South Mountain Endodontics

My tooth has had a root canal AND a surgery and it is failing. What can I do? These can often be retreated successfully. Even surgeries can fail if done
prematurely. The next step would be to go back in and re-treat the root canal to eliminate the source of the problem. Surgery often only treats one aspect of a
multifaceted issue.

My dentist said I have calcified canals. What does that mean? Calcified canals are teeth that have a smaller than normal space inside the tooth or no space at
all. Calcified canals take more time and are slightly more expensive because the diameter of the canal may be very small or non-existent thereby requiring smaller,
different, and sometimes multiple instruments to complete the treatment. These instruments can be expensive because they are made from exotic materials.
Sometimes a space must be created that was not previously there in order to treat the root canal.

Why is there a price range for root canals? The cost depends on the severity of the case and number of canals as well as the amount of time and amount of
materials used. Considering that you get to keep the tooth functioning for many decades to come, the price is negligible when compared to other things we enjoy on a
daily basis that depreciate rapidly. Your teeth will enhance your quality of life. You use them many times each day, and with adequate care you get to keep them for
the rest of your life. Not many people will keep a car or computer for 40 years -- or even 10 years. Your teeth are an excellent investment! For the money, the amount
you use them and how long you will keep them, you just can't beat the cost to benefit ratio. When you look at it in that light compared to other everyday expenses, you
can't afford not to keep your teeth.

What is the success rate of a root canal procedure? When you have a root canal procedure performed by a qualified endodontist, the success rate is generally
around 97% long term for first time root canals and slightly less for retreatment of existing root canals depending on the number and severity of problems.

Will I need a new crown after you do the root canal? We do not try to remove permanent crowns in most cases because the risks of breaking the tooth off or
shattering the porcelain crown are extremely high. It will also save you money if a new crown is not necessary. Dr. Molen can perform the root canal through the crown
that is later filled permanently by your dentist. Going through the crown greatly decreases the risk of fracturing the tooth. Attempting to remove the crown may fracture
the tooth, requiring extraction or a new crown. Whether or not you need a new crown is a subject you should discuss with your general dentist who will be doing your
restorative work.

When you do a root canal, do you cut off the roots? The roots are left in because they are the mechanism holding the tooth in the jaw so the tooth doesn't fall out.
The "pulp" or insides of the root are cleaned. It is then packed with a permanent filling material that seals the inside of the root from the outside.

My doctor said my roots are curved, or I have a broken instrument in my root. Can it be saved? Yes. Dr. Molen can perform root canal therapy on curved,
calcified canals, and many more difficult cases. He can also successfully perform root canal therapy on teeth that have a broken file or instrument inside of the root.

What is an abscess? When they hear the word "abscess" most people think of a pus filled area that you pop or drain. This is not the case in 90 % of cases. An
abscess is a dark spot at the tip of the root that shows up on the x-ray. This dark spot is most often an area of granulation tissue and less often a cyst. Granulation
tissue is similar to scar tissue and this develops in response to long term irritation either from necrotic (dead) tissue in the root or foreign matter from a previous root
canal that has failed. Your body is reacting to a localized irritation and is trying to clean it up. When this process goes on for months or years, the granulation tissue
accumulates in the area causing the bone to resorb. When the bone resorbs and is replaced with the granulation tissue that is less dense than bone, it shows up as a
darker spot on the x-ray. This is a local process only. It is not systemic and will not cause you to be sick, ill, or cause fatigue. The exception to this rule is if you are
swollen externally on the face or jaw to the point of disfigurement. Although it is most often a local process, you should not ignore it just because it is painless. These
areas will continue to grow (especially if it is a cyst) and will eventually what we refer to as "blow up" which can cause a great deal of pain and in rare cases can require
hospitalization and\or extraction.

What is a rubber dam? It is a 6 x 6 square of latex that is stretched over the affected tooth. We also have non-latex dental dams for those who have a latex allergy or
sensitivity. Dr. Molen always uses a dental dam or "rubber dam" as it is sometimes called, on every case to ensure the highest success rate possible for the root
canal procedure. Dental dams prevent contamination from the mouth into the root canal system and keep any spray or debris from the handpiece from getting into the
patient's mouth. Using a dental dam dramatically increases the long term success rate of the root canal procedure.

My dentist said the root canal I had has gone bad. He suggested I go to a specialist to have a surgery called an apicoectomy. What is that, and is that my
only option? An apicoectomy (surgery) is not as bad as one might think. It is performed through the side after lifting the gum tissue and cutting off the end of the root.
The opening in the end of the root is then sealed with a special filling and the gums put back with a few stitches. Pain is minimal, but there can be some discomfort. Once
again, surgery is more expensive, and does not have as favorable a prognosis as a retreat, but sometimes it is the only alternative. Because of prognostic indicators and
cost to the patient, Dr. Molen will always retreat a root canal before surgery when possible. Retreatment is almost always an option. Some endodontists may only want to
do surgery. Dr. Molen is an endodontist that specializes in retreatment of failed root canals, including teeth with posts. Dr. Molen is happy to give you a second opinion if
you have been advised to have surgery. We may be able to save you money and give you a better prognosis.

My tooth has a post in it. Does this automatically make me a candidate for surgery rather than a retreatment? No. Posts are not a definite indicator that one will
require surgery. Dr. Molen has retreated many root canals succesfully even when posts are present.

Another endodontist told me I needed a surgery. Why are you suggesting no surgery? One patient came to me for a second opinion and told me they went to a
local endodontist who suggested a surgery before the tooth ever had a root canal. A tooth MUST have a root canal done before a surgery. If it is not in that order the
success rate falls dramatically. Retreatment of previously failed root canals is almost always the preferred course with a better prognosis. Surgery is much more expensive
for the patient than root canal therapy and has a less favorable prognosis. South Mountain Endodontics uses a more conservative approach to root canal therapy. It is not
uncommon for doctors to suggest surgery to treat an abscess or infection in a tooth that has previously had a root canal. A more conservative approach is to retreat the
root canal. Retreatments have a better prognosis, cost less, and have a faster healing time than a surgery. Sometimes surgery is the only way to successfully treat an
existing root canal failure, but these cases are rare. If it is recommended that you see an endodontist for a surgery (apicoectomy), there is a 95% chance this can be
successfully retreated without the need for a surgery.

What if I have problems with the root canal after hours? Dr. Molen's cell phone number is given to the patient to call after hours if they have concerns after root canal
treatment. We cannot stress enough that Dr. Molen's work is done with the utmost care and quality. He is a perfectionist when it comes to his work. If you have had an
unhappy experience with a root canal, you'll find that a root canal at South Mountain Endodontics does not have to be uncomfortable. Dr. Molen uses very gentle and
careful techniques to make your experience as comfortable as possible. A common story coming from new patients is that in which a patient was given a root canal, then
a surgery, and finally an extraction by the same doctor. This has never happened at our office. This is not the preferred outcome for any patient and it is only a very rare
occasion that one would expect such circumstances to occur. Unfortunately, not all teeth can be saved. There are those that have circumstances beyond anyone's best
abilities but they are very rare.

What Can I Do If I'm Very Nervous Before the Procedure? Patients are treated the way Dr. Molen would expect to be treated, fairly and honestly with the highest
quality. Most patients feel particularly vulnerable because they just don't know enough about the procedure to ask the right questions. Dr. Molen will explain your options
before performing any major procedure so that you have enough information to ask questions. For this reason, many of our patients have referred family and friends for root
canal therapy. They also refer because they are pleasantly surprised at how painless a root canal can be. Please note that IV sedation will add a significant cost to your
root canal, but is not a necessary procedure to perform a root canal. We do not provide IV sedation. Sedation adds unnecessary risk and significant costs to you.
Patients who are excessively nervous about having a root canal may consult with their general dentist about prescribing a medication prior to the procedure which will help
them relax. This, however, will require that someone drive you to and from your appointment, but is often just as effective and will cost much less than sedation with fewer
risks. Some children have a great deal of fear and anxiety when visiting the dentist. If they are unable to sit still during the procedure and pose a risk to themselves by
grabbing instruments or moving excessively, it is best to see a specialist who is able to sedate your child. Your general dentist can provide you with other specialists who
provide sedation. We want to do what is in the best interests of your child.