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Endodontists specialize in saving natural teeth, which is why an endodontic practice should be your first call after a traumatic dental injury. While accidents or sports-related trauma are common causes of these dental injuries, they can also be the result of biting into something hard, teeth grinding during sleep, or an oral habit like chewing ice. A traumatic dental injury can be something as minor as a chipped tooth or as serious as a tooth that has been completely knocked out.

Regardless of how serious your injury is, it is important to see an endodontist as soon as possible for an evaluation. After any initial or follow-up examinations, treatment will be tailored to the type of dental trauma you have suffered and the severity of your injury.

Traumatic dental injuries include:

Teeth That Have Been Dislodged (Luxated)

A tooth may be pushed sideways, out of, or up into its socket as a result of a traumatic dental injury. In such cases, your tooth will be repositioned and stabilized by your endodontist or general dentist. If irreversible damage to the nerve, root, or blood vessels is discovered, a root canal procedure will likely be recommended to avoid tooth discoloration or abscess. This should be scheduled as soon as possible after the initial dental trauma.

Since their permanent teeth are still developing, children aged 12 and under may need special management and treatment. Your child’s endodontist will keep a close eye on the healing process and intervene promptly if any concerning changes occur. A number of follow-up visits may be needed in such situations.

Teeth That Have Been Knocked Out (Avulsed)

See an endodontist or dentist right away if one of your teeth is knocked out of the socket completely. Timely care is critical; if you get treated right away, your endodontist might be able to save your tooth.

When a tooth becomes avulsed or knocked out, place it back in the socket immediately and call an endodontist. If you are unable to reposition the tooth in the socket, put it in a cup of milk and bring it to our office. Do not try to clean the tooth by scrubbing or wiping it clean. To prevent additional tooth damage, avoid touching the root surface. 

Your endodontist will inspect the tooth, replace it in its socket, and evaluate you for any other dental and facial injuries. For the next few weeks, a stabilizing splint may be used to secure your tooth in place while the periodontal tissue heals around it. Root canal treatment can begin a week or two later, depending on the stage of root development. Proper pre-operative care and prompt endodontic treatment means there is a good chance your tooth can be saved.

Teeth That Are Fractured or Chipped

If your tooth has been chipped or fractured, it can usually be restored with a dental crown or other type of restoration from a general dentist or prosthodontist. That said, if a large portion of your tooth has been broken off due to trauma, a root canal will be needed if the pulp is exposed or damaged. Traumatic dental injuries may also result in several teeth being affected, even if they appear intact upon visual inspection. When you see an endodontist for your care, they will use advanced equipment to examine adjacent teeth to ensure that they have not suffered any injuries.

Schedule a Consultation for a Traumatic Dental Injury

We take the time to carefully analyze all of a patient’s potential risk factors at North Shore & Brookline Endodontics. To determine the best course of treatment, we use 3D imaging CBCT scans and clinical microscopic examinations, as appropriate.

If you have experienced a traumatic dental injury, contact us today to schedule an appointment for emergency endodontic care at one of our six North Shore & Boston-area locations.

When your dentist gives you a referral to North Shore & Brookline Endodontics, it’s because you require treatment from a dental professional with specialized training in root canal therapy or other procedures that save a compromised tooth. This referral doesn’t mean your general dentist is no longer providing your dental care; instead, it’s the beginning of a close collaboration between your dentist and our team at NSBENDO.

Why Your Dentist Referred You for Endodontic Care

While some general dentists perform root canals as part of their dental services, others refer all patients in need of root canals to endodontists. Even if your dentist does provide root canals, they may have referred you to our office because you have a complex case. While you might not have expected to be referred to another practice for your dental care, you can feel confident knowing that you’re in the best possible hands for your treatment, as endodontists specialize in saving natural teeth.

Endodontists receive advanced training and education in endodontics after earning their degrees in dentistry. Once they complete their training, their practice focuses solely on endodontic treatment, giving them a level of knowledge and experience unmatched by general dentists, who must provide a wide range of services. Our expertise allows us to work more efficiently, with greater precision, and our specialization means we can more easily accommodate patients who need immediate care.

Endodontic practices also have advanced technology that general dentists don’t typically have access to. These include state-of-the-art microscopes that provide a better view during treatment, fiber optics, CBCT, and ultrasonic tools. This technology yields better treatment results and a more comfortable patient experience.

How Your Endodontist and Dentist Work Together

Your dentist may refer you to NSBENDO for a root canal, endodontic retreatment, endodontic surgery, traumatic dental injury, or diagnosing unexplained dental pain. While we will receive information from your dentist with your referral, we will also conduct our own assessment and take any imaging that is needed.

If you are referred to our practice for a root canal, we will perform your endodontic treatment at NSBENDO, then send a full report of your procedure via mail or email to your general dentist. After your root canal, you will need to return to your dentist within 1 to 2 weeks to have a permanent restoration placed in order to restore your tooth structure. Failing to do so may result in re-infection of the root canal or the loss of your tooth.

Although your dentist will identify any issues with your restoration during your regular biannual oral evaluation appointments, we will also schedule an appointment with you a year from your treatment date to evaluate the outcome of your root canal and ensure that no further endodontic care is needed.

Learn More About Endodontic Treatment

If you have questions about coordinating care between your general dentist and NSBENDO, contact us today at one of our six North Shore and Boston-area locations and one of our team members will be happy to provide assistance.

Root canals are incredibly common, but are often feared. Modern dentistry ensures that a root canal is nearly pain-free, but myths and misunderstandings are rampant. Knowing what to expect from root canal treatment can ease your mind and help you relax as you await an upcoming root canal.

What Is a Root Canal?

To perform a root canal, the dentist first ensures that the tooth is completely numb. The next step is to create a small opening down through the tooth into its root chamber, exposing the canals. The canals are then thoroughly cleaned, smoothed, and reshaped. A post may be placed if necessary to support the tooth, and the canals are filled with a biocompatible sealing material. Finally, a temporary filling is created to protect the tooth while a crown is made.

Why Are Root Canals Performed?

A root canal can often save a tooth that would otherwise need to be extracted. Trauma and tooth decay are the most common reasons for a tooth’s pulp tissue to become infected, necessitating a root canal.

Some teeth that need root canals show no symptoms, but this is relatively rare. More often, you will experience such symptoms as swelling in the gums, severe pain when chewing, temperature sensitivity in the tooth, or tooth discoloration.

If the tooth is left untreated, it may become abscessed. Abscesses can cause severe pain and swelling, and leakage of blood or pus from the gum tissue. Eventually, an abscess can cause more damage, grow around the bone, and even lead to systemic infection.

Are Root Canals Painful?

Modern root canals are no more painful than any other dental work. In fact, since a tooth that needs a root canal can feel excruciating, many patients feel significantly better right away. If you do experience any pain or discomfort during the procedure, tell your dentist immediately, as you will need additional numbing medication.

What Should I Expect Afterward?

After the numbing medication wears off, it is common to feel some mild discomfort. This can be relieved by a mild, over the counter painkiller. The tooth may be sensitive to temperature extremes and chewing forces for a few days, so it is best to avoid chewing directly on it until this subsides. Of course, if you experience pain at any time, it is best to call your dentist immediately. Most people feel entirely normal in just two to three days.

Are Root Canals Risky?

Root canals are considered very safe, but there is a slight risk of complications from any medical or dental procedures. The most common, though still very rare, risk is re-infection. This could happen if your dentist missed any infected canals, or if the sealing material breaks down over time. If you experience any pain or symptoms of infection, call your dentist right away.

What Should I Expect Long-Term?

The overall effectiveness rate of root canals is around 95%, and many teeth never need further treatment. While waiting for your permanent crown, it is best to avoid biting or chewing directly on the tooth. After your crown is placed, though, the tooth will look and function just like any other. With proper oral hygiene and regular dentist visits, you are unlikely to have any further problems.

What Are the Alternatives to a Root Canal?

The only alternative to a root canal is extraction, after which the tooth can be replaced with a dental implant, a bridge, or a partial denture. These are excellent solutions for teeth that cannot be saved, but ultimately nothing is as good as your own natural tooth. If your tooth can be saved with a root canal, it is highly recommended.

North Shore & Brookline Endodontics is a specialty dental practice limited to endodontic therapy, with six clinics in the greater Boston area. Our mission is to use our knowledge and experience in root canal therapy to save teeth that would otherwise be lost. If you are searching for a skilled, compassionate endodontist in greater Boston, call the closest office today to learn how we can help.

Position on new Delta Dental DMIC:

We wish to inform dentists with whom we have a referral relationship that we have chosen to not participate in the new for profit Delta Dental, DMIC (DSM Massachusetts Insurance Company, Inc).  We have made this decision independently and with no collaboration with any other parties.

The purpose of this email is to clearly state how we believe this action affects patients with Delta Dental Service of Massachusetts insurance coverage.

We believe it has no effect on any patient who now has Delta Dental Insurance. We are under contract with Delta Dental Service of Massachusetts and have been for years.  Those contracts are continuing.

The proposed new DMIC PPO plan has yet to be approved and yet to be sold to employers. There are currently no patients who have this plan.

Therefore, we wish to emphasize to the dentists who trust their patients to our care for Endodontics that they can continue to refer their patients with Delta Insurance to our practice with confidence as we will continue to honor our contract to provide services to them.

Should you have an comments or questions about this, please contact our practice manager, Michele Whitley, or one of our doctors directly.  We are happy to discuss this decision with you.

Michele Whitley, (978) 532-4125,

The Doctors of NSBENDO

For information provided by DD of MA, please click this link: Delta Dental Follow-up Letter, 01/10/2017