Dr. Ian Jay Langer, D.M.D.

Some people have pain, some will not. No one can predict it for you. Only after the procedure will you know if you had pain. Suggestions to minimize pain:

1) If you can, take one ore two Advil afterward before the anesthetic wears off, or preferably 20 minutes before the root canal.
2) Have your dentist adjust the bite so you don't hit the tooth
3) Make sure your dentist uses proper sterile technique including using a RUBBER DAM to treat you (helps keep things clean and safe)
4) If it is a complicated tooth (multiple canals, severe infection) you may wish to consult an endodontist (root canal specialist).

Good luck.

If your endodontist sees a problem, even if there is no pain, better to take care of it before the pain starts. Just like HIGH BLOOD PRESSURE is the SILENT KILLER, if you don't get it checked, you may not know you have it until you are dead. Likewise, how many women go for their mammograms and pap smears checking for cancer? How many men get their prostates checked out. That spot on the lung, ignore it? If you wait for cancer to cause pain, you are at stage 4 and beyond saving. If the nerve is dead and gangrenous, why wait for it to blow up? Murphy's Law, it will blow up as you board that cruise ship or plane for an overdue vacation, blow up at your wedding...or your kid's wedding, in the middle of a blizzard with a state-of emergency declared with a ban on travel. There is no good time for root canal therapy or a trip to the dentist. Better to plan it and schedule it when it is less inconvenient because it will never be convenient. OH, you can also extract the tooth instead of saving it with a root canal or live with the infection until symptoms arise and hope you can get an appointment.

Yes, it is usually safe and safer than leaving the tooth with an active infection. Discuss this with your endodontist.

It is usually safe to treat and healthier than leaving an active infection. You would have to discuss your particulars with your endodontist as it does depend on a number of factors.

Treatment depends on diagnosing the cause. Is it an endodontic (root canal) infection or a periodontal (gum) infection? You cannot provide definitive treatment without knowing the source. If it is endodontic, then a trip to the endodontist is needed. Likewise, visit to the periodontist would be in order. The only other definitive treatment would be extraction.

The definition of emergency will vary from one individual to the next. For me, emergency is Pain or Swelling, with or without temperature or fever. For others, a broken front tooth may not have pain, but some kid's mother will be freaking out and calling every doctor under the sun even if there is no pain because it doesn't look good. Even a small chip can upset many patients and they then demand emergency appointments even if it is just a cosmetic issue.

I can't say specifically whether your husband is an emergency, but based on your description, if there is a problem, it should be addressed, evaluated and diagnosed ASAP to avoid pain, swelling, or loss of tooth.

This is difficult to answer without an exam. There are a number of possibilities including:1) brushing or flossing incorrectly, 2) Not having Fluoride vitamins, water, toothpaste, rinses, 3) Genetic or underlying medical issues, 4) Bad habits (smoking, sweets), 5) I would hate to say poor dentistry or dishonest dentistry - not common I would think but I have seen it - and 6) Different philosophies of dentists leading to different opinions...not that it is right or wrong (for example, 40 years ago, a dentist may see a cavity but wait until it is larger to treat because at that time, they would destroy more good tooth to get to the cavity to treat it. Today's materials allow the cavities to be treated when they are smaller. Or, a cavity may seem big and a large filling would be done that may last a few years before it blows up needing a root canal...or another dentist may say that it is a big filling, will ultimately need the root canal in the near future so do the root canal now before it abscesses and gets infected....no pain and easier to deal with. If your dentist cannot identify the cause, perhaps a 2nd opinion would be appropriate...at least to rule out bad dentistry. It the 2nd opinion agrees with the 1st, then clear conscience and continue treatment with original dentist.

Your options depend on what you want. Without an exam, I can't tell you what the course of treatment will be. If you do not wish to save the tooth, then you can have an extraction. If you wish to save the tooth, you should see an endodontist for definitive diagnosis and have the root canal if suggested. Good Luck.

Without seeing it or doing an exam, X-rays, and pulp testing, I couldn't tell you what to do. With that, if you wish to fix it, please see your dentist who can do the exam and give you options on how to fix it.

Depending on the location, type of cracking, wear and tear, etc, the ways to fix them are quite varied. There is no one right way to fix them...it depends on the cause. That said, you should see your dentist who will be able to best advise you.

Generally it should not be a problem. If you are having an endodontist retreat the root canal, he would help determine if the tooth is strong enough to withstand the retreatment. Retreatment is done all the time by endodontists. Good Luck.

This would depend on your dentist's or periodontist's recommendations. Some people need only twice a year, some quarterly, and some even monthly. Your dentist is the best one to advise you on your needs.

Pain? Rotting tooth? See an endodontist for evaluation. Endodontists (root canal specialists) save teeth and eliminate pain. Pulling a tooth should be last resort if necessary. For your individual case, an exam is required to determine if the tooth can be saved or needs to be pulled. An endodontist deals with the tough cases all the time. If a general dentist says that the root canal is too difficult and cannot be done, again, see an endodontist who specializes in treating teeth that the general dentist cannot or is unable or unwilling to treat.

Failed root canal therapy may experience pain, swelling, tenderness biting, pressure sensitive on the gums, pus draining through the gums and breakdown

Depending on how much tooth has been destroyed or damaged, the tooth may be able to be saved, possibly with root canal therapy. You would have to have a dentist or ENDODONTIST (root canal specialist) examine and evaluate the tooth. No other specific recommendations can be made without an exam. Only a dentist who did the exam can tell.

It can be any number of things. The infection may be spreading, it may be referred pain, it may be an independent problem. You have to see your dentist or endodontist to evaluate it to make the correct diagnosis.

You should clarify recovery. If you have pain when biting or chewing, you should check the bite and reduce it. That is the biggest complication I see and the easiest to correct. Often, the crown is off a little and your bite ever-so-slightly too hard on it. Not really noticeable at first.

There are risks associated with ALL surgery, that includes endodontic surgery. The usual risks include bleeding, bruising, nerve damage, unsuccessful outcome, pain, swelling, jaw fracture, sinus perforation, lost roots, poor healing and more. Depending on the location of the tooth/root, some problems may be more likely than others. Of course, the same risks
occur with extractions, implants, periodontal surgery, etc. This is the main reason why I recommend re-treatment of the root canal rather than surgery as a first choice. Most endodontists are retreating root canals that did not respond to the original treatment rather than surgery. Re-treatment offers a higher success rate when performed by an endodontist
compared to surgery on an infected root. If the tooth is properly cleaned out, then surgery success rates rise. Of course, re-treatment is usually more time consuming and will damage the crown, necessitating a new post and crown. Surgery is faster, but if it doesn't work, then what?

Apicoectomy is my 2nd choice of treatment. 1st choice is Re-treatment of the root canal. Last choice would be an implant. Endodontists are dentists who specialize in treating root canals and other pulpal problems. An endodontist should always be consulted if root canal therapy is failing or if you are told "it can't be treated," "too infected," "too complicated," "it
won't work," etc. In my own practice, about 25% of the patients have come in because the root canals failed the first time when done by their general dentist. Endodontists offer a higher success rate. Endodontists have surgical microscopes and specialized training that most general dentists do not have. Please understand that general dentists treat approximately 90% of the root canals in the USA. Endodontists get the tougher ones. Endodontists can have failed root canals, but so can implants (they have the same success rates). If the root canal failed because of fracture, then extraction and implant would be advisable. Endodontists can usually spot fractures with the microscope and thus recommend extraction before you go through the whole process of root canal therapy, post and crown and then problem from the missed fracture. Apicoectomy has about 90% success on an
uninfected canal, and 50% success on an infected canal. Re-treatment of the root canal offers about a 95% success rate. I feel it is always better to clean out the infection that is in the root canal rather than seal it into the root canal.

It is essentially an endodontist (root canal specialist) re-doing the original root canal treatment. Usually done with a microscope for improved vision, the endodontist removed the post (if present) and removes the root canal fillings, basically undoing everything that was done originally. The endodontist would look for missed canals, fractures and whatever else would have caused the original treatment to fail. Retreatment is not easy, the canals are filled with a "permanent" filling which means that it is not easy to remove. It may often take several visits, and in extreme cases, sometimes the endodontist will recommend surgery if required. Surgery is never a first choice (at least in endodontic offices). Retreatment usually has a higher success rate than endodontic surgery, which is why it is recommended as a first choice.