Why the nerve in my tooth may need to be removed

Endodontics is a branch of dentistry recognized by the American Dental Association involving treatment of the dental pulp (nerve and blood vessels) and surrounding tissues of the tooth. Endodontic therapy has been shown to be over 90% successful. When you look at your tooth in the mirror, what you see is the crown. The rest of the tooth hidden beneath the gum line, is called the root. A tooth can have as few as one and as many as five roots. Bacteria can be introduced into or near the pulp as a result of tooth decay, periodontal disease, tooth fracture or other problems, and can severely damage the pulp. With time, the damaged pulp may die and infect the surrounding bone and gums. When that happens, an Endodontic specialist removes the diseased pulp to save the tooth and prevent further infection and inflammation.

The tooth itself remains in the jaw and the infected or irritated nerves and blood vessels causing the problem are all that are removed. After successful Endodontic treatment, the tooth continues to perform normally but will require a restoration, most often a crown. Your restorative dentist will need to do this in two to four weeks.

I'm worried about x-rays. Should I be?

No. While x-rays will be necessary, the levels of radiation are extremely low and we use a lead shield in order to provide every level of safety that we can provide.

What about infection?

Again, there's no need for concern. We adhere to extremely rigorous standards of infection control advocated by OSHA, the Centers for Disease Control and the American Dental Association. We use isolated sterile water supplies for each dental unit. We utilize autoclave sterilization and barrier techniques to eliminate any risk of infection.

What happens after treatment?

When your root canal therapy has been completed, a record of your treatment will be sent to your restorative dentist.  Generally we will request that you are seen in two to four weeks following Endodontic treatment for the restoration. There are usually no restrictions after the procedure concerning driving or returning to work. Dr. Hagel-Bradway can be reached during business hours at the office or by cell phone after hours, if any questions or concerns arise before or after treatment.

Continue all medications for blood pressure, diabetes, thyroid problems and any other conditions as recommended by your physician. If there is a question, please call our office prior to your appointment.

If you have been advised by your physician or dentist to use antibiotic premedication because of diseased heart valve, hip, knee, cardiac or other prosthesis, or if you have rheumatic heart disease, please make sure you are on the appropriate antibiotic on the day of your appointment. If there is a question, please call our office prior to your appointment. The American Heart Association has issued new recommendations that recommend reduced requirements for premedication. We will review your health history to confirm that we are in compliance with those recommendations.

If you can take ibuprofen (Advil) or Naproxen sodium (Aleve), it does help reduce inflammation when taken pre-operatively. We recommend 2 tablets of either medication the night before, and 2 to 4 hours before Endodontic therapy.

General Post-Operative Instructions

Your tooth and surrounding gum tissue may be slightly tender for several days as a result of manipulation during treatment and previous condition of your tooth. We do not like you to feel any pain associated with treatment, but this does not mean that anything is wrong unless the tenderness persists. Think of your tooth as bruised and “baby it” accordingly for the first three days. After these three days remember that this is a temporary filling and does run he risk of fracture or falling out until it is covered with a protective restoration provided by your restorative dentist. You may be given a narcotic drug such a Vicodin to be taken only when you will not have responsibilities or will not be driving.

NOTE: Alcohol intake is not advised while taking any of these medications. Should you experience discomfort that cannot be controlled with the above listed medications, or should swelling develop, please contact our office immediately. If you have after hours concerns, please contact the doctor by cell phone. If you need to call after hours, please have your pharmacy number available.

After Completion of Endodontic Treatment

Endodontic treatment has now been completed and the root canal system has been definitively sealed. However, the outer or biting surface is sealed with a temporary restoration. A definitive restoration must be placed to protect your tooth against fracture and decay. Please confirm your restorative dental appointment with your general dentist. Included in your treatment is a follow-up examination to evaluate the progress of healing in six months to a year. This appointment will require only a few minutes and no additional fee will be charged for the first check-up visit. Please call for an appointment once you receive your reminder in the mail.

If you experience any symptoms or "strange feeling" that you did not anticipate, contact our office. Please note that we expect soreness to last up to a week. Usually a brief phone call can assist in resolution; at times we will need to see you to make adjustments.