Sat - By Appointment
July 15, 2016
If you’re about to have your first root canal treatment, you might be feeling pretty apprehensive about the whole thing, especially given all the stories floating around. Well, don’t worry — all will be revealed in this step-by-step walk-through of root canal treatment. Knowing what will happen ahead of time is more than half the battle; you will soon learn that it really is much ado about nothing.
So let’s start by dispelling a common myth: Root canal treatment doesn’t cause pain — it relieves it!
At The Root Of It All
Some background will be helpful. As you will note from the illustrations, a space inside the tooth called the pulp chamber houses the root canal system and pulp — the living tissue that keeps the tooth vital (alive). The pulp includes blood vessels, nerves and connective tissues, and, during childhood, creates the surrounding hard tissues of the tooth.
Endodontic treatment (“endo” – inside; “dont” – tooth), commonly known as root canal treatment, is needed when the pulp becomes inflamed or infected. The causes could be deep tooth decay, repeated dental procedures on one tooth (replacing a large filling, for example), or traumatic damage such as a crack, chip or even a root fracture. Gum disease can also give rise to root canal problems necessitating root canal treatment.
Any of these issues can result in acute inflammation of the pulp, which causes swelling and pressure inside the tooth (that has nowhere to go), leading to tooth pain and, eventually, irreversible damage to the pulp. Once the pulp dies, the pain may subside initially, sometimes to return as an acute (painful) infection spreading into the periapical tissues (“peri” – around; “apex” – end), particularly the bone. It could also become a chronic (long-standing) infection with symptoms ranging from mild to severe.
Generally speaking, whatever the cause of root canal or pulpal disease, root canal or endodontic treatment will be necessary to save the tooth. All dentists receive training in endodontic treatment and can perform root canal procedures, but often a general dentist will refer individuals who need endodontic treatment to an endodontist, a root canal specialist.
Endodontists are dentists who have completed an additional two or more years of advanced residency training in the diagnosis and management of diseases and disorders of the dental pulp, and in the diagnosis of dental pain; their focus is therefore on saving teeth. In order to make a proper assessment and accurate diagnosis of which tooth is affected and exactly what is causing the pain, a thorough history and examination is necessary, together with a radiographic picture (x-ray) of the tooth or area.
Your dentist or endodontist will check your medical history and current medications to ensure your health and treatment safety. If you are very nervous, an oral sedative or anti-anxiety medication may be helpful — discuss the options with your dentist or endodontist ahead of time.
Endodontic (Root Canal) Treatment, Step By Step
Preliminary treatment to remove the decay and the source of infection of the pulp is necessary, along with a determination of whether the lost tooth structure can be restored. If a fracture of the tooth has reached the pulp, or infection is associated with gum disease, it could be more difficult, if not impossible, to save the tooth.
RELATED Being prepared for oral surgery
The general sequence of a root canal procedure is as follows:
Local anesthesia is administered via injections to numb the tooth to be treated and the surrounding tissues. If the pulp in a tooth is acutely inflamed, and therefore very painful, it may take a while to get it numb, but your dentist will not start the treatment until it is.
A dental dam — a thin sheet of rubber or vinyl — will be placed over the affected and adjacent teeth. The tooth undergoing treatment protrudes through a hole punched in the dam, isolating it from the rest of the mouth. This allows the root canal treatment to be carried out in a sterile environment free from contamination by bacteria found in saliva or the rest of the mouth.
A small access hole is drilled through the biting surface of an affected back tooth or from behind a front tooth, allowing access to the pulp chamber and root canals for treatment.
The diseased and dead pulp tissue is removed from the tooth with specially designed instruments used to clean out the root canals and pulp chamber. This is not painful; the area is numb and the tissue being removed is either dead or dying. Once the pulp, along with the nerves contained in it, is removed, the tooth itself can no longer feel pain.
The canals are disinfected with antiseptic and antibacterial solutions.
The canals are then shaped with tiny flexible instruments to allow them to receive root canal fillings and sealers. The canals are washed and cleaned again to remove root canal debris prior to sealing them.
Root canal fillings are selected that will exactly fit into the freshly prepared canals. Usually a rubber-like material called gutta-percha is used to fill the canal space. It is a thermoplastic material (“thermo” – heat; “plastic” – to shape), which literally is heated and then compressed into and against the walls of the root canals to seal them. Together with adhesive cement called a sealer, the gutta-percha fills the prepared canal space. Sealing the canals is critically important to prevent them from becoming reinfected with bacteria.
A temporary or permanent filling material will then be placed to seal the access hole that was made to treat the canals, and the dental dam is removed. If the tooth lacks sufficient structure to hold a restoration (filling) in place, the dentist or endodontist may place a post (either metal or a very strong plastic) in one of the canals inside the tooth to help retain it.
After the procedure, an antibiotic may be prescribed to treat or prevent infection. Be sure to follow the instructions of your dentist or endodontist carefully. After-effects of treatment are minimal, generally lasting from a couple of days to about a week. It is normal to have some minor discomfort after treatment including slight soreness that can usually be managed with over-the-counter (aspirin, ibuprofen) medications or prescription (codeine-type) drugs, or a combination of the two.
Your tooth will need a permanent restoration — a filling or a crown — to replace lost tooth structure, and provide a complete seal to the top of the tooth. Your endodontist will send you back to your general dentist to determine which type of restoration is best for you. This step is of particular importance since many studies show that if the filled root canals are recontaminated with bacteria from the mouth, there could be a recurrence of infection around the tooth.
Knowledge Is Power
Almost like the root system of a plant, the root canals of a tooth have a main branch and many smaller side branches, and the whole system needs to be sealed during root canal treatment to be successful long term. Since root canals are very small spaces, they require a great deal of precision and care to treat well. Therefore, most endodontists today use state-of-the-art technology including digital (radiographic) imaging to diagnose root canal problems, and after treatment to verify that the canals are properly sealed; ultrasonic instrumentation to remove old canal fillings and posts and clean canals; and operating microscopes to accurately locate, visualize and seal root canal systems; it really is quite high-tech.
I have found that people who are nervous tend to lack information about endodontic (root canal) treatment; knowledge gives them the power to understand what’s to come and to eliminate their fears. I hope that this step-by-step explanation will alleviate any apprehension. Root canal treatment really does relieve pain, not cause it — and saves teeth.
RELATED Cavities and Tooth Decay
Share With Your Friends:
When I first found this office I was terrified of the dentist and I had constant anxiety when seeing dentists. Now I look forward to cleanings and my anxiety is...
Hayley Kaplan (Wellington, FL)
Dr. Gorbatov is an excellent dentist whose main priority is making sure his patients are comfortable and get the best dentistry he can offer. He provides an attentive service, and...
Natallia Harbacheuskaya (Hollywood, FL)
Great service Knowledgeable doctor Friendly staff 5+ stars!! Someone hacked into my account and gave false review. Not me!!! Outstanding service @ Dr Gorbatov Dentistry!!!!
Ellen Zlobinskiy (Hallandale Beach, FL)
Very impressed with Dr. Gorbatov's ethics. He truly cared about my situation, the fact that I was from another city and had limited time off of work to address my...
Tatiana Safonova (Sunny Isles Beach, FL)
Thank you doctor for my beautiful smile!
V V (Hollywood, FL)
The dentist fit me in last minute when my normal dentist was unavailable I tried them on the recommendation of a friend after I broke a veneer and had 3...
Mark Krawiec (Hollywood, FL)
Entire office & staff is very accommodating and attentive to all your needs. The dentist was very nice and professional and really took the time to explain to me everything...
Tiffany D. (Hollywood, FL)
Very good cleaning
Riley Purdy (West Palm Beach, FL)
Loved coming here, very nice Doctor and wonderful experience with a great cleaning. Receptionist is awesome too.
Lina Lobo (Greenacres, FL)
Jessica at the front has helped me tremendously and the Dr has made the large amount of work that I have had done painless
Celeste Clossin (Wellington, FL)
I have been going to this office now for the past 3 years. From Jessica working the front, to having my teeth cleaned, and both Drs. working on my teeth,...
Joanne Purdy (Wellington, FL)
I finally found a great dentist who does its all, root canals, caps, and implants. I needed major work on my mouth all at once, although it was expensive because...
Diane O’Brocki (Loxahatchee, FL)
Had a great experience with Dr.Gorbatov, he is really professional and doing great his job always with a smile)) Definitely recommending him
Tanya Kusiumova (Sunny Isles Beach, FL)
I always have a great experience when I come here, the staff is wonderful and I would not change my dental office for anything in the world.. Jessica is amazing...
Shiloh Robinson (Wellington, FL)
Very professional nice staff great service.
Thank you personally and from the bottom of my heart for the kindness and consideration you showed my mom, Catherine the other day! ?
Patrizia Rondelli (Hollywood, FL)
A Center for Dental Excellence is fantastic. They’re understanding and extremely competent. Not only is the dental care itself excellent, but their quality of caring about their patients is unparalleled....
Haylee J (Aberdeen, FL)
Benjamin R. (West Pam Beach, FL)
I was very fortunate to find Dr. Gorbatov right when I had a major issue with an old crown that fell off and led to a major infection just a...
Octavian Miron (Aventura, FL)
I had been looking for a dentist for a few months and I was referred to Dr. Gorbatov and I can certainly see why. I've always been a little skeptical...
Jazlyne Jimenez (Hallandale Beach, FL)
Well I’ve been going to Dr. Gorbatov since 1996.... Yes ! I’m a loyal. With all the dental issues I’ve had, he’s been able to resolve them and been keeping...
Burke Crump (Wellington, FL)
Love the staff and great service!!
Rebeca Saravia (Dania Beach, FL)
Dr. Gorbatov placed an implant for me, I am extremely happy with the result, I had absolutely no pain during the procedure after few month doctor put a crown, looks...
Sergey Kasatkin (Sunny Isles Beach, FL)
I would like say that this office is at the TOP of my list. The staff is awesome, it is very clean and you made at home as soon as...
Jazlyne Jimenez (Lake Worth, FL)
I had a procedure done by Dr. Gorbatov, it was amazing, I didn't feel anything, he has very gentle hands and techniques and I didn't even feel the shot! I...
Jessica Y Montero (West Palm Beach, FL)
Noel Reyes (Lake Worth, FL)
Everyone in the office is super amazingly fantastic! They're informative and understanding. Dr. Gorbatov has done great work on my teeth! The dental hygienist has been a charm, makes every...
John Kern (Hollywood, FL)
No teeth fell out mid cleaning. 10/10
Erik Purdy (West Palm Beach, FL)
The dentist is very friendly and gentle during procedures.
Sofie M (Sunny Isles Beach, FL)
Since me and my wife moved to Florida from Nj several years ago, we were looking for good dentist, the one we can trust. We tried a few but were...
Tatiana Lapushchik (Hollywood, FL)
Dr. Gorbatov was very thorough and went over all concerns I had (I'm not really a fan of the dentist). He is definitely the nicest Dentist I have ever been...
Sofia Rodriguez (Hallandale Beach, FL)
I have been with the dentist for a few years now and love the care I receive. You are taken care of from the front desk person, through your visit!...
Juan Rodriguez (Greenacres, FL)
For me, dental work always came with the presumption of pain and discomfort. That's why it was always very difficult to get any recommended work done, because all I'd have...
Iry T. (Hallandale Beach, FL)
I are retired dentist and visit dr Gorbatov,s office like a patien for dental works. We graduate the same school New York university and l can tell you the dr...
Shmuil Aronovich (Hallandale Beach, FL)
Excellent Service! Friendly, Clean and Prompt!
Deidre Reid-Thomas (West Palm Beach, FL)
Had an amazing experience. Staff was very caring and nice. They are very honest
Billie Selinsky (Wellington, FL)
Awesome service. Highly recommended
Iliana Gonzalez (Royal Palm Beach, FL)
Painless, professional and efficient. Dr Gorbatov is great!
Suzanne Wilt (West Palm Beach, FL)
The receptionist goes above and be on for the customers. Excellent service the doctor treats you with all his attention feels like I’m right at home and explain everything detailed....
Sophie Garcia (Royal Palm Beach, FL)
Fast service and the best staff! I highly recommend this Dentist. I've been going to this Dentist for 2 years and I travel far now just to come here. They...
Christine (Orlando, FL)
Absolutely amazing. Jess and Jessica at the front made me feel so comfortable and helped me conquer my fear of the dentist. The office is clean and welcoming I completely...
Hayley Kaplan (Wellington, FL)
Very happy with quick service, suggestions & prices. Will be a repeat customer
Jaclyn Franceschini (Fort Lauderdale, FL)
The atmosphere in this office is beyond believe, I instantly felt comfortable with Dr Dimitiri and his assistant Yuri. They work great together. I had 6 veneers put in and...
Ruslan Gahramanov (Sunny Isles Beach, FL)
S u p e r b ...Immaculate dentistry! I was impressed with a GREAT attention to details! His work is truly an ART and priceless! Everyone in the office is...
Gordana Skracic (Aventura, FL)
I went to the office to get teeth cleaning! The receptionist was overwhelmed with something, but she was the sweetest. My dental hygienist did great job, made sure I feel...
Elizaveta C. (Miami, FL)
Great staff I was nervous but they made me feel at ease. I am confident that they will give me the smile that I airways wanted. The receptionist personality is...
Uuggh uggh (West Palm Beach, FL)
I have been Dr. Gorbatov's patient for over 8 years and have always received excellent service. The facility and staff are wonderful. I would highly recommend A Center for Dental...
Teresita Camacho (Lake Worth, FL)
This is the Best Dental Office I ever was. Great personality, gentle touch and perfectionism in all aspects of cosmetic dentistry. Thank you Dr. Gorbatov for creating Smile I always...
Yuriy Gorobets (Hallandale Beach, FL)
Hello, Dr.Gorbatov is truly THE BEST ,so please just forget about all the rest! I truly witnessed MIRACLE IN MAKING!!! My sister now have a MOVIE STAR SMILE! Thank you...
Valnea Del Bianco (Hallandale Beach, FL)
This is the best dentist in the world who really cares about each and every patient and makes your smile look perfect! After visiting the new office you will be...
Kseniia Dursinova (Sunny Isles, FL)
I switched my dentist because i was dissatisfied with their service and decided to go to Dr.Gorbotov's office for my wisdom tooth extraction. I never thought I would see the...
Oleg Solovey (Sunny Isles, FL)
I've been looking for a good dentist since So. FL lacks them. Not anymore, great professional services, and best of all, you will find a personal touch. You will truly...
ML GG (Hollywood, FL)
This is IT!!!! As good as it gets!!! If you want a celebrity smile call his number.
Jacob F. (Miami)
I feel I have the best care possible under Dr. Gorbatov and his team. His work is top quality and because of him I know my teeth and the health...
Alex P. (Fort Lauderdale, FL)
From the minute I walked in the dr Gorbatov office till the and of my treatment I was pleasantly surprised with professionalism and care of Dr and his staff. I...
Anna (Hollywood, FL)
Been going here forever and they do an excellent job with all your dental needs and even with cosmetic dentistry as well!
Lauren Harris (Lake Worth, FL)
You are the best guys! You definitely make me smile more :) Thank you sooooo much! Olga Aksenova ❤️
Olga Axenova (Hallandale Beach, FL)
Love Dr. Gorbatov! He is skilled, professional, thorough, nice, and always keeps me comfortable. The assistants and office staff are great too. I highly recommend Dr. Gorbatov!
fannabl (Hallandale Beach, FL)
I had a great experience with Dr. Dmitry Gorbatov. He was able to save my tooth from getting a root canal. All the staff was really nice, and attentive. I...
Arthur R. (North Miami Beach, FL)
Excellent service , friendly & professional !!!
Mauricio Bonifacio (Sunny Isles, FL)
I recommend this place to anyone that needs any type of dental work done , I always feel welcome from the moment i sign in untill my visit is over...
Lyn F (Wellington, FL)
I have been going to Dr Gorbatov at A Center For Dental Excellence for many years now and their use of "Excellence" isn't just a marketing ploy and they definitely...
Lawrence F. (Lake Worth, FL)
I've been looking for a good dentist since So. FL lacks them. Not anymore, great professional services, and best of all, you will find a personal touch. You will truly...
ML GG (Aventura, FL)
Thank you Dr. Gorbatov for the great experience, your gentle touch and quality work you have done on my teeth. I have been very pleased with your professional, yet personable...
Irina D. (Port Orange, FL)
I have lived and worked all over North America. One of the greatest challenges of relocating is finding the best dental practice. "Center For Dental Excellence" was recommended to me...
Gregory Sutton (Wellington, FL)
Very helpful and amazing response time! Found them on Instagram and I'm happy I did!
Cece Esk (Hollywood, FL)
Very professional office. Good dentist.Clean dental office
Anna K. (Hollywood, FL)
First time here the staff and Dr were so informative and professional thank you for making my experience run so smooth ?
Evelyn Garcia (Greenacres, FL)
Wonderful facility and staff, very professional.
(Sunny Isles, FL)
Incredible how I was just taking my mother to her dentist appointment to me ending up becoming a patient, Jessica greeted me with such warmth and compassion and immediately noticed...
Aracelis Figueroa (Wellington, FL)
High-level professionals. Thank you, Dr. Gorbatov. I'm going to recommend your clinic to my friends. With best regards!
Vlad Shishko (Sunny Isles, FL)
I take my 90yr great grandmother to this office and they are so kind and she feels so loved here. Every visit she receives excellent service and quality work. Thank...
Farron Ann (Wellington, FL)
My experience was great.Doctor is very professional.I really recommend.The best place to go for your dental.
Olga Meverden (Sunny Isles Beach, FL)
I’ve been coming here for almost 10 years now and can surely say that the customer service provided is one of the best in town. Make sure to be nice...
Hype Kay (Royal Palm Beach, FL)
I know Dr. Gorbatov and use his service already for 15 years since we moved to Florida. He is an amazing doctor capable to do all types of dental and...
Eugenia Aulov-Volchek (Sunny Isles Beach, FL)
Dr. Gorbatov is an excellent dentist. I went to several other dentist and they all wanted to do a root canal, but Dr. Gorbatov was able to save my tooth....
Arthur Rubinovich (Sunny Isles, FL)
I want to say that I never write reviews. However I have to say that this dentist center is amazing! From the moment you enter you feel like family. Everyone...
Lisa Jerkins (Wellington, FL)
Dr. Gorbatov is an outstanding dental surgeon and professional in every sense of the word. He and his entire staff are wonderful--- by far the most knowledgeable and compassionate of...
Salt&Light (West Palm Beach, FL)
Good quality office, and dental work.
Igor Gonchar (Hallandale Beach, FL)
What a great experience at the dentist!! I wish I had found these guys years ago, maybe I wouldn't be so afraid of the dentist. Thought I needed a root...
Craig Balsam (Wellington, FL)
Very high professionalism, excellent atmosphere and responsiveness of employees have made this business one of the best. A well-functioning team led by one of the best professionals of the US...
Lili Ivanova (Sunny Isles Beach, FL)
I have been having a lot of issues with my teeth for quiet some time, including broken molars and bad procedures at other dental facilities. I came to Dr. Gorbatov...