing problem are infection or abscess draining, changes in soft tissue, and darkening of teeth. Also, after the dentist quizzes you on the symptoms, they will complete the evaluations that confirm if you need a root canal. These symptoms are lingering tooth sensitivity to cold and hot, tender gums, and pain when biting and chewing.
WHAT IS THE COST OF ROOT CANAL?
The cost of a root canal procedure will depend on the state you will have the procedure. Other determiners are if you will pay from your pocket without insurance and the dental facility. A high-end dental facility will be more expensive than those who are starting the practice. The root canal cost will vary with the teeth position that needs the treatment; either they are front or back teeth. Front teeth will range from $400 up to $1000, Bicuspids will range from $500 to $1100, while the Molars will range from $600 to $2000. These costs are inclusive of x-rays. The dental crown will cost from $400 to $1500 per tooth. Other costs are dental follow-ups.
DOES INSURANCE COVER ROOT CANAL?
Many Americans have a dental insurance cover which only caters for a routine dental checkup. Depending on the policy, the insurance will cover between 40% to 90% of the root canal cost procedure. The insurance will meet the treatment costs only after the insured has paid the deductibles. However, the insurer may refuse to pay for other treatments such as the dental crown, and the endodontist therapy if you recently purchased the policy. It is advisable to purchase a full coverage dental insurance that you can use from the first day without any restrictions. These will also cover dental treatment follow-ups.
WHAT IS ROOT CANAL RETREATMENT?
When an infection recurs after in a root canal procedure, or healing of the tooth fails, then retreatment is recommended. A root canal is meant to last a lifetime, but sometimes the tooth may become painful some months or even years after the procedure. An endodontist will evaluate the possible causes of the recurring issues and provide a corrective root canal treatment.
The retreatment will require the removal of the previous filling and placing a temporary filling. On the scheduled next visit, the temporary filling is removed, reshaped, and cleaned. The endodontist will fill and seal the new root canal with a temporary filling. During this procedure, the tooth may fracture and will require restoration to full functionality.
Best Practice in Contemporary Endodontics
Throughout history, medical and dental practice have varied significantly from one office or even one practitioner to the next. However, established best practices or standards of care in the dental industry now provide consistent treatment for patients regardless of which dentist they see or which practice employs them. These best practices in contemporary Endodontics are established based on scientific evidence regarding patient outcomes. This is often referred to as evidence-based healthcare.
Best Practice Improves Quality
This shift toward evidence-based practice was initiated by dentists, management, the public, and politicians with a goal of improving quality and consistency for patients. The guidelines that resulted from this movement serve several purposes:
they describe appropriate treatment based on evidence
they reduce variation among practitioners
they more clearly define when referral to a specialist is required
they promote continuing education
they promote efficiency to keep costs lower for patients
Case Difficulty Assessment Form Guides Referrals
The American Association of Endodontists has created a Case Difficulty Assessment Form and Guidelines to help general practice dentists determine when they can treat a patient in-house and when they should be referred to a specialist. Some of the factors that are considered include the patient’s medical history and the complexity of their dental condition. Cases assigned as minimal difficulty may be performed by general dentists, while moderately difficult cases should be either referred to an endodontist or treated by a general dentist with extensive experience. High-difficulty cases should always be referred.
These guidelines ensure that patients who need complex dental care receive it in the safest setting from the most qualified practitioners.
Endodontic Treatment Records
Endodontic treatment records are also governed by best practice. Good clinicians must keep thorough, accurate patient records to deliver the best possible care. The dental record must contain these items to meet quality standards:
documentation of review of the patient’s dental and medical history
the patient’s chief complaint with details surrounding time of onset, duration of symptoms, frequency, description of pain, and intensity
documentation of periodontal and pulpal tests performed for diagnosis
findings during the objective clinical exam
accurate documentation throughout treatment
Informed consent indicates that the patient has been made aware of their diagnosis, the risks and benefits of treatment, and alternative treatments available.
The Use of a Dental Dam
Dental dams are standard of care in endodontic, or root canal treatment. Dental dams isolate the tooth, improve visualization, and prevent the patient from aspirating or ingesting dental materials used in the procedure.
The use of an operating microscope during endodontic treatment is also highly recommended. Utilizing magnification makes locating obstructed canals easier, allows the dentist to more thoroughly remove materials such as posts and obturation materials, can limit the destruction of healthy dentin, and make cracks and fractures more visible.
The Importance of Quality Radiographic Imaging
While a simple bitewing radiograph can be revealing, diagnosis and treatment require additional periapical films, specifically in the sagittal view. This view can reveal additional complexities that often change the treatment plan. Endodontists have an ethical responsibility to ensure quality images are taken and to ensure the right views are taken in order to provide the best plan of care for the patient.
Root Canal Instruments
Root systems are intricate, often asymmetrical, and highly complex with variations in concavity and convexity of the walls and shape of the canals. Ultrasonic systems are considered best practice for excavating dentin or removing mineralization from canals. These systems are small and provide the best view and best access possible to narrow root tips.
Disinfection of Root Canals
Completely removing all bioburden from the root system to prevent further infection continues to be the top priority for endodontists and the American Association of Endodontics. When infection remains, it is typically because of canal complexities that make it difficult to reach and remove all necrotic tissues during the procedure or because of resistant organisms in the biofilm. Adequate irrigating during the shaping process is the single most effective way to cleanse the canals and prevent further infection. The volume of solution used in this process directly impacts the likelihood of further infection.
Root Canal Obturation
The material used to fill the canals has also been extensively researched. Gutta-percha often referred to as “medical-grade rubber,” is considered standard of practice filling material. Silver points and N2 are no longer accepted and fall below the standard of practice.
Sealing Root Canals
The coronal seal is especially important in preventing microorganisms from the oral cavity from causing new infection in the tooth following treatment. The best practice for sealing depends on the unique circumstances of each case, but the overall goal is to prevent contamination by cleaning, shaping, and filling the root canals thoroughly and then completely restoring the tooth with no leaks.
Ensuring Patient Safety
Like any other medical or dental procedure, there are risks to the patient receiving endodontic treatment. It is the endodontist’s responsibility to identify and limit risk to the patient by following the standard of care and best practices at all times. Some mishaps that may occur include:
- separated instruments, which can be limited by discarding shaping files after each use
- perforation, which can often be addressed through early diagnosis and treatment
- overfill into the neurovascular anatomy, which requires referral to a microsurgeon
- burns from ultrasonic instrumentation, which can be prevented by adhering to best practice (utilizing a coolant and stopping for cool down periodically)
- bleach injury, which can be prevented by limiting pressure on the irrigating syringe
General dentists and endodontists must strictly adhere to the ethical standards of care outlined here to best treat and protect their patients.