825 High Street
Worthington, OH 43085
Matthew S. Niemiec D.D.S, M.S.
Alexandra Smolik D.D.S, M.S.
Practice Limited to Endodontics

Frequently Asked Questions

Your dentist has decided that your tooth needs special care and has referred you to our office for treatment. As endodontists, Drs. Uhle and Niemiec have advanced training to save teeth with deep decay or cracks, abscessed teeth, and even teeth that have been traumatized. We can also diagnose oral and facial pain and perform surgical procedures when necessary. We are specialists in treating complicated cases such as teeth with narrow or blocked canals or unusual anatomy and use advanced technology, including the operating microscope, ultrasonics and digital imaging to help perform these special services. By referring you to our office, your dentist is showing a personal concern for the quality of your dental care.



What is an Endodontist?

An endodontist is a dentist with advanced training in treating the diseased or damaged pulp, or soft inner tissue, of you tooth. Endodontists spend at least two additional years after dental school training to become specialists in diagnosing and treating dental problems that originate inside your teeth. Endodontists limit their practices to the area of root canal diagnosis and treatment. They are specialists in treating complicated cases and also specialize in diagnosing and relieving oral pain and treating traumatic injuries to teeth.

What causes a tooth to need endodontic treatment (root canal)?

"Endo" is the Greek word for "inside" and "odont" is Greek for "tooth." Endodontic treatment treats the inside of the tooth. Inside the tooth, beneath the hard enamel and dentin, is a soft tissue called the pulp. The pulp contains blood vessels, nerves and connective tissue, and creates the surrounding hard tissues during tooth development. Endodontic therapy is necessary when the pulp of a tooth becomes inflamed or infected. The inflammation or infection can have a variety of causes: deep decay, repeated dental procedures on the tooth, or a crack, or a chip in the tooth. In addition a blow to a tooth may cause pulp damage even if the tooth has no visible chips or cracks. If an inflamed or infected pulp is left untreated it can cause pain or lead to an abscess. During treatment, we will remove the diseased pulp from inside the tooth, carefully clean and shape the root canal spaces and then seal the prepared canals with special filling materials.

What are the signs I may need endodontic treatment?

Signs of pulp damage include pain, prolonged sensitivity to heat or cold, swelling, gum tenderness, and discoloration of the tooth. Sometimes, there are no symptoms when a pulp degenerates and it may only be detected by a dental examination and x-rays.

How many appointments will my endodontic treatment take?

In these busy times, we understand your tight schedule. That's why we will complete most procedures in a single visit. During your examination, we will thoroughly explain all treatment options as well as answer any questions you might have. We will review your symptoms and digital x-ray with you and determine if treatment is needed. If endodontic therapy is needed, we will usually complete your procedure in one appointment if possible.

Will I have pain during or after this procedure?

With modern anesthetic techniques, people report having a root canal is as unremarkable as having a filling placed. We are experts in local anesthesia and will make sure your tooth is numb prior to starting any procedure. After treatment there may be some sensitivity or discomfort with your tooth for a few days. In addition your tooth may be tender to touch or bite on for 1-2 weeks. An appropriate over the counter analgesic (like Advil, Aspirin or Tylenol) is usually sufficient to help you through your discomfort. It is not unusual for your tooth to feel different for some time after the treatment is completed, however if you have severe pain or pressure please contact our office.

What do I need to do after my root canal is complete?

You should avoid biting or chewing anything hard on the treated tooth until the tooth is restored by your dentist. You will need to return to your general dentist for a permanent restoration or a crown. We like to see this happen within 30 days of your root canal to avoid loss of the temporary filling, bacterial leakage, reinfection or tooth fracture. An unrestored tooth can fracture so you should see your dentist as soon as possible to complete the treatment of your tooth following the root canal therapy. A complete report of your treatment and digital x-rays will be sent to your restorative dentist.

How long will my tooth last after endodontic treatment?

Although the pulp is removed, your tooth can survive because the tooth continues to be nourished by the surrounding tissues. With regular brushing and flossing, proper diet and periodic dental checkups your tooth should last a lifetime. While there is no guarantee, the success rate of endodontic procedures is very high. Most teeth are savable, however, if we feel that your tooth has a poor prognosis you will be informed of this at the time of the consultation. Occasionally an endodontically treated tooth may need an additional surgical procedure or have to be removed.

What are the alternatives to endodontic treatment?

Often the only other alternative is removal of the tooth. The extracted tooth must then be replaced with an implant, bridge or removable partial denture to restore chewing function and to prevent adjacent teeth from shifting. Because these options require extensive surgery or dental procedures on adjacent healthy teeth, they can be far more costly and time consuming than the endodontic procedure and restoration of the natural tooth. No matter how effective tooth replacements are, nothing is as good as your own natural tooth. You've probably already made an investment in saving your tooth. The payoff for choosing endodontic treatment could be a healthy, functioning natural tooth for many years to come.

What is endodontic retreatment?

With proper care, teeth that have had root canal treatment are over 90% successful and can last as long as other natural teeth. In some cases, however, a tooth that has received endodontic treatment fails to heal. Occasionally, the tooth becomes painful or diseased months or even years after successful treatment. If your tooth has not healed or has developed new problems, you have a second chance. Another procedure, endodontic retreatment, may be able to save your tooth. If you and Dr. Uhle or Niemiec choose retreatment, we will reopen your tooth to gain access to the root canal filling material. In many cases, complex restorative materials (crown, post and core material) must be disassembled and removed to permit access to the root canals. After removing the canal filling, we can clean the canals and carefully examine the inside of your tooth using a surgical microscope, searching for any additional canals or unusual anatomy that requires treatment. After cleaning the canals, they will be permanently filled and sealed and a temporary filling placed in the opening made in your tooth. If the canals are unusually narrow or blocked, endodontic surgery may be recommended.

When is surgical treatment needed?

If your endodontically treated tooth has not healed or has developed new problems, you have the option of another procedure called endodontic surgery or apicoectomy. If endodontic retreatment is not an option due to a canal obstruction or a post being present in the canal, then endodontic surgery should be considered. In this procedure, we open the gingival tissue near the tooth to examine the underlying bone and to remove any inflamed or infected tissue. The removal of the very end of the root is called an apicoectomy. After cleaning the root end, a small biocompatible filling called MTA is placed to seal the canals. Sutures are placed in the gingiva to help stabilize the tissue for proper healing. Over a period of months, the bone heals around the end of the root. Most patients return to work or other routine activities the next day.

What if I choose not to treat my tooth?

The inflamed pulp tissue inside the tooth will eventually break down and die. Once this happens, bacteria have access to the jaw bone and to your blood system. This leads to bone destruction, swelling or drainage from the gum. Once enough bone is destroyed the only treatment option would be to remove your tooth (see alternatives to endodontic treatment). An untreated infection has the potential for facial swelling, which can lead to life threatening situations of obstructed airway or brain abscess. Some studies suggest that untreated chronic jaw infections are linked to systemic health problems such as heart disease.

What new technologies are being used?

Click on Advanced Technology