Toothache
Introduction
Are you in pain? We will see you the same day you call for emergency pain relief! If you have a toothache without major swelling, there are two options: a temporary filling at the root level, which commits you to an endodontic (root canal) filling or extraction. Our office is committed to saving teeth, so only a tooth with serious gum infection, or decay or fracture at the gum line is considered for extraction.
Endodontic Treatment
Description
Endodontic treatment is the term for “root canal filling.” An inert filling material is placed from the top to the very end of the root to seal it from fluids around the bone which holds the tooth. Without this seal, there will be recurring infections, even if the canals were cleaned thoroughly. Routinely, a crown is be made over the tooth to prevent cracking.
Benefits
- Saving a tooth is always a better option than an extraction, implant, or bridge unless there is gum disease or decay at the bone level.
- There is a 95% success rate.
- With no more decay or gum disease, the tooth can last a lifetime.
Procedure
- We expose a radiograph (x-ray). Often, the bone damage at the end of the root can be seen. The infected tooth is shown in the first of the four illustrations.
- We numb your mouth using our distracting lip-shaking technique. If you are panicked about numbing, we offer nitrous oxide for relaxation. You’ll find out why it used to be called laughing gas! Or you can come in an hour early and take a couple of blue pills, feel wonderfully sleepy and dreamy, and not even remember what happened the next day!
- The root is accessed by opening a hole in the top of the tooth or crown.
- Wire files clean and enlarge the size of the canal.
- To be successful, the filling is condensed to the very end of the root. The filling is shown in brown.
Time
Front teeth and bicuspids require an hour to hour and a half. Molars take about two hours.
Cost of Root Canals
Fees are as follows: Front Teeth – $607. Bicuspids – $693. Molars – $930. You must also consider that most teeth require a crown following a root canal filling.
Extraction
Description
Extraction means removal of your tooth. Some patients I have know have said, “Pull it out,” “Take it out,” or “Take it off.”
Benefits
The only benefit is eliminating pain. Nevertheless, extractions may be the only solution. We only remove teeth if there is severe gum disease or decay at or below the bone level.
Procedure
- We numb your lip using our distracting lip-shaking technique. If you are panicked about numbing, we offer nitrous oxide for relaxation. You’ll find out why it used to be called laughing gas! Or you can come in an hour early and take a couple of blue pills, feel wonderfully sleepy and dreamy, and not even remember what happened the next day!
- We used specialized instrumentation to speed the process and improve outcome.
After Care
- You need to bite on gauze for half an hour to reduce bleeding.
- Take the medications prescribed for you.
- Don’t do sucking action with your mouth, like with a straw.
- Avoid rinsing vigorously.
- Don’t exercise hard for 2 days.
- Drink plenty of liquids, and eat as soon as it is comfortable to do so.
Complications
Bleeding
- It is normal to have a little oozing of blood. You will likely have some on your pillow the morning after.
- If bleeding is excessive, be sure you are placing pressure with gauze on the socket for 30 minutes at a time.
- A favorite remedy is to soak a tea bag in warm water and place on the socket, then bite down.
Pain
- Medications are only intended to take the severe edge off pain. Discomfort is normal.
- Prescribed narcotic drugs should not be taken more often than prescribed.
- You can add 800 mg of ibuprofen (4 tablets of Advil or other brand) every six hours in addition to narcotics.
- Using ice packs as described above to reduce swelling also reduces pain.
Time
It takes about a half hour to remove a single tooth.
Cost of Extractions
The fee for a simple extraction is $100. You should also consider replacing the space left by the extraction with bone grafting material to preserve the arch for a future implant, or improved maintenance and appearance of a bridge.
