FAQs
Educational Information
Today’s patient is very sophisticated, and we know you appreciate any further information we can offer you. This is why we have gathered answers to your most frequent questions.
We hope that this will clarify some terminology and bring information to you.
To view an answer, please click on the question. When you are done, click on the question again.
GENERAL INFORMATION
The word “Endodontic” has its root in ancient Greek. “Endo” means inside, and “Odont” means tooth. Every word starting with “Endodont” is related to treating the inside of the tooth, also called pulp.
An Endodontist is a specialist in root canals and other endodontic procedures. An endodontist is a dentist that performs exclusively endodontic services which brings him/her a very extensive knowledge and experience. The practice of an endodontist is specially equipped. All endodontists have two or more years of advanced training in endodontics. They specialize in performing routine as well as very complex cases.
The pulp is a soft tissue that contains nerves, blood vessels, and connective tissue. This is why most people refer to it as “nerve.” The pulp can become inflamed or infected. Some reasons are deep decay, an injury such as a crack or chip, and periodontal (gum) disease.
CLINICAL INFORMATION
When endodontic treatment is needed, you will have certain symptoms that we will describe below. Your general dentist can also detect the necessity of such a procedure when examining or x-raying your dentition. In some cases, there will even be an absence of discomfort. Should you feel any, don’t hesitate to get in touch with us so we can recommend over-the-counter medications until you come to be treated and permanently relieved.
The information we provide you in this chart is for educational purposes only. Your specific symptoms may require different actions. It should not be a substitute for professional medical and dental attention, diagnosis, and treatment. Please schedule a consultation if you have any of the following symptoms:
- Coming and going sensitivity to hot or cold foods
- Sensitivity to hot or cold foods lasting two to four weeks after a dental procedure
- Sharp or chronic pain or pressure felt in teeth, jaw, neck, eye, ear, and head
- Severe pain when chewing and biting
- Sensitivity that remains after eating hot or cold foods
- Swollen gums that release pus or blood when pressed
- Dull ache and pressure in upper teeth and jaw
- One of your teeth is more sensitive than others
- Sensitivity or pain when tapping on a tooth from the outside
The main reasons for retreatment are the following:
If you do not proceed with the necessary restoration, your tooth can need further treatment. At times, the restoration may let bacteria filter into the canals.
Sometimes, your tooth gets re-infected because of new trauma, a deep or new decay, or a loose, cracked, or broken filling or crown that lets bacteria through.
When a treated tooth is fractured, bacteria can infect it.
Also, the endodontist can find and treat very narrow, blocked (calcified) or curved canals not treated or that went undetected during the first procedure.
The main reasons for surgery are the following:
Sometimes, it helps the endodontist refine its diagnosis when there are persisting symptoms, but X-rays do not show any problem. The causes can be a very small fracture or an invisible new canal.
In other cases, a calcified (blocked) canal can be reachable only through the root’s end for cleaning and shaping. The treatment of damaged roots or surrounding bone requires surgery.
Finally, a tooth can fail to heal for no apparent reason, and the surgery will help cure it.
The most common surgery is the apicoectomy. Dr. Sayman also performs frequently two other types of surgery. The intentional replantation, which consists in extracting the tooth to treat it more efficiently and then replace in its socket. The other is separating a tooth in two to treat it.
The faster you get to your dentist, the higher the chance to save your tooth and relieve you from pain, as a cracked tooth usually hurts. The crack will never heal, but thanks to an endodontic procedure and crown placement, most teeth will function normally and last for years.
Clenching, grinding, and chewing on hard surfaces cause cracks in your teeth.
There are different types of cracks:
Most injuries occur to children, but adults can also suffer some in car accidents or sports mishaps. The fastest you get to your dentist, the highest the chance to save your tooth. Its condition will also affect the outcome. In children, the teeth are not mature yet. The root end also called the apex, is still open. To save the tooth, apexogenesis or apexification will be necessary.
Different types of injuries exist:
Emergency recommendations for knocked out tooth:
When you handle the tooth, touch it only by the usually visible part of it
If dirty, rinse it with water only and nothing else, do not scrub it or dry it
If possible put it back in place (socket) in your mouth and otherwise put it in milk or lightly salted water or if possible in your mouth, close to your cheek. Please be careful not to swallow it.
Do not wrap it in anything
Go to a dentist or endodontist in the next 30 min. if possible
Before leaving our office, we will give you a list of recommendations and explain them to you if you wish.
If you need narcotic medication and/or antibiotics, Dr. Sayman will write you a prescription before you leave his office. Please remember that those might make you drowsy, and you should be cautious when driving or operating dangerous machinery.
We will give you our post-hour phone number so you can reach Dr. Sayman to keep him updated at any time.
- You should not eat until the numbness in your mouth disappears. This will prevent you from inadvertently biting your cheek or tongue.
- You should not chew too much on the side where your treated tooth is for a few days and keep from chewing on the tooth itself until your dentist completes your restoration.
- Do brush and floss your teeth as usual.
- Should your tooth throbs, please keep your head elevated, even when you lie down, and do not perform strenuous activity. Please do contact us if you have any questions at 305 604 8876.
- Should your tooth be tender, we recommend you take a non-steroidal anti-inflammatory medication such as Ibuprofen (Advil or Motrin) for 2 to 5 days. In case you cannot take these, please take extra-strength Tylenol. Please take all your prescribed medication as directed by Dr. Sayman.
- Please do contact us if you have any questions at 305 604 8876.
- A mouth rinse with warm water can be relieving also. Rinse your mouth over a period of 15 minutes using water as hot as you can stand. You should repeat this operation three times a day. Another alternative is to sip a nice tea or infusion slowly but sugarless.
Some after-care tips specific to surgery:
- To prevent sutures from tearing, please do not lift or pull on your lips.
- To reduce the swelling, please place an ice pack (provided by Dr. Sayman) on the side where your treated tooth is. You can hold it on and off every 15 minutes after the surgery is done and repeat this operation the following 5-6 hours during the first day only. If swelling persists for more than 7 days, please call us at 305 604 8876.
- Please avoid chewing too hard on the treated area.
- Do not rinse your mouth the first day. On the second day, you will rinse your mouth with an antibacterial solution prescribed by Dr. Sayman.
- Because you can not brush only the treated area, Dr. Sayman will show you how to keep the area clean.
Insurance companies are complex to understand, and we try to clarify here for you some terms and procedures.
UCR is the amount insurance companies calculate and are willing to pay for a particular procedure regardless of the endodontist’s fees. There is no standard fee or accepted method for calculating the UCR.
Sometimes, your benefit is different from what you expected because:
- You have already used part or all of the benefits available to you for a determined year.
- Your plan covers only a percentage of your endodontist’s fees (1)
- Your plan does not cover the treatment you need (2)
- Your deductible isn’t met yet.
- The end of your waiting period isn’t reached yet, and you are not eligible for coverage.
- A mouth rinse with warm water can be relieving also. Rinse your mouth over a period of 15 minutes using water as hot as you can stand. You should repeat this operation three times a day. Another alternative is to sip a nice tea or infusion slowly but sugarless.
(1) Your insurance will reimburse the portion that they cover. They will calculate your coverage based on your plan’s UCR and other elements. The exact amount they cover will be exactly known at the time their check is received. They will send you an Explanation Of Benefits (EOB) that will detail everything. If you do not agree with them, you can appeal their decision, and we will assist you by providing you with a pre-established letter upon request.
(2) Dr. Sayman recommends a treatment because it is necessary to maintain good dental health. It would be unethical of him to jeopardize your health for financial reasons. Unfortunately, some employers or insurances do not include this consideration when planning for your coverage, and a needed treatment may not be covered. Employers subscribe to dental insurance for you to supplement the cost of care. Therefore, dental benefit plans offer only a method to help pay for your treatment. These insurances seldom cover the full amount charged for therapy.
Dr. Sayman accepts patients with insurance, and we will gladly file your claim for you. We will do the work for you, so you have a smooth and relaxing experience all along. Through experience, we have learned that dental staff must use their time to focus on treatment only. This is why to provide you with quality time and the best care as well as the lowest costs.
GENERAL INFORMATION
Dr. Sayman and his Staff do the following to protect you:
- They wash their hands and put on single-use gloves before seeing each patient
- They sterilize and disinfect all re-usable instruments and handpieces
- They frequently discard reusable instruments
- They dispose of needles and other sharp items in special containers
- They clean and disinfect all treatment surfaces and equipment between patients
- They cover surfaces and equipment with disposable protective coverings when possible
- They wear protective masks, eyewear, and overgarments
- They provide the patient with protective glasses and protect the patient’s mouth with a rubber dam
- They test sterilization equipment regularly for effectiveness
- They use the most modern and effective equipment available
- Dr. Sayman keeps updating himself about new techniques
- The time necessary depends on the procedure type and the case’s complexity (tooth involved, accessibility, number of teeth to cure.) It ranges from under one hour to two hours. Most procedures, including surgeries, can be finished in one session. Our receptionist will let you know when you call for an appointment.
A preliminary but utterly important consultation will be your first contact with Dr. Sayman. He will start with a comprehensive examination during which he will review your dental and medical history, screen your mouth for oral cancer and do a detailed intraoral clinical evaluation. He will take digital x-rays from different angles to thoroughly observe your tooth and its surrounding tissues. He will perform additional tests (hot, cold, biting, and percussion) and evaluate all existing endodontic procedures. Finally, if necessary, he will ask you questions and answer yours. After that, he will make his diagnosis. If therapy is needed, he will explain your recommended treatment plan and options, if any. Then our receptionist will explain to you in detail his fees.
- After your treatment, a free follow-up appointment will be given you. For surgeries, you will have one or two more visits. The first visit removes the sutures, and the second reevaluates your healing process.
Dr. Sayman will explain to you in understandable words what he will do and show you drawings so you can visualize what he is referring to.
Dr. Sayman and his Staff will do everything possible to make you feel relaxed. This helps a lot in having a comfortable procedure. On the day you are scheduled, try to avoid unpleasant situations and put on clothes where you feel totally at ease. On the other hand, using anesthetics and modern techniques will help you feel virtually nothing, even during the application of the anesthesia. It is quite frequent for Dr. Sayman to have his patients fall asleep during their therapy!!
The rubber dam is a thin sheet of latex that isolates your tooth and is essential for two main reasons. First, it ensures a sterile area where the tooth is treated and prevents infection by oral bacteria that may not already be present in the canal. Second, endodontists work with tiny files that can fall in your throat and go further. To recover one of those would mean to undergo a surgical procedure, which is otherwise unnecessary.
Dr. Sayman will use files to perform your treatment. They are used by hand and or mechanically, depending on the situation. While cleaning and giving shape to your canals, some irrigants are used. Their function is to disinfect the pulpal chamber. Then your canals will be sealed with an ADA-approved product called Gutta Percha. It is a natural product coming from trees. It has the appearance of a rubber. A sealant or adhesive cement will be combined with Gutta Percha to ensure a tight seal. Finally, a temporary filling will be placed to close the top of the tooth.
A calcified canal is a canal where calcium has deposited itself and has blocked the canal.
The endodontist will remove the damaged pulp and place medication into the root. This will help grow hard tissue near the root end. This new hard tissue will protect the permanent filling once done. Because this tooth will be especially fragile, it is very important to have a restoration done as soon as needed to ensure the success of this procedure.
Before leaving our office, we will give you a list of recommendations and explain them if you wish.
If you need narcotic medication and/or antibiotics, Dr. Sayman will write you a prescription before you leave his office. Please remember that those might make you drowsy, and you should be cautious when driving or operating dangerous machinery. We will give you our post-hour phone number so you can reach Dr. Sayman to keep him updated at any time.
- You should not eat until the numbness in your mouth disappears. This will prevent you from inadvertently biting your cheek or tongue.
- You should not chew too much on the side where your treated tooth is for a few days and keep from chewing on the tooth itself until your dentist completes your restoration.
- Do brush and floss your teeth as usual.
- Should your tooth throbs, please keep your head elevated, even when you lie down, and do not perform strenuous activity. Please do contact us if you have any questions at 305 604 8876.
- Should your tooth be tender, we recommend you take a non-steroidal anti-inflammatory medication such as Ibuprofen or Advil for at least three to five days. In case you cannot take these, please take extra-strength Tylenol. ?Please take all your prescribed medication as directed. Please do contact us if you have any questions at 305 604 8876.
A mouth rinse with warm water can be relieving also. Rinse your mouth over a period of 15 minutes using water as hot as you can stand. You should repeat this operation three times a day. Another alternative is to sip a nice tea or infusion slowly but sugarless.
Some after-care tips specific to surgery:
- Please do not lift or pull on your lips to prevent sutures from tearing.
- To reduce the swelling, please place an ice pack on the side where your treated tooth is. You can hold it there for 15 minutes and repeat this operation several times during the first day only. ?If swelling persists, please call us at 305 604 8876.
- Please avoid chewing too hard and any food that can lodge itself in between the suture points.
- Please rinse your mouth with warm water and avoid using other mouthwash for a couple of days after surgery.
- Do brush your teeth but gently in the area treated.
One of our priorities is that you feel highly comfortable. Of course, your body has undergone a procedure and has a normal way to deal with it and start its natural healing process.
You can expect to have some slight bleeding, minor swelling, and some tenderness, if any.
Your tooth may feel a little different from your other teeth for a few days, which is normal.
We make every effort to cure you and have you feel comfortable. As we deal with the human body, sometimes things are different than customary. You should then get in touch with us.
Please find following the main reasons why you should contact us, and please feel free to call us with any other questions you might have at 305 604 8876.
- If you have a visible swelling inside or outside of your mouth
- If you have a temperature
- If you are experiencing an allergic reaction to any medication
- If you have any severe discomfort right after treatment or after even a few days
- If your filling has come out
- If you have excessive bleeding
Your mouth will feel numb for a few hours after your treatment. In the meantime, try to have only liquids and avoid eating as much as possible so you won’t bite yourself.
You should avoid chewing on that tooth until you get your final restoration. In any case, you should avoid chewing too much on that side during the first few days.
Most patients return to their usual routine or work after treatment. If you can postpone some strenuous activity for a few days, it is highly recommended to do so. If you undergo surgery, you can usually drive yourself home. Please check with Dr. Sayman before doing so. Dr. Sayman will let you know what applies in your specific case.
The “nerve” of your tooth extends from the crown (visible part of the tooth) to the tip of the roots where it connects to some surrounding tissues. The pulp (nerve) is essential during your tooth’s growth and development. When your tooth has finished growing, it can survive without its internal pulp as the surrounding tissues at the tip of the roots nourish it. This is why your tooth still feels alive. As strange as it may sound, even with just roots remaining, you still have a tooth, and it is still considered “alive.”
The treated tooth may get re-infected by bacteria and will need additional endodontic treatment.
If you chew on that tooth, it is likely that a fracture will occur, which will result in additional endodontic treatment or the extraction of the cracked tooth.
Most likely, your condition will worsen and cause pain or lead to an abscess. The then-needed procedure will be more complex and expensive, not in your health or financial best interest.
If you do not proceed with the necessary restoration, your tooth can need further treatment. At times, the restoration may let bacteria leak into the canals. Sometimes, your tooth gets re-infected because of new trauma, new decay, a loose, cracked, broken filling, or crown that lets bacteria contaminate the canal. When a treated tooth is fractured, bacteria can infect it. Also, the endodontist can find and treat very narrow, blocked (calcified) or curved canals not treated or that went undetected during the first procedure.
A tooth, though looking like porcelain, is a live body, just like your arm. A good parallel can be set between an arm and a tooth. You wouldn’t amputate your arm if it weren’t necessary, and if necessary, you would try to save as much arm as possible. The same assumption is true for your tooth.
An extraction is a dentist’s last resort for two main reasons. First of all, it is always better to save a natural tooth. Second, after extracting, you need to replace the missing tooth with an implant, bridge, or removable partial denture to restore your chewing function and prevent adjacent teeth from shifting or upper or lower tooth from moving outward. By doing so, you often have to undergo another surgery or dental procedures on adjacent healthy teeth. Of course, sometimes, it is the only option for you.