Services

Consultation and Diagnostic

Your dentist has referred you to our office for an endodontic evaluation and possible treatment. We will review your medical and dental history, chief complaint, perform diagnostic tests, and analyze all x-rays. It is sometimes necessary to have additional images taken in order to provide a three dimensional view of the tooth in question.

  1. Determine if you are in need of endodontic (root canal) treatment.
  2. Identify the source of the pain.

Patients often experience generalized pain and are unable to identify the problem tooth. Sometimes pain can be felt in an area that is different from the one in which it originates. When the source of pain is different from the site of pain, this is commonly known as referred pain.

Differential Diagnosis of Oral Facial Pain

Endodontists are trained to differentiate between pain of endodontic origin and non-endodontic pain. Not all oral pain implies that root canal therapy is needed. Even though pain may mimic that of a "toothache", other possible causes of pain may be periodontal abscess, temporo-mandibular joint (TMJ) disorder, cracked tooth syndrome, sinus infection, bruxism (grinding), atypical facial neuralgia, blocked salivary gland, cervical (neck) problems, etc.

In such cases, endodontic treatment is NOT necessary, since it will NOT resolve the problem. A referral to the proper medical treating physician will be made.

In our office, we use magnification and illumination to assist in diagnosing. A surgical operating microscope is used in every case. It provides enhanced visualization of the endodontic access or surgical area up to 25 times. This is especially beneficial for accurate visualization of complex anatomy cases, for locating root fractures or defects, for root-end surgery, for removal of separated instruments, and for locating canals. In some cases, your endodontist may also request a 3D Imaging be taken to visualize and treat the unique and sometimes intricate pathology presented by your individual case.

Root Canal Therapy

Deep Infection

A root canal is one of the most common dental procedures performed, well over 14 million every year. This simple treatment can save your natural teeth and prevent the need for dental implants or bridges. At the center of your tooth is pulp.Pulp is a collection of blood vessels that helps to build the surrounding tooth.

Infection of the pulp can be caused by trauma to the tooth, deep decay, cracks and chips, or repeated dental procedures. Symptoms of the infection can be identified as visible injury or swelling of the tooth, sensitivity to temperature or pain in the tooth and gums.

If you experience any of these symptoms, your dentist will most likely recommend non-surgical treatment to eliminate the diseased pulp. This injured pulp is removed and the root canal system is thoroughly cleaned and sealed. This therapy usually involves local anesthesia and may be completed in one or more visits depending on the treatment required. Success for this type of treatment occurs in about 90% of cases. If your tooth is not amenable to endodontic treatment or the chance of success is unfavorable, you will be informed at the time of consultation or when a complication becomes evident during or after treatment. We use local anesthesia to eliminate discomfort. In addition, we will provide nitrous oxide analgesia if indicated. You will be able to drive home after your treatment, and you probably will be comfortable returning to your normal routine.

What happens after treatment?

When your root canal therapy has been completed, a record of your treatment will be sent to your restorative dentist. You should contact their office for a follow-up restoration within a few weeks of completion at our office. Your restorative dentist will decide on what type of restoration is necessary to protect your tooth. It is rare for endodontic patients to experience complications after routine endodontic treatment or microsurgery. If a problem does occur, however, we are available at all times to respond. To prevent further decay, continue to practice good dental hygiene.

How much will it cost?

The cost associated with this procedure can vary depending on factors such as the severity of damage to the affected tooth and which tooth is affected. In general, endodontic treatment is much less expensive than tooth removal and replacement with an implant.

Endodontic Retreatment

Endodontic

With the appropriate care, your teeth that have had endodontic treatment will last as long as other natural teeth. Yet, a tooth that has received treatment may fail to heal or pain may continue to exist. Sometimes, the pain may occur months or years after treatment. If so, endodontic retreatment may be needed.

Improper healing may be caused by:

  • Curved or narrow canals were not treated during the initial treatment.
  • Complicated canals went undetected during the initial treatment.
  • The crown or restoration was not placed within the appropriate amount of time following the procedure.
  • The crown or restoration did not prevent saliva from contaminating the inside of the tooth.

In some cases, new problems can influence a tooth that was successfully treated:

  • New decay can expose a root canal filling material, causing infection.
  • A cracked or loose filling or crown can expose the tooth to new infection.

Once retreatment has been selected as a solution to your problem, the doctors will reopen your tooth to gain access to the root canal filling material. This restorative material will be removed to enable access to the root canal. The doctors will now clean your canals and carefully examine the inside of the problematic tooth. Once cleaned, the doctors will fill and seal the canals and place a temporary filling in the tooth.

At this point, you will need to return to your general dentist as soon as possible in order to have a new crown or restoration placed on the tooth to restore full functionality.

Endodontic Surgery

Why would I need Endodontic Surgery?

Generally, a root canal is all that is needed to save teeth with injured pulp from extraction. Occasionally, this non-surgical procedure will not be sufficient to heal the tooth and your endodontist will recommend surgery.

Endodontic surgery can be used to locate fractures or hidden canals that do not appear on x-rays but still manifest pain in the tooth. Damaged root surfaces or the surrounding bone may also be treated with this procedure. The most common surgery used to save damaged teeth is an apicoectomy or root-end resection.

What is an Apicoectomy?

The video on the right illustrates this simple procedure. An incision is made in the gum tissue to expose the bone and surrounding inflamed tissue. The damaged tissue is removed along with the end of the root tip. A root-end filling is placed to prevent reinfection of the root and the gum is sutured. The bone naturally heals around the root over a period of months restoring full function.

Following the procedure, there may be some discomfort or slight swelling while the incision heals. This is normal for any surgical procedure. To alleviate any discomfort, an appropriate pain medication will be recommended. If you have pain that does not respond to medication, please call our office.

Dental Implants

Dental implants are changing the way people live! With them, people are rediscovering the comfort and confidence to eat, speak, laugh and enjoy life.
Dental Implants

When you are referred to our office for endodontic treatment, we are focused on relieving symptoms and saving teeth. There are circumstances when a tooth can't be saved and removal is necessary.

When a decision must be made about the prognosis of the tooth, your endodontist is in a unique position to evaluate whether endodontic therapy or implant placement will provide long-term success. We are experienced and skilled in extraction, grafting and dental implant procedures, when indicated, to help you and your restorative dentist replace a hopeless or missing tooth with a healthy, functional implant-retained crown.

Dental implants are designed to provide a foundation for replacement teeth that look, feel and function like natural teeth. The person who has lost teeth regains the ability to eat virtually anything and can smile with confidence, knowing that teeth appear natural and that facial contours will be preserved. The implants are tiny titanium posts which are placed into the jawbone where teeth are missing. The bone bonds with the titanium, creating a strong foundation for artificial teeth. In addition, dental implants can help preserve facial structure, preventing the bone deterioration which occurs when teeth are missing.

Evaluation for Dental Implants

If, like many others, you feel implant dentistry is the choice for you, we ask that you undergo a dental/radiographic examination and health history. During these consultation visits, your specific needs and considerations will be addressed by your doctor or by an Oral and Maxillofacial Surgeon referred by our practice. Your questions and concerns are important to us and our team will work with you very closely to help make your procedure a success.

Dental Implant Procedure

Dental implants are metal anchors, which act as tooth root substitutes. They are surgically placed into the jawbone. Small posts are then attached to the implant, which protrude through the gums. These posts provide stable anchors for artificial replacement teeth.

For most patients, the placement of dental implants involves two surgical procedures. First, implants are placed within your jawbone. For the first three to six months following surgery, the implants are beneath the surface of the gums, gradually bonding with the jawbone. You should be able to wear temporary dentures and eat a soft diet during this time. At the same time, your restorative dentist designs the final bridgework or denture, which will ultimately improve both function and aesthetics.

After the implant has bonded to the jawbone, the second phase begins. The surgeon will uncover the implants and attach a small healing collar. We can then start making your new teeth. An impression must be taken. Then posts or attachments can be connected to the implants. The replacement teeth are then made over the posts or attachments. The entire procedure usually takes six to eight months. Most patients do not experience any disruption in their daily life. For more information on dental implants and care for your teeth following a dental implant, please click here.

Periodontal Services

Crown Lengthening for Tooth Restoration

When a tooth breaks, or if there is severe decay, the remaining healthy tooth area is reduced and this can affect the potential for successful tooth restoration. With crown lengthening, more of the tooth’s surface will be exposed and this will help act as an anchor for future restorative work such as crowns, veneers, or more.

Your gums need at least 2mm of tooth surface area to bond with in order to prevent trapped foods and other potential problems. If part of a tooth is missing or if the decay is too deep, there might not be enough of a crown to work with. In situations like this, crown lengthening is used to recreate the required amount of exposed tooth so that restorative dental procedures will not weaken or fall off.

Gum Grafts to Correct Exposed Tooth Roots

Exposed tooth roots are the result of gum recession. Perhaps you wish to enhance your smile by covering one or more of these roots that make your teeth appear too long. Or, maybe you're not bothered by the appearance of these areas, but you cringe because the exposed roots are sensitive to hot or cold foods and liquids.

Your gums may have receded for a variety of reasons, including aggressive tooth brushing or periodontal disease. You may not be in control of what caused the recession, but prior to treatment we can help you identify the factors contributing to the problem. Once these contributing factors are controlled, a soft tissue graft procedure will repair the defect and help to prevent additional recession and bone loss.

Sinus Lift or Sinus Augmentation

A procedure that is also referred to as "sinus lift" or "sinus graft” or “sinus augmentation" is a commonly used method for growing bone in upper jaw (maxilla) in the area of the posterior premolar and molar teeth. The maxillary sinuses are hollow cavities that occupy the back of the upper jaw above the posterior teeth. Often the roots of the upper jaw penetrate into the maxillary sinus when they are present. When these teeth are lost or removed, the bone that is left behind is usually inadequate to support dental implants.

The method that is used to grow bone in this area is very technique sensitive, and should only be attempted by highly trained dental surgeons. General dentists do not have adequate training to handle these types of procedures.

Pocket Reduction Surgery

Your bone and gum tissue should fit snugly around your teeth like a turtleneck around your neck. When you have periodontal disease, this supporting tissue and bone is destroyed, forming "pockets" around the teeth.

Over time, these pockets become deeper, providing a larger space for bacteria to live. As bacteria develop around the teeth, they can accumulate and advance under the gum tissue. These deep pockets collect even more bacteria, resulting in further bone and tissue loss. Eventually, if too much bone is lost, the teeth will need to be extracted.

Generally pocket reduction surgery is recommended to reduce pockets that are pockets that are too deep to clean with daily at-home oral hygiene and a professional care routine.

During a pocket reduction surgery procedure, the gum tissue is gently moved away from your teeth and the disease-causing bacteria are removed and cleaned before securing the tissue into place with small micro-sutures. In some cases, irregular surfaces of the damaged bone are smoothed to limit areas where disease-causing bacteria can hide. This allows the gum tissue to better reattach to healthy bone.