What is a root canal?

• A root canal is a procedure that extracts decayed pulp from the central part of the tooth, as well as cleaning, shaping and filling of the canal system with gutta percha and a dental sealer. The procedure enables you to keep your natural tooth, which is preferable to any type of replacement. For more information click here.
   

I have no pain, why do I need a root canal?

• The lack of pain is not always an indication that nothing is going on. A lot of times, you can have a large infection without any pain. When a tooth is lingering to cold and then suddenly stops hurting, after a period of time, it just means that the pulp has finally become necrotic or died. If you don't have a root canal then it will develop an abscess and start aching, throbbing, and swelling. Antibiotics will get rid of the swelling and pain, for a short period of time, but it cannot get rid of the underlying infection because the blood supply to the tooth is gone. The only way to get rid of the infection is to do a root canal or extract the tooth.

When is endodontic treatment necessary?

• Endodontic treatment is necessary when the pulp, the soft tissue inside the root canal, becomes inflamed or infected. The inflammation or infection can have a variety of causes: deep decay, repeated dental procedures on the tooth, or a crack or chip in the tooth. In addition, an injury to a tooth may cause pulp damage even if the tooth has no visible chips or cracks.

What sedation techniques are available?

• We mainly provide oral sedation with halcion or valium. These drugs work really well and are a cheaper alternative to nitrous. Sedation, in general, does not get rid of pain but will help relax a patient with dental anxiety. The only drawback is that it requires the patient to have a driver to take them to the appointment and back. If this is your first time visting Dr. Le, then the first appointment is usually a consultation to further discuss the patient's anxiety. It also allows Dr. Le to prescribe the oral sedation if desired.
   

Will I feel pain during or after the procedure?

• Most patients that have a root canal procedure performed are pleasantly surprised that the most uncomfortable part of the root canal is holding their mouth open for the duration of the procedure. Patients often say things like, "If I knew it was going to be that easy, I would have had it done a long time ago." Contrary to popular belief, modern techniques and anesthetics have made root canals relatively painless for a vast majority of patients.
  
  After treatment, your tooth may feel sensitive for a few days, especially if there was pain or infection before the procedure. This discomfort can be relieved with over-the-counter or prescription medications. Follow your endodontist’s instructions carefully.

Will the tooth need any special care or additional treatment after endodontic treatment?

• You should not chew or bite on the treated tooth until you have had it restored by your dentist. The unrestored tooth is susceptible to fracture, so you should see your dentist for a full restoration as soon as possible. This is because the access opening is usually filled with a temporary filling material called Cavit or IRM. It is only meant to be there for up to three weeks and needs to be removed by your general dentist. If it is not removed within 3 weeks, the root canal can fail due to leakage which is the number one cause of root canal failure. Otherwise, you need only to practice good oral hygiene including brushing, flossing, and regular checkups and cleanings.
  
  Most endodontically treated teeth last as long as other natural teeth. In a few cases, a tooth that has undergone endodontic treatment does not heal or the pain continues. Occasionally, the tooth may become painful or diseased months or even years after successful treatment. Often when this occurs, repeating the endodontic procedure can save the tooth.

Why do you use a rubber dam?

• The rubber dam is the most important step in the root canal because it will keep the tooth sterile or clean when the root canal is being treated. The high success rate that most endodontist can obtain is in large part related to the use of the rubber dam. The goal of the root canal is to remove and clean the pulp tissue. Without the rubber dam, bacteria can have access to the root canal tooth from saliva.
  
  A dental dam is a thin sheet of natural or synthetic latex (non-latex) laid across the open mouth during a root canal as a safety precaution. It provides the ability to concentrate on the tooth without interference from the patient’s tongue or cheek. The rubber dam also will eliminate frequent rinsing, as the saliva ejector can be securely placed under the dam. This avoids the many soggy cotton roll replacements during procedures. Additionally, this protective measure keeps harmful solutions and infected matter from falling down the throat or contaminating other teeth.

Why can't antibiotics get rid of my tooth infection?

• A typical tooth infection takes place on the inside of a tooth. The infection causes the tissue inside the tooth to die. When you take an antibiotic, it will circulate throughout your bloodstream. So if the tooth pulp is dead inside, the blood will not circulate there. This is why the antibiotic will not do much. Inappropriate use of antibiotics can actually promote the development of antibiotic resistant bacteria. These resistant bacteria increase the chances of your tooth infection spreading uncontrolled into your throat or brain. You don't want to delay the treatment of a tooth infection; it can result in very serious consequences

Where are you located?

• 1595 Grand Ave #105, San Marcos, CA 92078

  From Oceanside:
  Take 78 East and exit Rancho Santa Fe and turn right. At the second stoplight turn left onto Grand Avenue. Two blocks on the right side between Pawnee and Navajo, look for a one-story medical building. If you've reached Las Posas, then you went too far. Please arrive 10-15 minutes before your appointment time to fill out any necessary paperwork.
  
  From Escondido:
  Take 78 West and exit Rancho Santa Fe and turn left. At the third stoplight turn left onto Grand Avenue. Two blocks on the right side between Pawnee and Navajo, look for a one-story medical building. If you've reached Las Posas, then you went too far. Please arrive 10-15 minutes before your appointment time to fill out any necessary paperwork.

Are you contracted with my insurance?

• As a courtesy, our office staff will call your insurance and find out your co-pay before you come to your appointment. Please have patience since it takes time for us to call the insurance company. We can usually let you know the day before your appointment. If you need to know earlier, please let us know. There are many insurances and many plans within each one. Make sure you have specialty coverage if you have an HMO insurance, also any necessary referral forms.
  
  Insurance benefits quoted are always an estimate. The reason why it is an estimate is because there may be other claims out there that have not been recorded by your insurance yet. If you ever have any questions about your coverage, please call your insurance. Make sure you are being quoted for a specialist fee not the general dentist fee.
  
  If you desire a written quote from your insurance we need to pre-authorize for the treatment which takes a minimum of 2 weeks.

Do you take payments?

• Normally we do not take multiple payments since our office only sees you for that one appointment time. We try to make it convenient for our patients. We accept VISA, MC, Discover, AMEX, and care-credit. Care credit is a credit card that allows you to have a payment plan with up to 12 months interest free.

Why did my dentist refer me to a specialist? Can't my dentist do the root canal for me?

• Although general dentists can do root canals, a good dentist knows his own limitations and will refer you to a specialist if there are complications in your case. These might include calcified canals, curves, and long roots. Sometimes the infection may be too large for the dentist to handle. It is in your best interest that your dentist refers you out. There is no monetary advantage for your dentist to refer you to a specialist; they are simply looking out for your best interest. As an endodontist, Dr. Le is more well equipped to handle your tough root canal. He utilizes special tools that most general dentists do not have. The microscope is one of the most important pieces of equipment that he uses. It allows him to magnify the tooth so he can better locate the entire canal.

My tooth was not hurting until my dentist drilled on my tooth. Why is that?

• Anytime a dentist drills on a tooth, it can be traumatic to the pulp tissue. Depending on how deep the filling is, the nerve can start dying and start causing pain that same day. The amount of dental work you had on that tooth in your life time gets all added up to this point when the pulp starts to die. Crown preparation can be pretty traumatic to the nerve so if the tooth continues to hurt after it was drilled on, then get it evaluated for a root canal. Bacteria is the major cause of the tooth dying.

What are the signs a root canal is needed?

• If you have a tooth that is dying then sensitivity to cold will linger or you may have chewing pain that wakes you up at night. Heat is felt when the tooth nerve is almost dead and cold actually starts calming the nerve down. Eventually the pain goes away but it will get an abscess later on and start causing pain again. Just because the pain went away for a period of time, does not mean the tooth has healed. Always get a consultation because later on it will become abscessed and your symptoms will be aching, throbbing and swelling. The prognosis of a root canal is related to the size of the infection. The sooner you get the root canal done, the better the prognosis and the experience you will have.