South Mountain Endodontics

Some Misconceptions About Posts

Posts are used to strengthen teeth. False. Posts, as a general rule, can weaken teeth due to the need to remove tooth or root structure in order to place the post. This
thins the root wall making it more susceptible to horizontal or vertical fractures. One post in the tooth may be necessary to retain a crown and will not adversely affect the
strength of that tooth.

Your tooth needs three or four posts because it is very weak. False. The rule is, use the smallest possible post to accomplish what needs to be done. This statement
is meant for one post. Rarely would you need two. Three or more posts in a single tooth is detrimental to the tooth and can become quite expensive. A second opinion from
Dr. Molen would be wise in a situation where two, three or four posts are suggested.

Because your tooth had a post in it before your root canal, we will need to put one back in the tooth. Assuming the tooth has a crown on it already, this is
usually false -- but not always. If the tooth has a crown on it already there is rarely a case where any post is needed. A post is used to anchor a build up or as
replacement of tooth structure when there is very little visible tooth remaining. If the crown is already on the tooth and the root canal made a hole in the crown, there is
seldom a need for a post. A filling in the chamber and access should be sufficient and essentially performs the same function as a post. If a post is suggested in this
situation, it is best to ask why.

My tooth already has a post in it. Does this require a surgery as opposed to a root canal? Dr.Molen has often retreated root canals with posts without the need for
surgery. It is very rare that we have to perform surgery in these situations. Not only will a surgery cost more, it also has a less desirable prognosis than that of retreating the
tooth.

Frequently Asked Questions About Pain Control

When I visit the dentist, I am unable to get numb. Even after several shots, I still feel everything. Is there something wrong with me? Because it is vitally
important to patient comfort, Endodontists are specially trained to deal with patients who are difficult to numb. We can use different anesthetics as well as different
techniques to numb the tooth on any patient who has had a hard time getting numb in the past. Dealing directly with the nerve requires Dr. Molen to make the tooth
completely numb. If he can't get the teeth numb, he can't work on patients because the nerve is what he is working on. Surprisingly, there have been patients who ask not
to be numbed. Dr. Molen was able to work on these patients successfully and with great results and response from the patient. But this is only on request of the patient and
one who has the ability to remain calm during the procedure.

My pain feels like it's on the top, but my doctor said it was a bottom tooth (or vice versa). My doctor said it could be referred pain. What is referred pain?
Referred pain is the pain you feel that does not always correlate with the area that is actually causing the problem. It is not totally understood. However, there are certain
patterns and ways that pain travels that help us determine where the pain is actually occurring. We also have different diagnostic techniques that allow us to pinpoint the
exact tooth or teeth that are affected even if the pain you are experiencing does not match exactly. Pain can be referred from top to bottom or bottom to top. You can also
have pain in the ear that is coming from a lower tooth, not an upper tooth as you might expect. These are the most common. Pain will less often be referred from front to
back or vice versa. Pain does not travel from one side to the other.

I can't pinpoint where the pain is coming from. What if you do the wrong tooth? Dr. Molen always does all the diagnostics to double check which tooth is causing
the problem even if the dentist sends a paper with the tooth number. Double and triple checking has allowed Dr. Molen a perfect record when it comes to treating the correct
tooth. If he is unsure, or the symptoms don't afford a clear and precise picture, Dr. Molen will wait and perform the tests at a later date to get an exact location of which
tooth is causing the problem. Dr. Molen has never taken a "shotgun" approach. There are cases where two teeth next to each other both need root canals. Sometimes you
can wait on the second root canal if it is not yet symptomatic. If after having a root canal on the first one, it does not produce pain-free results within the expected period of
time, you are most likely experiencing symptoms from the second tooth as well. You may decide then to have that done as soon as possible. Dr. Molen will advise you if
during the examination it is apparent that more than one tooth is affected and perform the first root canal on the tooth that is most symptomatic during the exam. The option
to wait on having a root canal on the second tooth is strictly for your convenience and often makes it easier on your pocketbook. But again, these are in cases where the
2nd tooth requiring a root canal is not yet producing pain or swelling. It is still best to do the root canal as soon as you are financially and physically able in order to avoid
pain and/or complications that can be associated with waiting. Note that sinus problems can often be mistaken for tooth pain, and vice-versa, and can be misdiagnosed. We
have been known to send a patient to a medical doctor for evaluation of their sinuses. There are also other conditions which can give symptoms similar to root canal
symptoms that must be evaluated by neurologists. These patients were referred to the proper medical doctors for the care they needed. We will not do a root canal without
proper diagnostic tests and procedures to produce symptoms required in order to perform a root canal unless the patient insists and is willing to have an "at-your-own-risk"
root canal performed.

Will it be painful after the root canal? I have heard horror stories. Before modern technical advancements, root canal therapy was considered an unpleasant
experience. Very few root canals done today in the correct manner will evoke the same response. Dr. Molen gives instructions on pain control and a cell phone number to
every patient who has work done at the office. Most patients who need a return appointment say they took over-the-counter pain relievers once or not at all. Most patients
are very pleasantly surprised at how little sensitivity there is following a root canal procedure. Ibuprofen is the recommended pain therapy as it not only controls pain but will
help the inflammation which is affecting your tooth.

I have had a Toradol shot after root canal therapy previously. Do you do that? Some offices give a Decadron shot -- also know as Toradol -- or a "steroid" after each
visit on every patient whether or not it is requested by the patient. The fee is around $45 per injection. It is a procedure that Dr. Molen feels is unnecessary and costs you
more. Dr. Molen has never had to give these shots to make a patient comfortable. They can sometimes create additional pain and facial bruising.

Do I have to be sedated? No. South Mountain Endodontics does not charge any sedation fees, conscious, intravenous, or otherwise, because they are unnecessary
procedures that carry additional risks to the patient. Patients have a positive experience without sedation and do not have to pay the high fee required to be sedated. Be
wary of those who suggest sedation when you the patient have not requested it. There are potentially serious health risks involved in sedation. Dr. Molen will always give
you the option to wait for treatment or even seek another opinion. You will not be pushed or rushed into anything about which you are unsure.We may, however,
recommend sedation for a patient when the fear of the procedure causes a patient such severe anxiety that they are unable to remain calm during the procedure. Attempting
to perform a root canal on a patient in this condition can be more dangerous for the patient as they may often grab at the instruments or move suddenly which makes it
difficult for the dentist to carefully complete the procedure. In these cases, you may speak to your general dentist regarding a referral to a doctor who is able to sedate or we
will refer you to an oral surgeon or other doctor who is able to sedate you. Another alternative if you have difficulty remaining calm and have a great deal of anxiety is to
speak with your general dentist regarding your anxiety. He/she can often prescribe medication which can be taken one hour before the procedure and will help to calm your
nerves. This, however, will require that someone else drive you to and from the doctor's office.