Endodontics San Francisco, CA


Endodontic root canal treatment and retreatment.

Each tooth in your mouth sits in bone and is surrounded by gum tissue. Approximately two-thirds of each tooth (the root portion) is in the jaw bone. Inside every tooth is a canal or canals (usually depending on the number of roots the tooth has). Each canal has a vein, artery, and nerve in it. Collectively they are referred to as the pulp. Sometimes, because of trauma like decay or a large filling, the pulp becomes irritated and can get infected. In this case, root canal (a.k.a. endodontic treatment) is necessary in order to save the tooth.

A small hole is made in the top part of the tooth, the canal(s) is cleaned of infected (or dead) pulp, made sterile then filled with material specific for the procedure. The whole process can usually take from one or more appointments, depending on the number of roots.

Root Canals

Root Canal

What you need to know about root canals.

It’s understandable that you might feel a bit anxious when you hear “root canal,” but with modern anesthetics, you’ll rarely be in any pain and it is a necessary procedure to save your tooth. Below we answer some of the frequently asked questions associated with root canals.

What is a root canal?

Underneath your tooth’s outer enamel and within the dentin is an area of soft tissue called the pulp, which carries the tooth’s nerves, veins, arteries, and lymph vessels. Root canals are very small, thin divisions that branch off from the top pulp chamber down to the tip of the root. A tooth has at least one but no more than four root canals.

Why does a toothache cause pain?

When the pulp becomes infected due to a deep cavity or fracture that allows bacteria to seep in, or injury due to trauma, it can die. Damaged or dead pulp causes increased blood flow, and this pressure cannot be relieved from inside the tooth. Pain in the tooth is commonly felt when biting down, chewing, or applying hot or cold foods and drinks.

Why do I need root canal treatment?

Because the tooth will not heal by itself. Without treatment, the infection will spread, the bone around the tooth will begin to degenerate, and the tooth may fall out. The pain usually worsens until one is forced to seek emergency dental attention. The only alternative is usually extraction of the tooth, which can cause surrounding teeth to shift crookedly, resulting in a bad bite. Though an extraction is cheaper, the space left behind will require an implant or a bridge, which can be more expensive than root canal therapy. If you have the choice, it’s always best to keep your original teeth.

What is involved in root canal treatment?

First, you will probably be given a local anesthetic to numb the area. A rubber sheet is then placed around the tooth to isolate it. Next, a gap is drilled from the crown and any affected tissue is cleaned and reshaped. Medication may be inserted into the area to help fight bacteria. Depending on the condition of the tooth, the crown may then be sealed temporarily to guard against recontamination, or the tooth may be left open to drain, or we may go right ahead and fill the canals. If you’re given a temporary filling, it’s usually removed at the next visit and the canal(s) are filled. Once filled, the area is permanently sealed and a gold or porcelain crown is placed over the tooth to strengthen its structure and improve appearance.

What happens after treatment?

Swelling may cause discomfort for a few days, which can be controlled by an over-the-counter pain killer. A follow-up exam can monitor tissue healing. From this point on, brush and floss regularly, avoid chewing hard foods on the treated tooth and see your dentist regularly.

Internal Bleaching

Internal Bleaching

Whiten your teeth from the inside out.

Occasionally a dark area in a tooth may be coming from deep inside the tooth. When this develops it is usually because blood or other liquids have leaked into the inside of a tooth following a root canal procedure. In our office, we can use internal bleaching to whiten the tooth from the inside out. We drill a small hole and insert a peroxide gel into the internal cavity of the tooth. The solution is left inside the tooth for about a week during which time it perforates into the dentin (structure inside the enamel, lightening the color of the tooth. Next, the gel is drained from the tooth and the hole filled. This method of internal bleaching is highly effective, and the tooth will be significantly whiter. If you notice the appearance of internal stains and think you may need internal bleaching to please contact our office to determine whether it is the correct procedure for you.

Abscess Removal

Abscess Removal

Treatment for an infected and abscessed tooth.

An abscess is a pocket of infection that forms around the root of your tooth. Your body, in an effort to isolate the infection, naturally creates a wall around it. While at first there may be no visible symptoms, redness and painful swelling of the gums usually follows. Unless removed, the abscess will continue to grow and eventually decay everything that it contacts including teeth, jawbone, gums, and connective tissues.

To remove the abscess we drain the infection, relieving the swelling and reducing pain. In more serious cases a root canal procedure may be needed to remove infected pulp inside the roots. An antibiotic may be prescribed to help fight or prevent infection. Should you experience any of the symptoms described above, please contact us immediately. Our office has extensive expertise to treat and heal abscesses successfully.