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R. David Pagan D.M.D, P.C
4224 Plank Road
Fredericksburg, VA 22407


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Frequently Asked Questions

Why do I need endodontic treatment?

Sometimes the pulp inside your tooth becomes inflamed or infected. This can be caused by deep decay, repeated dental procedures on the tooth, a crack or chip in the tooth, or a blow to the tooth. Occasionally a healthy tooth is treated endodontically to facilitate the placement or improve the outcome of crown and bridgework.

What are the signs of needing endodontic treatment?

Signs to look for include pain, prolonged sensitivity to heat or cold, discoloration of the tooth, and swelling and tenderness in the nearby gums. But sometimes, there are no symptoms.

How does endodontic treatment save the tooth?

The endodontist removes the inflamed or infected pulp, carefully cleans and shapes the inside of the tooth, then fills and seals the space. Afterwards, you return to your general dentist or prosthodontist, who will place a crown or other restoration on the tooth to protect it and restore it to full function.

Will I feel pain during or after the procedure?

While many patients may be in great pain before seeing an endodontist, most report that the pain is relieved by the endodontist and that they are comfortable during the procedure. Our goal is for you to be as comfortable as possible – please let your endodontist know if you are experiencing discomfort. For the first few days after treatment, the tooth may feel sensitive, especially if there was pain or infection before the procedure. You may take over-the-counter pain pills if you experience discomfort, or your endodontist may give you a prescription medication. The endodontist will tell you how to care for your tooth at home.

What possible adverse effects could I experience after my treatment?

A few patients experience some discomfort and possibly swelling of the gums that lasts several days. Occasionally a “flare up” occurs, with pain and swelling, that may require incision and drainage. Joint pain and limited opening sometimes occurs due to your mouth being open during the relatively lengthy procedure.

Will the tooth need any special care?

You should not chew or bite on the treated tooth until you have had it restored by your general dentist because your tooth could fracture. This is why crowns are virtually mandatory on posterior teeth. Otherwise, just practice good oral hygiene - brushing, flossing and regular checkups and cleanings. Endodontically treated teeth can last for many years, even a lifetime.

What causes an endodontically treated tooth to need additional treatment?

Breakage of root canal instruments, or perforation through the side of the tooth, sometimes occurs during the procedure, which could necessitate surgery or extraction. Your tooth could fail to respond to the treatment, in which case additional treatment, surgery, or even extraction may be required. New trauma, deep decay, or a loose, cracked or broken filling can cause new infection in your tooth, which would necessitate retreatment. In some cases, your endodontist may discover very narrow or curved canals that could not be treated during the initial procedure, but are causing persistent disease and require treatment.

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