Specialty Services

Your dentist has decided that your tooth needs special care and has referred you to an endodontist. As an endodontist, Dr. Samyn has advanced training to save teeth with deep decay or cracks, abscessed teeth, and even teeth that have been traumatized. He can also diagnose oral and facial pain and perform surgical procedures when necessary. He is specialized in treating complicated cases such as teeth with narrow or blocked canals or unusual anatomy. Dr. Samyn uses advanced technology, including the operating microscope, ultrasonics and digital imaging to help perform these special services. By referring you to a specialist, your dentist is showing a personal concern for the quality of your dental care.

FAQs

What is an Endodontist?
An endodontist is a dentist with advanced training in treating the diseased or damaged pulp, or soft inner tissue, of you tooth. Endodontists spend at least two additional years after dental school training to become specialists in diagnosing and treating dental problems that originate inside your teeth. Endodontists limit their practices to the area of root canal diagnosis and treatment. They are specialized in treating complicated cases and also specialize in diagnosing and relieving oral pain and treating traumatic injuries to teeth.
What causes a tooth to need endodontic treatment (root canal)?
“Endo” is the Greek word for “inside” and “odont” is Greek for “tooth.” Endodontic treatment treats the inside of the tooth. Inside the tooth, beneath the hard enamel and dentin, is a soft tissue called the pulp. The pulp contains blood vessels, nerves and connective tissue, and creates the surrounding hard tissues during tooth development. Endodontic therapy is necessary when the pulp of a tooth 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 a chip in the tooth. In addition a blow to a tooth may cause pulp damage even if the tooth has no visible chips or cracks. If an inflamed or infected pulp is left untreated it can cause pain or lead to an abscess.
What are the signs I may need endodontic treatment?
Signs of pulp damage include pain, prolonged sensitivity to heat or cold, swelling, gum tenderness, and discoloration of the tooth. Sometimes, there are no symptoms when a pulp degenerates and it may only be detected by a dental examination and x-rays.
How many appointments will my endodontic treatment take?
In these busy times, we understand your tight schedule. That’s why Dr. Samyn will complete most procedures in a single visit. During your examination, Dr. Samyn will thoroughly explain all treatment options as well as answer any questions you might have. He will review your symptoms and digital x-ray with you and determine if treatment is needed. If endodontic therapy is needed, Dr. Samyn will usually complete your procedure in one appointment.
Will I have pain during or after this procedure?
With modern techniques people report having a root canal is as unremarkable as having a filling placed. Dr. Samyn will make sure your tooth is sleeping prior to starting any procedure. After treatment there may be some sensitivity of you tooth, usually with chewing, for a few days. An appropriate over the counter analgesic is usually sufficient to help you through your discomfort. It is not unusual for your tooth to feel different for sometime after the treatment is completed, however if you have severe pain or pressure please contact our office.
What do I need to do after my root canal is complete?
You should avoid biting or chewing anything hard in the treated area for the first few days. If your tooth requires a crown you should avoid chewing hard things until you see your general dentist. If a temporary filling was placed you will need to return to your general dentist for a permanent restoration, usually a crown. We like to see this happen within 30 days of your root canal to avoid loss of the temporary filling, bacterial leakage, reinfection or tooth fracture. An unrestored tooth can fracture so you should see your dentist as soon as possible to complete the treatment of your tooth following the root canal therapy.
How long will my tooth last after endodontic treatment?
Although the pulp is removed, your tooth can survive because the tooth continues to be nourished by the surrounding tissues. With regular brushing and flossing, proper diet and periodic dental checkups your tooth should last a lifetime. While there is no guarantee, the success rate of endodontic procedures is very high. Most teeth are savable, however, if Dr. Samyn feels that your tooth has a poor prognosis you will be informed of this at the time of the consultation. Occasionally an endodontically treated tooth may need an additional surgical procedure or have to be removed.
What are the alternatives to endodontic treatment?
Often the only other alternative is removal of the tooth. The extracted tooth must then be replaced with an implant, bridge or removable partial denture to restore chewing function and to prevent adjacent teeth from shifting. Because these options require extensive surgery or dental procedures on adjacent healthy teeth, they can be far more costly and time consuming than the endodontic procedure and restoration of the natural tooth. No matter how effective tooth replacements are, nothing is as good as your own natural tooth. You’ve probably already made an investment in saving your tooth. The payoff for choosing endodontic treatment could be a healthy, functioning natural tooth for many years to come.
What is endodontic retreatment?
With proper care, teeth that have had root canal treatment are over 90% successful and can last as long as other natural teeth. In some cases, however, a tooth that has received endodontic treatment fails to heal. Occasionally, the tooth becomes painful or diseased months or even years after successful treatment. If your tooth has not healed or has developed new problems, you have a second chance. Another procedure, endodontic retreatment, may be able to save your tooth. If you and Dr. Samyn choose retreatment, he will reopen your tooth to gain access to the root canal filling material. In many cases, complex restorative materials (crown, post and core material) must be disassembled and removed to permit access to the root canals. After removing the canal filling, Dr. Samyn can clean the canals and carefully examine the inside of your tooth using magnification and illumination, searching for any additional canals or unusual anatomy that requires treatment. After cleaning the canals, they will be filled and sealed and a temporary filling placed in the tooth. If the canals are unusually narrow or blocked, endodontic surgery may be recommended.
When is surgical treatment needed?
If your endodontically treated tooth has not healed or has developed new problems, you have the option of another procedure called endodontic surgery or apicoectomy. If endodontic retreatment is not an option due to a canal obstruction or a post being present in the canal, then endodontic surgery should be considered. In this procedure, Dr. Samyn opens the gingival tissue near the tooth to examine the underlying bone and to remove any inflamed or infected tissue. The removal of the very end of the root is called an apicoectomy. After cleaning the root end, a small biocompatible filling called MTA is placed to seal the canal. A few stitches or sutures are placed in the gingiva to help stabilize the tissue for proper healing. Over a period of months, the bone heals around the end of the root. Most patients return to work or other routine activities the next day.

Guide to Dental Symptoms

Symptom: Momentary sensitivity to hot or cold foods.
Possible problem: If this discomfort lasts only moments, sensitivity to hot and cold foods generally does not signal a serious problem. The sensitivity may be caused by a small decay, a loose filling or by minimal gum recession that exposes small areas of the root surface. What to do: Try using toothpastes made for sensitive teeth. Brush up and down with a soft brush; brushing sideways wears away exposed root surfaces. If this is unsuccessful, see your general dentist. If the sensitivity is coming from decay you should see your general dentist.
Symptom: Sensitivity to hot or cold foods after dental treatment.
Possible problem: Dental work may inflame the pulp inside the tooth causing temporary sensitivity.
What to do: Wait two to four weeks. If the pain persists or worsens, see your general dentist.
Symptom: Sharp pain when biting down on food.
Possible problem: There are several possible causes of this type of pain: decay, a loose filling or crack in the tooth. There may also be damage to the pulp tissue inside the tooth.
What to do: See a dentist for evaluation. If the problem is pulp tissue damage, your dentist may send you to an endodontist. Endodontists are dentists who specialize in pulp-related procedures. Your endodontist will perform a procedure that cleans out the damaged pulp and fills and seals the remaining space. This procedure is commonly called a “root canal.”
Symptom: Lingering pain after eating hot or cold foods.
Possible problem: This probably means the pulp has been damaged by deep decay or physical trauma.
What to do: See your dentist or endodontist to save the tooth with root canal treatment.
Symptom: Constant and severe pain and pressure, swelling of gum and sensitivity to touch.
Possible problem: A tooth may have become abscessed, causing an infection in the surrounding gingival tissue and bone.
What to do: See your endodontist for evaluation and treatment to relieve the pain and save the tooth.
Symptom: Dull ache and pressure in upper teeth and jaw.
Possible problem: The pain of a sinus headache is often felt in the face and teeth. Grinding of teeth, a condition known as bruxism, can also cause this type of ache.
What to do: For sinus headache, see your physician. For bruxism, consult your dentist. If pain is severe and chronic, see your endodontist for evaluation. Reference; AAE.org

Myths About Root Canal Treatment

There are many misconceptions surrounding root canal (endodontic) treatment. The American Association of Endodontists wants you to have accurate information. As always, when considering any medical procedure, you should get as much information as you can about all of your options. Your dentist or endodontist can answer many of your questions, and if you still have concerns, it is often wise to seek a second opinion.

Myth #1: Root canal treatment is painful.
Truth: Root canal treatment doesn't cause pain, it relieves it. Most patients see their dentist or endodontist when they have a severe toothache. The toothache can be caused by damaged tissues in the tooth. Root canal treatment removes this damaged tissue from the tooth, thereby relieving the pain you feel. The perception of root canals being painful began decades ago when root canal treatment was painful. But with the latest technologies and anesthetics, root canal treatment today is no more uncomfortable than having a filling placed. In fact, a recent survey showed that patients who have experienced root canal treatment are six times more likely to describe it as "painless" than patients who have not had root canal treatment. Thanks to modern techniques, things just aren’t like they used to be, and thank goodness for that!
Myth #2: Root canal treatment causes illness.
Truth: Root canal treatment is a safe and effective procedure. Research studies performed in the 1930s and 1940s and those conducted in later years showed no relationship between the presence of endodontically treated teeth and the presence of illness. Instead, researchers found that people with root canal fillings were no more likely to be ill than people without them. Over the past several years, however, a very small number of dentists and physicians have been claiming that teeth that have received root canal (endodontic) treatment contribute to the occurrence of illness and disease in the body. This claim is based on the outdated research performed by Dr. Weston Price from 1910-1930. His research stated that bacteria trapped in the teeth during root canal treatment can cause almost any type of disease, including arthritis, heart disease, kidney disease, and others. The presence of bacteria in teeth and mouth has been an accepted fact for many years. But presence of bacteria does not constitute "infection" and is not necessarily a threat to a person's health. Bacteria are present in the mouth and teeth at all times, even in teeth that have never had a cavity or other trauma. More recent attempts to copy the research of Dr. Price (and to check its accuracy) have been unsuccessful. Researchers now believe that the earlier findings may have been caused by poor sanitation and imprecise research techniques that were common in the early 1900s. These more recent studies support the truth we report today, that teeth that receive proper endodontic treatment do not cause illness.
Myth #3: A good alternative to root canal treatment is extraction (removing the tooth).
Truth: Saving your natural teeth, if possible, is usually the best option. Nothing can completely replace your natural tooth. An artificial tooth can sometimes cause you to avoid certain foods. Keeping your own teeth is important so that you can continue to enjoy the wide variety of foods necessary to maintain the proper nutrient balance in your diet. Endodontic treatment, along with appropriate restoration, is a cost-effective way to treat teeth with damaged pulp and is usually less expensive than extraction and placement of a bridge or an implant. Endodontic treatment also has a very high success rate. Many root canal treated teeth last a lifetime. Placement of a bridge or an implant will require significantly more time in treatment and may result in further procedures to adjacent teeth and supporting tissues. Millions of healthy endodontically treated teeth serve patients all over the world, years and years after treatment. Those healthy teeth are helping patients chew efficiently, maintain the natural appearance of their smiles and enhance their enjoyment of life. Through endodontic treatment, endodontists and dentists worldwide enable patients to keep their natural teeth for a lifetime. Reference AAE.org

What's inside a tooth?

From the outside, a tooth looks like a hard, solid substance. But this cut-away illustration reveals that a tooth is really a complex system of specialized tissues.

Enamel
The shiny, hard, white tissue covering the tooth is the strongest tissue in your body. It has to be! Your jaws place as much as 128 pounds of pressure on your teeth when you chew, bite, clench, or grind.
Dentin
This tissue makes up most of the body of the tooth. Even though dentin is hard and feels solid to the touch, it's actually microscopically porous and needs a covering of enamel or an artificial crown to protect it from decay-causing bacteria in your saliva.
Pulp
This soft tissue contains blood vessels, nerves, and connective tissue. The pulp provides nourishment for the tooth during growth and development. Once the tooth is mature, the pulp's only function is sensory. A fully developed tooth can survive without the pulp. If this tissue is damaged, your dentist or endodontist can remove it and save your tooth with endodontic (root canal) treatment.
Crown
This is the part of the tooth you can see above the gum line.
Root
This part of the tooth sits in the bone below the gum. Believe it or not, the root of your tooth is usually twice as long as the crown, the part you see above the gum line.
Bone
The roots of your teeth are anchored by bone. Healthy teeth stimulate and keep bone tissue healthy and vice versa.
Periodontal ligament
Like the springs that hold a trampoline to its frame, this tissue supports the tooth and holds it in place in the bony socket surrounding the tooth. This tissue cushions both the tooth and the surrounding bone against the shock of chewing and biting.
Gum
Dentists call this the "gingiva." It covers the bone surrounding your teeth. When you brush your teeth after meals and floss daily, you keep this tissue healthy. That's important, because gum disease can cause bone loss. Gum disease can also expose the tooth roots to decay. If root decay affects the pulp, you may need root canal treatment.

For more information about endodontics please visit the AAE.org and ADA.org websites.