What is a Root Canal?
A root canal is a procedure performed by an advanced-practice dentist or an endodontist to help a patient maintain his or her natural teeth when this material known as the dental pulp becomes infected. The tissue inside each tooth contains blood vessels and nerves, which can become infected through deep cavities, traumatic dental injuries, or fractures in the teeth. With his additional training, Manhattan dentist Dr. Marc Lazare, D.D.S., M.A.G.D. performs endodontic services along with cosmetic and general dentistry for patients who need a root canal therapy.
While many dental practitioners feel comfortable performing root canal procedures on their patients, if they feel that a root canal therapy is very complicated or out of their comfort zone, they will refer their patient to an Endodontist.
During a root canal treatment, the dentist or endodontist drills into the tooth to remove the pulp. A special drill and technique are utilized to clear the root canals and any additional infected tissue.
Synthetic material is then injected into the roots to seal the area from future infection. Durable, artificial material is used to replace the tooth pulp. Following the procedure, the tooth may be crowned, where a tooth-shaped structure is fixed above the remaining natural tooth to create a realistic replacement.
Tooth Infection Symptoms
A tooth infection occurs when bacteria infiltrates the tooth pulp, which can eventually travel down the roots and affect the jawbone. Bacteria can enter the inner tooth through a large cavity or injury to the tooth.
The dental pulp is the live tissue found within each external tooth structure (dental crown). It contains blood vessels, nerves, and connective tissue. The nerves within the pulp are large and can cause significant issues – including pain and dental abscess – , when the tooth pulp is impacted.
Some telltale signs that the tooth pulp has been affected are:
- Tooth discoloration
- Dark spots on the roots visible by X-ray
- Abscessed tooth
Dental Abscess Explained
An abscess is the byproduct of an infection that can form within the teeth, gums, or jawbone. The abscess appears as a red and spherical pocket of pus. Pus is a thick fluid that consists of dead leukocytes (white blood cells) that were attempting to kill the bacteria and other debris from the cells.
The infection is trapped and unable to fully leave the body, which can lead to a painful lump. Sometimes, dental abscesses drain, which can cause a foul taste in the mouth but may lead to temporary pain relief due to the release of pressure.
Tooth abscess symptoms may include localized swelling, swollen lymph nodes, oral pain (teeth, jaw, face), headaches, or even sepsis. Patients who suspect they may have an abscessed tooth should schedule an appointment for endodontics at our Manhattan dental office right away. Dr. Lazare may suggest drainage, root canal therapy, extraction, or another service combined with an antibiotic regimen.
Dead Tooth Diagnosis
Teeth are alive and they can die. When they do, they produce telltale signs that they are no longer receiving nutrients through the blood found in the tooth pulp. Patients may notice discoloration of the tooth, which can be yellow, brown, or gray. Often, tooth pain is associated with this change and patients may notice increased sensitivity or chronic discomfort. Other signs of a dead tooth are a foul taste or bad breath and swelling around the gum line.
Preparing for Root Canal
Before patients undergo a root canal therapy, they should request a pre-treatment estimate from their dental insurance to determine coverage for the procedure and the root canal cost. The dentist will ensure that he has access to current dental X-rays, a full history (medical and surgical), and may begin by treating the infection in advance. This can consist of draining of an abscess and/or prescribing an antibiotic regimen. Any concerns or anxiety can be discussed in advance, and the patient can be provided with medications to help ease any worries before the beginning of the procedure.
The Root Canal Procedure
Patients will be sedated before a root canal procedure. Endodontics largely concern the nerves within the tooth, and our patients can rest assured that Dr. Lazare is focused on offsetting discomfort and pain, he will discuss sedation dentistry options during your consultation. Before the 90-minute procedure, patients will be seated comfortably in a dental chair with the television show or movie of their choice provided as a distraction.
- Anti-anxiety medication or nitrous oxide, sometimes called “laughing gas”, are provided and the affected tooth and surrounding area are numbed.
- A special shield and dressing are placed to isolate the tooth and prevent the spread of bacteria or body fluids in the mouth. This step also helps to maintain a dry working environment.
- A special drill is used to access the pulp and roots of the tooth through the crown.
- The root canals are irrigated and desinfected.
- A smaller drill is used to remove the tooth pulp and shape the canals.
- Dental materials are used to seal off the canals to help the tooth maintain its structure and integrity and prevent future infection from occurring.
- Sealant and tooth-building material may be placed where the pulp existed and a temporary or permanent crown is fitted over the tooth. Because Dr. Lazare performs much of the work of a general dentist, he may be able to perform this final step during the initial root canal appointment to avoid the placement of a temporary tooth filling.
What is an Endodontist?
Endodontics is the study, diagnosis, and treatment of damaged or infected dental pulp. Endodontists begin as general dentists who undergo additional training for specialization in tooth pulp issues.
Because an endodontist is concerned with the innermost areas of each tooth, they perform minor procedures like root canals when needed.
These procedures are so common that some people think of an endodontist solely as a root canal specialist. Endodontic procedures can save your tooth, which may otherwise need to be extracted.
Differences Between a Dentist and an Endodontist
A dentist is an oral health professional who is trained in the care of the teeth and gums. Some patients inquire about the difference between a dentist with the credentials DMD vs DDS, which is a Doctor of Medicine in Dentistry or a Doctor of Dental Surgery. Universities determine what to name the degree program, but dentists with a DMD or DDS follow the same curriculum and training.
A dentist’s office will provide professional cleanings, which most people are very familiar with. Plaque is scraped from the teeth and oral health problems are diagnosed. Dentists can also perform procedures like dental fillings or more involved minor surgeries like tooth extraction.
Dentists also X-ray the teeth and jawbones to determine the need for wisdom teeth removal, braces, and filling cavities. Often, dentists work with other oral health experts like endodontists, orthodontists, and prosthodontists for comprehensive patient care.
An endodontist is a dentist who has completed an additional two years of schooling and training to become proficient in diagnosing and treating issues of the dental pulp.
Endodontists in New York City will not typically have any additional credentials listed after their post-nominal initials.
While some dentists may perform less extensive root canals, advanced cases or root canal re-treatments may be referred to an endodontist.
Endodontists are specialists in complicated root canal and decaying tooth cases.
A common issue that endodontists treat is an infected tooth, which can be diagnosed by X-ray, discoloration, and reaction to temperature. Often, multiple methods will be used to confirm there is an infected or dead tooth.
Why Choose Endodontic Care?
The pulp contains blood vessels, nerves, and connective tissue that are responsible for forming the surrounding Dentin and Enamel during tooth development. The pulp receives its nourishment supply from vessels that enter the end of the root. Although the pulp is important during development of the tooth, it is not necessary for the function of the tooth. The tooth continues to be nourished by the tissues surrounding it even after the pulp is removed.
Root canal treatments and other endodontic care options are a great way for patients with significant tooth decay, traumatic injury, or those at risk for tooth loss to end tooth pain and save the natural tooth, as well as cracked teeth.
Human teeth are composed of very strong materials and most dentists, especially those with a biomimetic background like NY’s endodontist and general dentist Dr. Lazare, find that root canal therapy or other endodontics are often better options than replacement. Ongoing endodontic problems can lead to serious health consequences and should be addressed promptly.
When the tooth shows discoloration, conventional bleaching treatments are ineffective at reversing the darker color. Dr. Lazare is a skilled cosmetic dentist, however, and may use advanced cosmetic dentistry techniques like internal bleaching to improve the tooth’s appearance.
Root Canal Recovery
Depending on the circumstances of each patient’s case, there may be more specific instructions provided for recovery from a root canal procedure in New York City. In general, Dr. Lazare may suggest eating soft foods, treating root canal pain or swelling with over-the-counter medications, and practicing optimal oral hygiene.
Patients may experience cheek pain or facial swelling after a root canal treatment, and Dr. Lazare can advise patients on what is normal vs. when they should contact the NY office for potential complications. Swelling after a root canal is a normal reaction to inflammation caused by the procedure, but it can also indicate a bacterial infection or a reaction to the medications administered or the materials used in endodontics.
If a temporary tooth filling was placed, patients may be asked to avoid hard or sticky foods until it is replaced. While the nerve has been removed from the tooth, patients may experience some pain after root canal therapy, which can be the result of damage caused before the procedure.
In cases where a root canal fails and bacteria remains, there may be noticeable pain for longer than three days or an abscess near the tooth. An abscess after root canal treatment is rare but may be possible if all the infection has not been removed or if the tooth is compromised following the treatment. Patients can schedule a follow-up appointment to address any concerns.
Risks Associated with Endodontic Procedures
Though Dr. Lazare’s root canal therapy is minimally-invasive, any dental treatment can lead to side effects and may carry certain risks. Some of the potential concerns are listed below.
- Swelling after root canal
- Pain after root canal
- Tooth discoloration
- Treatment failure
- Infection after root canal and crown
- Formation of root canal abscess
- Reaction to medications
- Tooth root fracture
Frequently Asked Questions
Generally, patients can expect to be at Dr. Lazare’s NY office for root canal therapy for a total of approximately two hours. Preparation, including numbing and administration of medications, requires about 30 minutes, while the root canal procedure itself takes about 90 minutes. During endodontic treatments, patients can watch TV shows or movies to pass the time.
Most patients report tooth nerve pain before the root canal as bacteria damage the structures of the inner tooth and infiltrate large nerves, causing root canal infection. Root canal pain is less common, but insufficient numbing can cause pain during the procedure.
Pain can occur following root canal treatment if some bacteria remain, or an injury such as tooth root fracture exists. Throbbing pain after root canal treatment might be the result of damage caused by an infection that remains after a root canal and dental crown placement.
The total cost for a root canal treatment in NY is usually $1,000-$2,000 but will depend on many factors. These include the case severity, whether or not the dentist or endodontist is performing re-treatment, and wherein New York City the procedure is being completed.
Additionally, the complexity of the case and the patient’s dental insurance will also contribute to the total cost. When a root canal is performed, the tooth may be crowned or covered above the gum line by an artificial tooth. The labs that create crowns charge different prices for their services.
A bump can form on the gums following root canal treatment if the infection remains, causing an abscess that must be treated. An abscess might appear like a white spot or a pimple on the gums that contains pus following a root canal. Typically, this is indicative that a dental fistula has formed after a root canal. The fistula forms on the gum as the bacterial infection attempts to leave the gums and exit the body.
Because lumps on the gums can be attributed to other issues after a root canal treatment, like swelling from the procedure, a cyst, or other dental issues, Dr. Lazare should see the patient at his Manhattan practice to diagnose the issue.
A patient many experience phantom nerve pain after a root canal, or if the root canal fails, there may still be bacteria present within the tooth or roots. This can cause pain and sensitivity because healthy, live tissue becomes damaged by the infection.
Other patients who experience a lot of facial swelling after a root canal may be sensitive to cold or other sensations because other nerves have been impacted by inflammation due to the immunological response to the infection.
Why Choose Dr. Lazare?
- B.A. University of Pennsylvania (Major: Natural Sciences)
- D.D.S. New York University College of Dentistry (Class President)
- Intern in General Practice Residency Program, Department of Dentistry North Shore University Hospital, Manhasset, N.Y.
- Chief Resident in General Practice Residency Program, Department of Dentistry North Shore University Hospital
- Present Active Member of the Attending Staff- North Shore University Hospital
- Present Member of the Clinical Faculty- NYU College of Dentistry
- Master in the Academy of General Dentistry – Awarded in 2011
- President of the Academy Of Biomimetic Dentistry and Long time Executive Board Member
- Fellow in the Academy of General Dentistry
- Fellow in the International Academy for Dental-Facial Esthetics
- NEW YORK LICENSE #046840 ISSUED1996
Contact the Upper East Side New York, NY office of Dr. Lazare at 212-861-2599.