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Tri-City Endodontics 604-492-3034

 

General Information

Common Questions

What is an Endodontist and what do they do?

Endodontists are dentists who specialize in saving teeth through endodontic therapy procedures or root canal treatment, involving the soft inner tissue of the teeth, called the pulp.  The word "endodontic" comes from "endo" meaning inside and "odont" meaning tooth.  Like many medical terms, it's Greek.  All dentists are trained in diagnosis and endodontic therapy, however, some teeth can be especially difficult to diagnose and treat.  That’s why you may have been referred to an endodontic specialist like Dr. Parhar.

In addition to dental school, Dr. Parhar studied at the Graduate Endodontics program at UBC for 3 additional years where he received advanced education in this kind of treatment. He studied root canal techniques and procedures in greater depth, for diagnosis and treatment of more difficult cases. In Canada to gain the title of a "Certified Specialist in Endodontics" it is required to complete the requirements of the Royal College of Dentists of Canada which includes graduation from an accredited specialty program as well as completion of a rigorous board exam process.  

As endodontic therapy or root canal treatment can be very complicated, many dentists choose to refer their patients to endodontists due to their advanced training and knowledge, as they are often more capable of managing such complicated cases with a better long term outcome.

If your dentist has referred you to Dr. Parhar, it is because they want the best for your oral health and tooth. The treatment was too complicated for them to complete successfully and your dentist wanted to make sure your tooth was treated properly to minimize the chances of any future problems. By having your tooth treated properly, it has the best chance of lasting as long as possible and remaining functional.  


I have X-rays from my Referring Doctor. Will I need additional X-rays, and will I be charged?
 
Radiographs or X-rays sent from your referring office are always appreciated. We will import these images into your patient file. New radiographs are required medico-legally, in order to make a proper diagnosis.  There is no additional cost for radiographs pertaining to one specific area of interest.  Additional radiographs for separate areas of interest are billed accordingly.
 
In addition to the regular x-rays, we may recommended a CBCT or 3D image to help with the diagnosis/treatment of your tooth. There is an additional fee for this imaging which is added to your consultation fee.  We will discuss this with you thoroughly before providing the 3D imaging for you.
 

What are the symptoms that my tooth needs a root canal treatment?
 
A tooth usually needs root canal treatment due to the nerve or pulp becoming infected by bacteria. The symptoms can be quite variable but there are some signs and symtpoms that may indicate that you should see your dentist.  Constant, acute, throbbing pain can be suggestive of need for root canal treatment. Sensitivity to heat and cold can also indicate signs of the start of infection, especially sensitivity to heat that lingers. Tenderness to biting and chewing is common.  Also, the presence of a bump or swelling on the gum can indicate that the infection is draining from a tooth.
 

My tooth doesn't hurt so why do I need a root canal treatment?
 
 In most cases a tooth develops symptoms due to infection of the pulp or nerve and the diagnosis of the need for a root canal treatment is straightforward. However, in some cases the tooth becomes infected and no symptoms develop. There is a chronic infection present but your body's immune system has been addressing the infection and keeping symptoms from arising. A balance has occurred between the infection and your body so no symptoms develop. The infection is first noted by an x-ray.  The x-rays may show a change in the bone around the tooth that is suggestive of an infection. When we examine the tooth, the tooth usually doesn't respond to testing such as responding to cold which confirms the diagnosis and need for root canal treatment to keep the tooth.

Can I expect to have pain during and following my root canal treatment?
 
This is a very common question that is asked by many patients that we see and a very valid one. No one likes have to endure pain.  More often than not the reason that a root canal is needed is that there is infection and associated pain. So when a patient comes in and has pain our goal is to get them out of pain.  In most cases, the local anesthetic we use will numb the area adequately so that there is no pain during the procedure. However, if there has been pain for a long period of time or there is an acute infection with an abscess, obtaining complete numbness can be difficult. The nerves do not respond as well to the anesthetic in these cases and the patient have some sensation during the procedure. Usually we can add more anesthesia by a different means and this can help. So generally, there is no pain during the procedure but there can be when there is an acute infection or there has been pain for a long period. The good thing is that if there is pain before the treatment, it is usually resolved very quickly and often gone by the next day.
 
After a root canal procedure, a patient may experience some pain after the procedure, or post-operative discomfort.  We typically will tell the patient that the tooth may be tender or sore for 2-3 days after treatment and this could last for up to a week. Usually, it improves daily.  The reason that there can be pain after the procedure is that during treatment, an inflammatory reaction or bruising may be caused around the end of the tooth and this can lead to some discomfort after the treatment.  In addition, if there has been an acute infection it takes time for your body's immune system to heal the area and there may be phase where the area is tender.  As healing takes place, the symptoms will resolve. Many of think that the tooth has the nerve removed now and why is there still pain.  However, when there has been an insult to a tooth such as an infection, it takes your body days and even weeks to fully resolve the symptoms.
 
In most cases we tell our patients to take 400mg Advil after the procedure and every 4 hours for the first 2-3 days and this will minimize any discomfort that they might experience.  If pain or symptoms persist for more than 4-6 weeks, it would be recommended to return to your dentist to have the area reassessed as the area may not be healing adequately. 

How long do root canals take?

Each case is unique, but an average root canal takes between one to two hours.  Also, multiple visits may be required to complete  a root canal as we want to make sure that your tooth is healing before we finish your treatment.


What is the recovery time involved with a root canal treatment?

The recovery time is very quick for most patients. Generally, you are able to function normally after treatment and often your pain is greatly improved after the procedure.  However, it is not unusual to experience some mild discomfort which may last a couple of days up to a week.  This will resolve over this time and over-the-counter analgeics such as Advil or Tylenol are helpful in managing any soreness or discomfort that you may have.


Do I need a crown or new crown after having a root canal treatment?
 
Whenever a tooth has treatment performed- a filling, root canal treatment, or a crown- the tooth is weakened as tooth structure is removed.  The key to a tooth surviving is the amount of tooth structure that it has to help resist the everyday stresses of the mouth.
 
Basically, the more you do to a tooth the weaker it becomes.  The common dogma is that after a tooth has had a root canal treatment, that a crown should be placed to "strengthen the tooth".
 
This is not entirely true but let me expand on this.  The teeth in the back of your mouth, the molars, get a great deal of stress daily from chewing, grinding etc. If these teeth require large fillings then this can further weaken the tooth. If a root canal treatment is required then more tooth structure will likely be removed to perform the procedure. Over time, with added treatment the amount of tooth structure is lessened and a crown is required to cover and strengthen the tooth. In addition,  it may minimize the chances  of the tooth fracturing.  So it is not just that a root canal treatment was performed but it is the overall loss of tooth structure that determines the need for a crown, along with where the tooth is located in the mouth.
 
In the case of teeth in the front of the mouth- incisors, canines and bicuspids- a root canal treatment may be required but if there is enough tooth structure then often a crown is not required and a filling may be sufficient.  These teeth are often relatively intact when a root canal treatment is needed. Also, the teeth in the front are exposed to less stresses than the molars.  However, if one of these teeth already has a very large filling then a crown will strengthen the tooth and restore the natural appearance and esthetics.   The concern is that if there is enough tooth structure, then by performing a crown you often have to cut away good tooth structure and this also will weaken the tooth so at times it can be counterproductive. This is a fine balance and needs to be considered as we want to keep the tooth as strong as possible.  

What are the alternatives to Endodontic treatment?

The only other option is extraction. If you decide that you do not want to proceed with endodontic treatment to save your tooth, you can have the tooth extracted. In the future, this tooth can be replaced with a bridge or implant supported crown.  However, If your tooth is deemed worth saving, then keeping the tooth via root canal treatment is usually the best and most cost-effective option.


Will I need to return to your office for follow-ups after the procedure is finished?

Yes, for most root canal treatments, we recommend that patients return to the office 1 year after the procedure was finished. This is to ensure that your tooth has healed and that there is no longer an infection present.  Our office will send a reminder notice to you when you are due for a recall appointment. This is a no charge visit.