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Keith G. Kanter, D.D.S., P.A.

 

General Information

What is an Endodontist?

An Endodontist is a dentist who has undergone a minimum of 2 years of extra postgraduate training. This Specialist training allows an Endodontist to:

(1)deal with diseases of the dental pulp and supporting structures.

(2)diagnose facial pain and related problems.

Your general dentist sometimes refers patients for consultation when the diagnosis is complicated or when treatment is more difficult than normal. Aside from providing treatment, Dr. Kanter's role is also that of educator. Either he or his staff will educate you of your choices in treatment, expected outcomes, and probable costs. We find that our happiest clients have had a consultation visit followed by treatment at a different appointment.
This allows you, the patient, to absorb the information and ask questions that you did not think of at the first visit. We strongly believe that "No one likes surprises" whether it is in the form of unexpected treatment outcomes or expenses you were not aware that exist in the overall treatment of your tooth.

What is Endodontics?

Endodontics is a specialty of Dentistry that deals with diseases of the dental pulp and its supporting structures. Endodontists are Dentists with special post-graduate training in this field. Endodontists are also experienced at finding the cause of oral and facial pain that has been difficult to diagnose. Although General Dentists can perform Endodontic treatment, patients are often referred to an Endodontist when the case is complicated or more difficult than usual.
In order to understand Endodontic treatment, it helps to know something about the anatomy of a tooth. Teeth have several layers. The outside layer of the tooth is composed of a hard layer called Enamel. Enamel is supported by an inner layer called Dentin, which has at its center a soft tissue known as the Pulp. The pulp contains blood vessels, nerves, and connective tissue that are responsible for forming the surrounding Dentin and Enamel during tooth development. The pulp receives its nourishment supply from vessels which enter the end of the root. Although the pulp is important during development of the tooth, it is NOT necessary for function of the tooth. The tooth continues to be nourished by the tissues surrounding it even after the pulp is removed. Please note, we do NOT remove the roots, only the soft tissue contents of the roots are removed.

In order to understand Endodontic treatment, it helps to know something about the anatomy of a tooth. Teeth have several layers. The outside layer of the tooth is composed of a hard layer called Enamel. Enamel is supported by an inner layer called Dentin, which has at its center a soft tissue known as the Pulp. The pulp contains blood vessels, nerves, and connective tissue that are responsible for forming the surrounding Dentin and Enamel during tooth development. The pulp receives its nourishment supply from vessels which enter the end of the root. Although the pulp is important during development of the tooth, it is not necessary for function of the tooth. The tooth continues to be nourished by the tissues surrounding it even after the pulp is removed.
Why would I need Endodontic treatment?

Endodontic treatment ("getting a root canal") is necessary when the pulp becomes inflamed or infected. The most common reasons for inflammation or infection are deep cavities (caries), repeated dental procedures, cracks or chips. Trauma can also cause inflammation and often shows up as discoloration of the tooth. If pulp inflammation or infection is left untreated, it can cause pain or lead to an abscess, which could result in loss of the tooth.

Signs and Symptoms

The most common symptom of a tooth that requires treatment is pain. Spontaneous pain, or pain induced by heat or cold are almost always signs that your nerve is dying or dead. Often times, an infected tooth will hurt following chewing on it.

Patients usually describe the pain as "lingering" and "deep". Due to the unique nerve structure of teeth, the pain is often referred to a different area or tooth. A complete exam is required for all cases, no matter how obvious the need may appear to be.
Finally, if the tooth died slowly, there may be no pain currently, and the only sign would be an abscess discovered on an X-Ray by your dentist.

How Can Endodontic Treatment help me?

Dr. Kanter will remove the inflammed or infected pulp. The empty space will be sterilized with different chemicals. He then shapes the canal system and then seals the prepared space with a rubber material called Gutta Percha. At this point, the permanent filling for the ROOT has been placed, but the chewing surface will only have a TEMPORARY placed inside it.
After treatment is completed, you will be instructed to return to your dentist for a permanent filling on the chewing surface of the tooth. The restoration of the tooth is a very important part of the overall treatment because it seals the cleaned canals from the oral environment. Your saliva contains bacteria, and if you do not seal the tooth, it will become re-infected. Insurance does not cover a retreatment if you did not follow up with a permanent restoration.

Will I feel pain during or after the procedure?

With todays anesthetics, and antibiotics, we can usually treat you in a painless manner. If you have anxiety, we often prescribe Valium prior to treatment. Patients often tell us that "getting a root canal was easier than a filling".
Following treatment, expect your tooth to be sore for several days. Treat it like a "sprained ankle". Chew on it if you have to, but try not to. The severity of pain following root canal treatment is usually directly related to the length of time you have been in pain PRIOR to treatment. Scientific studies show the most effective medicine used to treat this type of dental pain is with Advil (also called Ibuprofin or Motrin). Dr. Kanter or his staff will direct you to the appropriate medicine following treatment.