Why does a tooth need endodontic treatment?

• A tooth needs endodontic treatment when its pulp or “nerve” is damaged. Common causes include deep cavities, extensive restorations (fillings, crowns or bridges), trauma and hairline fractures. Teeth in this condition can be extremely uncomfortable or completely symptom-free. While it might be tempting to leave pulp-damaged symptom-free teeth alone, they will eventually cause abscesses and are better treated before that happens. Endodontic treatment involves removing remnants of the pulp, meticulously cleaning the canals, and then sealing the canals with an inert material.

How many x-rays will be needed?

• Dental x-rays are the primary means of controlling the cleaning and sealing of the canals. Every film has a specific purpose in achieving an accurate diagnosis and successful treatment. Most teeth will need a total of four to five individual x-rays over the course of the procedure.

What material is used in my tooth?

• A natural rubber called Gutta Percha is the tried and true material used to seal canals. It has been extensively tested and has been proven to be accepted by the body. Since it is inert it does not wash out, corrode or break down so it effectively seals the canal(s) keeping the tooth comfortable and functional long-term.

Is my endodontically treated tooth dead?

• No! While endodontically teeth do not react to cold or heat, and will not develop a toothache if a cavity forms, they are anchored to the jaw by a healthy living ligament.

How long does an endodontically treated tooth last?

• Our goal for an endodontically treated tooth is for it to last the life of the patient. Unless something happens to the tooth such as leakage/redecay around a restoration or vertical root fractures, our success rates are well over 90%.

Can endodontically treated teeth get cavities?

• Absolutely! Endodontic treatment does not change the chemistry of the saliva or the bacteria in it that cause cavities. It is therefore crucial that the teeth be maintained with regular brushing and flossing. Check-ups every six months with your general dentist are also necessary so that any problems can be diagnosed and repaired before they become severe.

Does endodontic treatment hurt?

• We find that local anesthesia with current techniques allows our treatment to proceed with little or no discomfort. We generally use more anesthetic than you are used to receiving for your general dental procedures to ensure maximum comfort.

How long does treatment take?

• Dr. Landau is usually able to complete his work at each visit in approximately 15-20 minutes. The number of visits depends on the individual tooth. Teeth with relatively simple anatomy and no infection can often be treated in a single visit. More complicated teeth and those with infections may require a second or third visit. We schedule an hour for appointments to allow time for patient questions and to give our local anesthetic plenty of time to take full effect.

How far apart will my visits be?

• Once the remains of the pulp are removed at the first visit, the tooth should be stable and comfortable. We can now be flexible with the time between visits. The receptionist will work with you to accomodate your scheduling needs. Patients who are available on short notice can be placed on our cancellation list and will be called as appointment times become available.

Will my tooth turn dark after endodontic treatment?

• Absolutely not! While this happened in the old days with the old materials, there should be no discoloration of a tooth after endodontic treatment.

What has to be done after endodontic treatment of my tooth?

• Dr. Landau will place a temporary filling in the tooth after each visit. When endodontic treatment is complete, you will contact your general dentist to schedule a permanent restoration. Your general dentist has extensive training and experience in restorative dentistry and is the best qualified professional to place the permanent restoration.

Will my tooth need a crown after endodontic treatment?

• That depends on the condition of the tooth. Most teeth that end up needing endodontic treatment have been weakened by the decay process and need the protection of a full coverage restoration to prevent fractures with use. Your general dentist will discuss your treatment options with you and help you make the best choice.

What if I have an emergency when the office is closed?

• If you call the 518-438-4400 number after hours, you will always reach our answering service. Let them know you are having an emergency and need to talk to the doctor. They will page Dr. Landau and he will call you back. On the rare occasion that Dr. Landau is unavailable, there is always another endodontic specialist on call to take care of the emergency.

What should I do if a tooth is knocked out?

• Proper management of an avulsed tooth is critical to its retention in the mouth. The more quickly the tooth is repositioned the better. More than an hour out-of-mouth time makes the likelihood of success much lower. If you cannot put the tooth back in its socket yourself, the tooth should be stored in milk and brought to Dr. Landau, your general dentist or a hospital emergency room. Once the tooth has been repositioned it needs to be held in place with a splint for two weeks and then endodontic treatment must be started. If endodontic treatment is not done then the root will resorb and the tooth will be lost.

What if I have further questions?

• Please don’t hesitate to ask! There are no stupid questions. Our receptionist has extensive experience and can explain almost everything. The dental assistants are knowledgable as well. Any other questions can be answered by the doctor. While he is generally not able to come to the phone in the middle of the schedule, Dr. Landau can always call a patient at the end of the day and devote as much time as is needed to answer any and all questions.