Endodontics

What Is An Endodontist?

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An Endodontist is a dentist who has undergone a minimum of 2 years of extra postgraduate training. Such dentist has fulfilled the American Dental Association (ADA) requirements to become a dental specialist. " Endodontia " literally means inside the " tooth ".

The specialty training allows an Endodontist to:

1. Save teeth that otherwise be extracted.
2. Diagnose facial pain and related problems.

Your general dentist sometimes refers patients for consultation when the diagnosis is complicated or when treatment requires a more complex treatment approach.

As an Endodontist, aside from providing treatment, Dr. Garcia’s role is also that of an educator. We will make sure that the patient understands why they require treatment, what treatment involves and what we can do to ensure the best possible outcome. We believe that a properly informed patient has the best chance of achieving the optimal result and we will make every effort to explain treatment in complete detail.

What is a Board Certified-Diplomate Endodontist?

A Diplomate is an Endodontist who has made significant achievements beyond the mandatory educational requirements of the specialty and who is certified by the American Board of Endodontics.
Dr. Garcia underwent the rigorous examination process held by the Officers and Directors of the American Board of Endodontics and became a Diplomate of the American Board of Endodontists.

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Our Services

Root Canal Treatment

A root canal consists in the removal of the infected or inflamed nerve from the inside of the tooth's root. The actual root structure will remain in your mandible or maxilla which is what holds your tooth in place.

If it's determined that you have a root canal problem and the tooth is structurally and strategically worth saving, a root canal procedure is initiated. Root canal treatment is performed under local anesthetic. Dr. Garcia uses double strength anesthetics as well as the finest techniques to ensure a comfortable experience.

The tooth will then be isolated with a dental shield prior to treatment. This dental shield serves to minimize inoculation of bacteria from the outside of the tooth during the procedure. The tooth is cleaned and defective fillings and decay completely removed. The canals inside of the roots are located and cleaned / disinfected.

The number of visits to complete your root canal will depend on your particular case. Some cases may require two visits, although many are completed in one visit . When dealing with an extremely complex case or a heavily inflamed/infected tooth, treatment may need to be prolonged in order to achieve the best outcome possible. We will do whatever it takes and spend all the necessary amount of time to reach that goal.

Since the purpose of this treatment is to allow the patient to keep his or her tooth, we believe in an individualized approach to treatment for each patient and each scenario. We do our best to be selective in the teeth we treat, thereby increasing the chances for success. After the initial examination, we will discuss with you the chances of success before any endodontic procedure is performed.

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Endodontists Diagnose and Treat Pain

Very often, oral pain such as a toothaches can be difficult to pinpoint.  Because of the vast network of nerves in the oral cavity, the pain originating from a damaged or diseased tooth often is felt in another tooth and/or in the head, neck, or ear region.

Another complex factor to consider is myofacial pain. This is pain originating in the muscles of the jaw, face, or neck region. Myofacial pain could be precipitated by stress. Don't be surprised if you find out that your pain is not a root canal problem.

It is very important to identify the correct source of the patient's pain to ensure correct treatment is delivered. Dr. Garcia will spend all the necessary time carefully examining and discussing the given circumstances. 

Will I need to return to your office after the Treatment is completed ?

Once endodontic therapy is completed your tooth should be examined periodically, usually every 6 - 12 months.  This allows us to make sure that the tooth has healed or continues to heal properly.  You will be sent a notice in the mail or we will call you when it's time for a follow up appointment. We like to make sure that the work performed at our office continues to serve you well.  

Root Canal Retreatment

Root Canal Retreatment

Occasionally a tooth that has undergone endodontic treatment fails to heal or pain continues despite therapy. Although rare, sometimes a tooth initially responds to root canal therapy but becomes painful or diseased months or years later. A tooth may not heal as expected following initial treatment for a variety of reasons:

  • calcified or curved canals were not treated during the initial procedure
  • complicated anatomy went untreated in the first procedure
  • delay in placement of the crown or final restoration following the initial endodontic treatment
  • the restoration did not seal the inside of the tooth prevention salivary contamination

In other cases, a new problem can arise causing a previously successfully treated tooth to fail.

  • new decay, recurrent decay, can expose the root canal filling to bacteria, causing a new infection in the tooth
  • a loose or broken crown or filling can allow salivary contamination inside the tooth leading to a new infection
  • the tooth sustains a fracture
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Endodontic Surgery

Why Would I Need Endodontic Surgery?

Endodontic surgery can help save your tooth in variety of situations.

  • Occasionally, canals are too calcified and narrow for the instruments used in nonsurgical root canal treatment to reach the end of the root. Endodontic surgery is then required to clean and seal the remainder of the canal.
  • When symptoms persist, endodontic surgery may be used as a diagnostic aid. Your tooth may have a tiny fracture or canal that could not be located during nonsurgical treatment. Endodontic surgery allows the entire root of your tooth to be examined allowing the problem to be located and the correct treatment provided.
  • Endodontic surgery is also performed to treat damaged root surfaces or surrounding bone.

The most common surgical procedure performed to save a tooth is termed an apicoectomy. This is done when infection and inflammation persist in the bony area around the end of your root following a root canal.

Why Would I Need An Apicoectomy?

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An apicoectomy is performed when infection and inflammation persist in the bony area around the end of your root following a root canal.

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A small incision is made near the tooth to allow visualization of the underlying bone and allow for removal of the inflamed or infected tissue.

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The very end of the root is also removed and a filling is placed to seal the end of the root canal. A few sutures or stitches are then placed to allow the tissue to heal properly.

Traumatic Dental Injuries

Traumatic Dental Injuries

With advanced technology, dentists are helping people retain their teeth longer. Because people are living longer and more stressful lives, habits such as clenching, grinding, and chewing on ice or other hard objects lead to more cracks in teeth.

Fractured Cusp

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When a cusp or the pointed part of the chewing surface of your tooth becomes weakened, the cusp will fracture. Part of the cusp may break off or may need to be removed by your dentist. The pulp is rarely damaged by a fractured cusp. Root canal treatment is seldom required. Your tooth will usually be restored with a crown by your dentist.

Split Tooth

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A split tooth is a cracked tooth in which there are two distinct mobile segments. Very rarely can a split tooth be saved. Extraction is usually required.

Cracked Tooth

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The crack extends from the chewing surface of the tooth vertically towards the root. A cracked tooth is not completely split into two separate segments. Due to the location of the crack, damage to the pulp is common. Endodontic treatment is usually needed to treat the damaged pulp. A crown will then be placed to support and protect the cracked tooth. At times, the crack may extend below the gingival tissue requiring extraction.

Vertical Root Fracture

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Vertical root fractures typically occur in teeth that have had previous endodontic treatment. Vertical root fractures are cracks that begin in the root and extend toward the chewing surface. Very rarely can a tooth with a vertical root fracture be maintained. Extraction is usually recommended.

Questions?

How do I know if my tooth is cracked?

The cracked tooth presents with a variety of symptoms, which can include erratic pain when chewing, pain on release of biting, or pain when your tooth is exposed to extreme temperatures. The pain may come and go and there may be difficulty in locating which tooth is causing the discomfort.

How will my cracked tooth be treated?

The treatment and outcome for your cracked tooth depends upon the type, location and extent of the crack.