It seems that our schedules continue to get busier these days and are full of activities that need to be accomplished, particularly this time of year. If you are dealing with the challenge of an infected or injured tooth, you may wonder if you really have to schedule a dental appointment to place a permanent crown over a tooth that’s been treated with a root canal. There’s so much else to do!

You may ask,“Can’t I wait until early next year to schedule my crown appointment?” The short answer to that question is NO. Here are a few reasons why you should schedule your follow up appointment to receive your crown within one to three weeks after your root canal.

Reasons Why You Should Not Delay Getting A Crown After Root Canal Treatment

1. A longer wait means a longer period of being extra careful. Many of the instructions you receive after your root canal – especially the ones related to eating soft, bland foods – are designed to protect the temporary crown. If you wait longer to get a crown, you will have to continue that regimen.
2. Until a final restoration (crown) is placed, your tooth remains at risk of further damage. A root canal-treated tooth can be more brittle after the procedure, and a permanent crown is needed to prevent future damage.
3. Your tooth may suffer extra sensitivity without a crown. Some teeth treated by root canals can become more sensitive to heat or cold. Permanent crowns reduce this effect.
4. The longer you wait, the more likely you are to have the temporary crown fall out. Your temporary crown is not secured to your tooth in the same way a permanent crown is. If it falls off, the chances that you will experience increased pain or reinfection can skyrocket, as can cost. Such situations often result in unplanned emergency trips to the dentist.
5. A permanent crown gives your natural tooth the best shot at long-term survival. A study published in the May 2020 Journal of Endodontics reported that natural teeth treated with a permanent crown restoration have a survival rate of more than 90 percent over nine years. The extra layer of outer protection provided by the crown safeguards the interior protection offered by the root canal.

“Having a root canal is the first step to rescuing a compromised natural tooth,” says Dr. Susan L. Wood, who practices with the Phoenix Endodontic Group. “Having a permanent crown placed over that tooth within one to three weeks ensures a much higher level of certainty that your tooth repair will last a lifetime.”

If you’ve been referred to a Phoenix endodontist and have never seen one before, you might wonder what services they provide. Endodontics is recognized as an official specialty field for dentists by the American Dental Association. Endodontists attend two to three years of additional training after graduating from dental school. During their post-graduate training, they receive instruction in advanced microsurgical techniques and learn the latest in effective pain management methods.

Here’s a quick look at the types of procedures Phoenix Endodontic Group performs as part of their mission to save natural teeth whenever possible.

Procedures Performed By Phoenix Endodontists

1. Root canals and root canal retreatments. Root canals are frequently how patients first meet an endodontist. The procedure preserves natural teeth by cleaning infection out of a tooth’s root canal, and replacing the nerve pulp inside of a tooth with biocompatible material. A crown is placed over the treated tooth to protect it. Root canal retreatments can fix things that go wrong with an initial root canal, such as new decay entering the tooth or the tooth being further fractured.
2. Endodontic surgeries. Root canals, which are a non-surgical procedure, are typically very effective at treating a tooth threatened by infection or structural damage. Some cases require more intensive treatment. An apicoectomy is a surgery that treats damaged root surfaces or persistent infections in the bone surrounding the tooth. Recovery time for endodontic surgeries, just as for root canals, is usually brief. Postoperative discomfort is usually mild and easily remedied.
3. Dental trauma treatment. Your Phoenix endodontist can help save a damaged tooth, but you must act quickly. Regardless of the level of damage to a tooth – from a small chip or crack to a tooth that’s been knocked out of your mouth – you need a full examination of your teeth and gums to determine the next steps to be taken. An endodontist has equipment, dental training, and experience to preserve a damaged tooth; they can determine if a root canal or another procedure is the best one to protect and preserve the structure of your tooth.
4. Dental implants. More and more Phoenix endodontists are providing dental implant services for patients. The reasoning? All dentists receive training related to dental implants in dental school, with many endodontists receiving additional training in the placement of implants, as well. Endodontists are uniquely positioned to determine if a natural tooth can be saved. If a tooth cannot be saved, your endodontist can play a key role in the replacement of it.

“Phoenix Endodontic Group endodontists work closely with general dentists from across the Valley of the Sun to provide the best treatment results for all our patients,” says Dr. Susan L. Wood, of the Phoenix Endodontic Group. “Together, we can diagnose, collaborate, and treat dental challenges, so each patient experiences the most positive outcome for their case.”

While persistent pain is a common sign that a tooth is in trouble and may need root canal treatment, it isn’t the only indicator. If your tooth doesn’t hurt but you have other symptoms, you shouldn’t ignore the problem until it DOES.

To understand why pain should not be your only indicator to check with your endodontist to see if you need a root canal, let’s look at how dental professionals assess a potential root canal case.

You May Need A Root Canal – Whether You’re In Pain Or Not!

When you go to the endodontist to be evaluated for a root canal, they will take x-rays of your teeth, as well as examine your mouth and gums carefully, performing tests to determine if your tooth’s nerve pulp is damaged. They will ask you questions about symptoms you may be experiencing. Some conditions that will definitely get their attention include:

1. Swollen gums. Often, waste products from a tooth with dying or dead pulp will build up near the affected tooth, causing tenderness and swelling in your gums. The swelling doesn’t have to be constant to be of concern.
2. Gum boils. This term refers to a small pimple-like pocket of pus that can form on the gum near the affected tooth. If the boil drains into your mouth, you may experience an unpleasant taste in your mouth or bad breath.
3. An individually darkened or discolored tooth. A tooth that is noticeably darker than those around it can signal that the tooth has experienced some sort of trauma or damage. While not every darkened tooth needs a root canal treatment, discoloration frequently prompts investigation to clarify what is going on inside the roots of the tooth.
4. Tooth mobility. If an individual tooth feels loose, your endodontist will want to evaluate the cause. A loose tooth can be caused by acidic waste products from an infection softening the bone around that tooth’s root.
5. A chip or crack in the tooth. Even if it isn’t causing pain yet, chips and cracks in the enamel of a tooth can let in infection, allowing damage to the nerve pulp that can only be treated with a root canal.

“Tooth pain can indicate a variety of dental conditions best treated with prompt intervention,” says Dr. Susan L. Wood, who practices with the Phoenix Endodontic Group. “However, pain is not the only or even sometimes the most reliable signal that something needs attention. Your endodontist has the equipment and the experience to evaluate your symptoms and discuss whether a root canal or another type of procedure is needed to return your mouth and gums to full health.”

For many years, comedians have regularly used the term “root canal” to capture any painful experience. The jokes weren’t funny to anyone who actually needed a root canal – fear of pain was sometimes enough to keep them from getting badly needed care.

Today’s root canals, though,  have advanced dramatically in terms of technique and technology from 20 or even 10 years ago. In many cases, a root canal now relieves dental pain, instead of intensifying it.

Your endodontist is trained in pain management for root canals and other procedures that involve the roots and nerve pulp of your teeth. The amount of discomfort you experience during and after a root canal will vary with your individual circumstances, but here are some of the most common factors that can impact your pain level.

What Factors Influence Root Canal Pain?

1. The amount of infection in or damage to the tooth prior to the procedure. Root canals are performed on teeth with infected, inflamed, or damaged tooth pulp. One common symptom of tooth pulp damage is persistent tooth pain. If your tooth is badly infected before your root canal, it can also be more sensitive afterward.
2. How you use pain relievers after your root canal. Some tenderness and sensitivity is expected after the procedure. Your endodontist can provide guidance on when to take over-the-counter pain relievers and what kind of dosing schedule to maintain until the pain is no longer a distraction.
3. How closely you listen to and follow post-procedure instructions from your endodontist. After your root canal, you will want to avoid chewing with the affected tooth until it has received a permanent dental restoration (typically a crown). You will also want to choose soft, cool foods like applesauce or yogurt to eat for the first few days. Hard, hot, or crunchy foods increase the likelihood you will feel sensitivity or pain when you eat.
4. How quickly you report any severe post-procedure pain. It’s imperative you call your endodontist right away if you experience sharp or severe pain after your root canal; this can indicate that infection has returned. You will need to be seen to assess the situation, and your endodontist can plan additional pain and infection management steps.

“Today’s root canals rarely involve severe pain,” says Dr. Susan L. Wood, who practices at the Phoenix Endodontic Group. “Your endodontist is your partner in managing discomfort after a root canal and is the first person you should call if that pain becomes severe.”

While more and more Americans are becoming aware of the benefits of preserving natural teeth, you may still find yourself with a number of questions and no little anxiety when a root canal is the suggested option for saving a diseased or damaged tooth. Root canals can be an intricate procedure, depending on the extent of the damage to the tooth. Occasionally, sedation is called for. However, most of the time, patients are awake during the procedure and fully aware of each step the endodontist is taking. Each case is different, though, so let’s look at the issue a little more broadly.

How Endodontists Manage Pain And Patient Awareness During Root Canals

• For most root canals, local anesthesia is used to numb the area around the affected tooth. This is a necessary step because your endodontist will be removing pulp and nerve fibers from your tooth. You will likely be fully awake during the entire procedure. Your mouth, including your lips, may feel numb for several hours after the procedure, so it is important to be careful if you eat or drink before full feeling returns to the numbed area. Be sure to follow your endodontist’s guidelines for eating and drinking, though.
• For patients with dental anxiety or dental phobia, some level of sedation may be necessary for the root canal to be a success. Sedation can range from minimal (just to take the edge off your jitters) to deep (where you may be barely conscious, but able to be awakened). It can be delivered by inhalation, orally, or intravenously. General anesthesia – during which you are completely unconscious – is rarely used for root canals and requires special training to safely administer.

Dr. Susan L. Wood, of the Phoenix Endodontic Group, encourages patients to discuss questions related to wakefulness and anxiety with their endodontist during the planning stages of their root canal. “In our practice, we make sure all our patients are fully informed and arrive ready for their root canal,” she says. “We can discuss your individual needs prior to beginning the procedure and offer solutions that will help you feel comfortable, safe, and pain-free.”

Root canals are often the treatment of choice when you develop a serious infection involving your natural tooth’s pulp, or if your tooth has been chipped, cracked, or otherwise damaged. However, while root canals have a high success rate and a high patient satisfaction rate, not every root canal ends up being a permanent solution.

The factors that initially bring a patient to the endodontist influence whether their tooth can be saved by a root canal. Here is a short list of conditions that can make saving a tooth with a root canal treatment more challenging.

Factors That Can Interfere With Saving Natural Teeth With Root Canals

1. Teeth with long or unusually curved roots. Endodontists use special tools and seal the roots. If a patient’s canals are hard to clean, it may be less likely that the treatment will be permanently successful.

2. A crack in the tooth root. Even though teeth treated with a root canal are protected above the gum line with a restoration such as a crown, if the root itself develops a crack, infection can re-enter the tooth.

3. Advanced periodontal disease. Your gums play an integral role in your oral health and if you have severe or recurrent gum disease, saving your natural tooth through a root canal is far less likely to be successful.

4. Previous root canal treatment of the tooth. There are ways to treat a tooth if the original root canal fails, such as a retreatment or an apicoectomy. However, the success rates for additional procedures are not as high as for a first-time root canal treatment.

“Although root canal treatment often provides a lifelong solution for a damaged or infected natural tooth, it isn’t the best choice for every patient,” says Dr. Susan L. Wood, an endodontist who practices with the Phoenix Endodontic Group. “Our staff can perform a thorough examination and advise you on your best treatment options.”