Root Canal Treatment in Midtown Manhattan

Signs you may need a root canal

Root canal treatment is for a tooth whose pulp, the core of nerves and blood vessels inside it, can no longer heal. Common warning signs include:

• a throbbing toothache, or pain that wakes you at night
• sensitivity to hot or cold that lingers after the food or drink is gone
• pain when you bite down or chew on one tooth
• swollen or tender gum near a tooth, or a small pimple-like bump on the gum that may leak
• a tooth that has turned darker than its neighbors
• a deep cavity, a large old filling or a crack that reaches far into the tooth

Some infected teeth cause no pain and only show up on an X-ray. And not every sensitive tooth needs a root canal: a shallow cavity, gum recession or teeth grinding can cause similar symptoms, so we test the tooth before recommending anything.

The treatment suits a natural tooth that can still be restored. If a tooth is split down the root, broken far below the gum line or has lost most of its supporting bone, Dr. Avner will talk with you about removing and replacing it instead.

What root canal treatment is

Every tooth has a small hollow space in its center called the pulp chamber. It continues down each root as a narrow channel, the root canal. Front teeth usually have one canal, while molars have several.

During treatment, the inflamed or infected pulp is taken out, and the canals are cleaned, shaped and disinfected. They are then filled with gutta-percha, a flexible material made for root canals, and sealed. A fully developed tooth does not need its pulp to stay in place, because the bone and gum around the root keep supporting it.

Root canal treatment is part of general dentistry and one of the areas Dr. Avner focuses on. If your tooth has unusually complex roots or needs an old root canal redone, he will tell you whether he recommends an endodontist, a dentist who limits their work to root canals.

Benefits and what to expect

Saving a natural tooth keeps your own root in the jawbone, your normal bite and the look of your smile. You avoid a gap that could let nearby teeth drift, and you may not need an implant, bridge or partial denture in that spot. Removing the infected tissue also helps keep the infection from spreading.

Local anesthesia numbs the tooth and the gum around it, so you should feel pressure and vibration rather than sharp pain. If you feel anything sharp, tell us. We can pause and give you more anesthetic.

Afterward, the tooth may feel tender for a few days, especially when you bite, and over-the-counter pain relievers are usually enough. Until the final filling or crown is in place, chew on the other side and avoid hard or sticky foods.

Results vary. How long a treated tooth lasts depends on how much healthy structure is left, how soon it gets its final restoration, your bite, and how well you look after your teeth and gums. After the exam, Dr. Avner will give you a realistic view of the outlook for your tooth.

How a root canal works, step by step

1. Exam and X-rays. Dr. Avner looks at the tooth and takes X-rays to see the roots and the bone around them. Simple tests, such as tapping on the tooth or touching it with something cold, help show whether the pulp can recover.
2. Numbing. Local anesthesia numbs the tooth and nearby gum. We wait until the area is fully numb before starting.
3. Opening the tooth. Dr. Avner makes a small access hole through the chewing surface of a back tooth, or the inner side of a front tooth, to reach the pulp chamber.
4. Cleaning the canals. Fine instruments remove the pulp from the chamber and from each canal. The canals are shaped and rinsed with disinfecting solutions.
5. Filling and sealing. The clean, dry canals are packed with gutta-percha and a sealer, closing them off from bacteria.
6. Temporary filling. A temporary filling covers the access hole. If an infection needs more time to settle, medication may be placed inside the tooth and the treatment finished at a second visit.
7. Final restoration. The tooth then needs a final filling or a dental crown. Back teeth often need a crown to protect them from heavy chewing forces. We have an on-site dental laboratory, which we use for restorations such as crowns.