What’s the difference between an endodontist and a general dentist?

All endodontists are dentists, but there are real differences worth knowing about. Endodontists complete 2–3 extra years of residency after dental school, and that entire time is spent focused on root canal treatment and diagnosing tooth pain.

Experience is another big difference. Endodontists perform around 25 root canals per week on average, while general dentists do about 2 per week. That kind of focused repetition means faster treatment, more efficiency, and real expertise when something unusual comes up.

We also use equipment that most general dental offices simply don’t have: dental operating microscopes that magnify up to 25×, 3D CBCT imaging, and advanced cleaning systems like GentleWave. When it comes to tricky cases—teeth with unusual anatomy, calcified canals, failed root canals, or pain that’s hard to pin down—that’s exactly what our training prepared us for.

Your general dentist might refer you to us for complex situations, or you can come to us directly for any root canal. Either way works.

What is a root canal, and why might I need one?

A root canal is a procedure to remove infected or inflamed tissue from inside your tooth, clean and disinfect the space thoroughly, and then seal it up so the tooth doesn’t have to be extracted.

Every tooth has soft tissue inside called the pulp. It contains blood vessels, nerves, and connective tissue, and it sits beneath the hard enamel and dentin layers. When bacteria get into this pulp—usually through deep decay, a crack, or trauma—it causes infection that can be incredibly painful and lead to an abscess.

Once your adult teeth are fully developed, the pulp has already done its main job. Your tooth can survive perfectly well without it because the surrounding tissues continue to nourish it. So when we remove infected pulp, we’re eliminating the pain and infection while letting you keep your natural tooth.

You typically need a root canal when bacteria have invaded the pulp through deep cavities, cracks or chips, repeated dental work on the same tooth, or trauma (sometimes even when there’s no visible damage).

What are the signs I might need a root canal?

The most common signs include:

• Severe pain when you chew or bite down
• Sensitivity to hot or cold that lingers after the source is gone
• Swollen or tender gums near a particular tooth
• A small pimple on your gums (a fistula) that may drain pus
• Darkening or discoloration of the tooth
• A chipped or cracked tooth
• Deep decay that shows up as a dark spot

Some teeth that need root canal treatment show no symptoms at all. This is exactly why regular dental checkups matter. We can catch problems before they start causing pain. And if you do have symptoms, don’t put off getting evaluated; waiting too long can sometimes mean losing the tooth entirely.

Does a root canal hurt?

This is far and away the most common question we get, and the honest answer surprises most people: modern root canal treatment feels about the same as getting a regular filling.

The reputation root canals have for being painful comes from decades ago, before we had today’s anesthesia and technology. These days, most patients stay comfortable through the whole thing. Research from the AAE shows that patients who choose root canal treatment are six times more likely to describe it as painless compared to patients who choose extraction instead.

Here’s what’s really going on: root canal treatment relieves pain. It doesn’t cause it. The discomfort people associate with root canals actually comes from the infection that made the procedure necessary in the first place. Once we remove that infected tissue, you feel better.

We’re trained specifically in pain management and use advanced anesthesia techniques to make sure you’re completely numb, even if you usually have trouble getting numb at the dentist. And if you’re anxious, we have options to help you relax too.

What sedation options are available for anxious patients?

Dental anxiety is completely real, and we take it seriously. We have several options depending on what you need:

• Local anesthesia – standard for every procedure. We numb just the area we’re working on. You stay awake and aware but don’t feel pain, and you can drive yourself home afterward.
• Nitrous oxide (laughing gas) – a mild sedative you breathe through a mask. It helps you relax while staying conscious, and the effects wear off quickly once we stop it.
• Oral sedation – a prescription medication you take before your appointment for deeper relaxation. You’ll need someone to drive you home afterward.
• IV sedation – for severe anxiety or particularly complex cases. It’s administered through an IV and provides deeper sedation, though you’re still responsive.

If anxiety has been keeping you from getting dental care, please tell us. We’ve helped plenty of nervous patients get through treatment comfortably.

What should I expect during the root canal procedure?

The process is straightforward. We start by examining your tooth and taking X-rays or 3D CBCT images so we understand exactly what we’re working with anatomically. Then we numb the area thoroughly with local anesthetic.

Once you’re numb, we place a small protective sheet called a dental dam around the tooth. This keeps everything clean and dry while we work. We make a small opening in the crown of the tooth to access the inside, then use tiny instruments along with advanced technology like our GentleWave system to remove all the pulp tissue and thoroughly clean and disinfect the entire root canal system.

After cleaning, we fill the canals with a biocompatible material called gutta-percha and seal everything with adhesive cement. Finally, we place a temporary filling to close the opening until you can get back to your general dentist for a permanent crown.

Most procedures take somewhere between 60 and 90 minutes and can be finished in a single appointment. Molars and other complex cases with multiple canals sometimes need a second visit, but that’s not typical.

What can I expect after root canal treatment?

Right after treatment, your mouth will be numb for 2–4 hours. Avoid eating until that wears off. It’s surprisingly easy to bite your cheek or tongue without realizing it.

Over the first few days, some tenderness or sensitivity is normal, especially if you had pain or infection before the procedure. Over-the-counter pain medication like ibuprofen or acetaminophen usually handles it well. A good tip: take an anti-inflammatory medication before the numbness wears off for the best relief.

Most people recover within 2–3 days and can go back to work or school the same day as treatment. Full tissue healing takes a few weeks. Long-term, your tooth might feel a little different from your other teeth for a while, but you should be able to chew normally without any pain.

Call us if you experience severe pain that medication doesn’t help, pain that gets worse after the first few days, visible swelling inside or outside your mouth, fever, your temporary filling falling out, or your original symptoms coming back.

What should I eat after a root canal?

For the first 24 hours, stick with soft foods at lukewarm temperatures. Smoothies, protein shakes, yogurt, soup (not too hot), applesauce, and mashed potatoes all work well.

For the next few days, keep things soft—scrambled eggs, oatmeal, pasta, and well-cooked vegetables are good choices. Stay away from hard foods like nuts and ice, sticky foods like caramel and gum, crunchy foods like chips and raw vegetables, anything very hot or cold, and acidic or spicy foods until you’ve healed up.

A few practical tips: wait about 30–45 minutes for the temporary filling to harden before you eat anything, wait until the numbness is gone (usually 2–3 hours) so you don’t accidentally bite yourself, and chew on the opposite side of your mouth until you get your permanent crown placed.

How successful are root canals?

Root canal treatment has an excellent track record, with success rates between 90–95%. Long-term studies show that 97% of treated teeth are still going strong at 10 years, 85% make it to 20 years, and 81% last 30 years or more.

More than 15 million root canals are performed successfully in the U.S. every year. With proper care (getting your crown placed promptly, keeping up with oral hygiene, and regular dental visits) many root-canal-treated teeth last a lifetime.

The factors that matter most for long-term success are: the quality of the crown, good oral-hygiene habits, regular checkups, and wearing a night guard if you grind your teeth.

What types of cracked teeth can be treated, and which require extraction?

Not all cracks are the same, and understanding the differences matters:

• Craze lines – tiny superficial cracks that only affect the enamel. They’re extremely common, don’t hurt, and don’t need treatment.
• Fractured cusp – a piece of the chewing surface breaks off, usually around an existing filling. It rarely affects the pulp; treatment is typically a new filling or crown.
• Cracked tooth – the crack extends from the chewing surface down toward the root. Early treatment is critical. If we catch it before it goes below the gum line, the tooth can usually be saved with a root canal and crown. If it extends below the gum line, extraction is typically the only option.
• Split tooth – essentially a cracked tooth that never received treatment and has now separated into distinct segments. Usually the whole tooth can’t be saved, though sometimes we can salvage a portion.
• Vertical root fracture – starts in the root and may extend toward the crown. These usually require extraction, though occasionally surgery can save the tooth.

Unlike bones, cracked teeth can’t heal themselves. But treatment can relieve pain and stop the crack from getting worse. With early diagnosis and proper treatment, most cracked teeth keep working well for years.

What is a vertical root fracture, and why is it serious?

A vertical root fracture is a crack that starts in the root of your tooth and may extend up toward the crown. It’s a serious problem for several reasons.

It’s actually the third most common reason for extracting teeth that have had root canal treatment. The fracture creates an opening for bacteria to get in, which causes infection and bone loss. Symptoms are often minimal, so it can be hard to catch early, and if it goes untreated, the surrounding bone can erode significantly.

You might notice pain when chewing, localized swelling, a small pimple on the gums that drains, or a deep narrow pocket between the tooth and gum. Diagnosing these fractures often requires advanced imaging like CBCT and examination under a microscope; regular X-rays may not show them at all.

Unfortunately, extraction is usually necessary because there’s no way to seal the fracture and bacteria will keep causing infection. In some cases with multi-rooted teeth, we may be able to remove just the fractured root and save the rest of the tooth, but that’s not always possible.

What is tooth resorption, and can it be treated?

Tooth resorption is when your body starts breaking down and absorbing tooth tissue. It’s perfectly normal in children (that’s how baby teeth fall out), but in permanent teeth it’s a problem.

Internal resorption starts inside the tooth, in the pulp chamber. It’s relatively rare and usually discovered on routine X-rays. Sometimes you’ll notice a pink discoloration showing through the tooth. Treatment is root canal therapy. Once we remove the pulp, the resorption process stops.

External resorption starts on the outside surface of the root and is more common. It can be triggered by trauma, orthodontic treatment, gum disease, or chronic infection. How we treat it depends on how severe it is and where it’s happening.

The tricky thing about resorption is that it often progresses without any symptoms. Regular dental checkups with X-rays are the only way to catch it early, when treatment works best. If resorption has already significantly weakened the tooth structure, extraction may be necessary.

What if my previous root canal has failed? Can the tooth still be saved?

In most cases, yes. A failed root canal can be retreated. We call this endodontic retreatment, and it gives your tooth another chance.

Root canals fail in only about 2–14% of cases, and when they do, it’s usually because of missed or untreated canals, inadequate cleaning or sealing of canals, delayed crown placement after the original treatment, new decay around the restoration, or fractures in the tooth.

Signs that a previous root canal may have failed include pain coming back, sensitivity when biting, swelling, a pimple on the gums, or discoloration. These symptoms can show up weeks, months, or even years after the original treatment.

Retreatment involves removing the crown and the previous filling material, then re-cleaning and examining the canals using magnification and 3D imaging. We disinfect everything, refill the canals, and reseal them. Retreatment has about an 85% success rate at six years, so the odds of keeping your natural tooth are quite good.

What’s the difference between retreatment and an apicoectomy?

Both options exist for teeth where the initial root canal didn’t work, but they address different problems.

Retreatment makes sense when the issue is within the canal system itself: missed canals, inadequate sealing, contamination through a compromised restoration, or when it’s the first time treatment has failed.

An apicoectomy (root-end surgery) is the better choice when retreatment has already been tried or isn’t feasible, when calcified canals prevent access to the root tip, when a broken instrument is blocking the canal, when there’s a fracture near the root tip, or when infection is limited to just the root tip area.

During an apicoectomy, we access the root tip through the gum tissue, remove the infected tissue along with the last few millimeters of the root, and seal it from the end. Modern microsurgical techniques give apicoectomies success rates between 85–95%.

What is a dental abscess, and why is treatment urgent?

A dental abscess is a pocket of pus caused by bacterial infection, typically forming at the tip of a tooth root when bacteria get in through a cavity or crack.

Symptoms include severe, persistent, throbbing toothache that may radiate to your jaw, neck, or ear; sensitivity to hot, cold, and pressure; fever; swelling in your face, cheek, or neck; foul-tasting drainage if the abscess ruptures; and swollen lymph nodes.

A dental abscess will not go away on its own. It can spread to the jaw bone, cause deep neck infections, and in rare cases lead to sepsis, which is life-threatening. If you have difficulty breathing or swallowing, severe facial swelling, high fever, or rapid heartbeat, get emergency care immediately.

Root canal treatment addresses the source of infection by removing the infected pulp tissue and draining the abscess. Antibiotics might be prescribed to help fight the infection, but they can’t cure an abscess by themselves. The source of infection has to be treated directly.

What should I do if I knock out a tooth?

Time is critical here, so act fast.

Find the tooth and pick it up by the crown (the part you chew with), never by the root. If it’s dirty, rinse it gently with water. Don’t scrub it or use soap. Try to put it back into the socket immediately, then hold it in place with gentle pressure or by biting on gauze.

If you can’t get it back in, keep the tooth moist. Milk is the best option. You can also keep it between your cheek and gum, or in saline solution. Get to a dentist or endodontist within 30 minutes if at all possible.

The faster you act, the better your chances of saving the tooth. Teeth can sometimes be saved even after an hour, but success rates drop as time passes. After the tooth is reimplanted, it’ll need to be splinted in place and will typically require root canal treatment within a week or two.

Don’t try to reimplant knocked-out baby teeth. Doing so can damage the permanent tooth developing underneath.

What is the GentleWave procedure, and how is it different from traditional root canals?

The GentleWave System represents the most advanced technology available for cleaning root canal systems. Traditional root canal treatment relies primarily on metal files to scrape the canal walls. GentleWave takes a completely different approach, using fluid dynamics combined with sound-wave energy to reach every part of your tooth’s root canal system.

Think of it like a precision power-washing system for the inside of your tooth. The procedure creates a powerful vortex of cleaning solutions combined with acoustic energy that reaches into microscopic spaces (tiny side canals and tubules) that files simply cannot access. Traditional methods may leave up to 60% of canal walls untouched. GentleWave doesn’t have that limitation.

The benefits are real: superior cleaning, more preservation of your natural tooth structure (because it requires a smaller access opening), less discomfort after treatment (many patients report minimal to no pain), single-visit completion for most cases, and outstanding success rates. Clinical studies show 97.3–97.7% success rates at 12 months. Over 2 million patients have been treated with GentleWave.

What is Fotona laser treatment, and how does it benefit root canal patients?

Our Fotona laser uses advanced protocols called PIPS and SWEEPS to take root canal cleaning beyond what traditional methods can achieve.

When we direct precise pulses of laser light into the cleaning solutions inside your tooth, it creates microscopic shockwaves that push those solutions deep into every corner of the root canal system. The laser tip stays safely in the main chamber of the tooth. It never goes down into the roots themselves, which makes it both safe and remarkably effective.

The benefits include superior disinfection that reaches complex anatomy, lateral canals, and the microscopic tubules where bacteria like to hide. It’s minimally invasive because it allows us to use smaller file sizes, preserving more of your natural tooth structure. There’s reduced risk of complications since there’s less chance of pushing cleaning solutions past the root tip. And patients generally find it comfortable, with treatment typically finished in one session.

What is CBCT imaging, and why is it better than regular X-rays?

CBCT stands for Cone Beam Computed Tomography, and it’s advanced 3D imaging technology designed specifically for dental applications. Regular X-rays give you a flat, 2D picture where structures overlap and can obscure details. CBCT creates a detailed three-dimensional model of your teeth, jaw, and surrounding structures.

The scan itself is quick and painless. You sit comfortably while the scanner rotates once around your head in about 17 seconds, capturing up to hundreds of individual images. Our software combines all of those into a 3D model we can examine from any angle.

CBCT shows us things traditional X-rays might miss entirely: additional root canals that are hidden, fractures and cracks, the true extent of infections, complex root anatomy, and how close roots are to nerves and sinuses.

In terms of safety, CBCT exposes you to roughly the same radiation as about two weeks of normal background radiation. That’s far less than a medical CT scan. We use CBCT for complex anatomy, suspected fractures, retreatments, surgical planning, and any time traditional X-rays don’t give us enough information to treat you well.

Is it better to get a root canal or just extract the tooth?

Saving your natural tooth is almost always the better choice. Nothing artificial (whether it’s an implant, bridge, or denture) can fully match the look, feel, and function of your own tooth.

Root canal treatment preserves your natural tooth and bite, maintains your facial structure, prevents adjacent teeth from shifting, has high success rates (90–95%), is usually less expensive than extraction plus replacement, offers faster recovery, and is typically one procedure versus multiple procedures for extraction and replacement.

Extraction, on the other hand, requires replacement to prevent problems down the road. Missing teeth cause bone loss in the jaw over time, and adjacent teeth may shift and affect your bite. When you factor in replacement costs, extraction typically ends up more expensive. It’s also more invasive with a longer recovery period.

Research shows that patients who choose root canal treatment are six times more likely to describe the experience as painless compared to those who choose extraction.

There are situations where extraction becomes necessary—severe fractures, inadequate bone support, or tooth structure that’s too damaged to restore properly. We’ll always be honest with you about your options and explain the reasoning behind our recommendations.

Why should I choose a specialist for my root canal instead of my general dentist?

Your general dentist can absolutely perform root canal treatment, and many do it successfully. But there are some compelling reasons to consider seeing an endodontist.

Volume matters. We perform around 25 root canals per week compared to about 2 for general dentists. That concentrated experience means we’ve encountered virtually every variation in tooth anatomy and every possible complication. We also have 2–3 additional years of specialized education focused entirely on saving teeth.

The equipment makes a real difference too. Dental operating microscopes with up to 25× magnification, 3D CBCT imaging, GentleWave cleaning systems, and Fotona laser technology are standard in our practice but aren’t typically found in general dental offices.

Efficiency is another factor. We often complete treatment in a single visit, and our focused expertise usually means less time in the chair. For complex cases involving unusual anatomy, calcified canals, previous failed treatments, or difficult diagnoses, specialist training makes a measurable difference in outcomes.

The additional investment in specialist care tends to pay off through higher success rates, fewer complications, and better long-term results—especially when the case is complex.

How do you decide whether a tooth can be saved or needs to be extracted?

We use everything available to us—clinical examination, 3D imaging, and our combined experience—to accurately assess whether your tooth can be saved.

Teeth can often be saved even in challenging situations. Advances in endodontics have made it possible to save teeth that would have been lost just a few years ago.

Factors that work in favor of saving the tooth include adequate remaining tooth structure, cracks that haven’t extended below the gum line, sufficient bone support around the tooth, root canals that we can access, and a tooth that can be properly restored with a crown afterward.

Situations that may require extraction include vertical root fractures, severe fractures extending deep below the gum line, inadequate bone support from advanced periodontal disease, root canals that simply cannot be accessed, and insufficient tooth structure remaining to support a restoration.

We’re always honest with our assessments. If your tooth can be saved, we’ll put together a treatment plan. If extraction really is the best option, we’ll explain exactly why and talk through your replacement options.

Does dental insurance cover root canal treatment?

Most dental insurance plans do cover root canal treatment, classifying it as a “major restorative procedure.” Typical coverage runs 50–80% of the cost after your deductible is met.

Root canals usually fall under “endodontic services” or “major services” in your plan. Some insurers require pre-authorization. Some plans have waiting periods of 6–12 months for new members. Annual maximum limits (often $1,000–$2,000 per year) may affect your total coverage, and seeing an in-network provider typically gets you the best savings.

Keep in mind that the crown placed after your root canal is a separate procedure, usually billed through your general dentist. Our team verifies your insurance benefits before treatment, gives you a clear estimate of your out-of-pocket costs, and we accept options like CareCredit, payment plans, and HSA/FSA funds.

How much does root canal treatment cost?

Costs vary depending on which tooth needs treatment (front teeth have fewer canals than molars) and how complex your case is. Typical ranges are:

• $800–$1,300 for front teeth (incisors and canines)
• $1,000–$1,500 for premolars
• $1,200–$2,000 for molars

With insurance, your out-of-pocket cost usually falls somewhere between $200 and $800 depending on your specific coverage. Remember that crown costs (typically $800–$1,500 or more) are separate and handled by your general dentist.

While specialist care may cost a bit more upfront, it often saves money in the long run. Higher success rates, advanced technology, and efficiency mean fewer complications and less chance of needing retreatment.

How long does treatment take, and how many appointments will I need?

Most root canals can be finished in one or two appointments.

• Front teeth: about 30–45 minutes
• Premolars: around 45–60 minutes
• Molars: 60–90 minutes

Some situations call for multiple visits: severe infection that needs medication between appointments, multiple roots with complex anatomy, calcified canals that require additional time, or cases where we need to monitor healing before doing the final seal.

After your root canal, you’ll go back to your general dentist within 1–4 weeks for your permanent crown. That’s a separate appointment.

How quickly can I return to normal activities after treatment?

Most patients go back to work or school the same day. There aren’t really any significant activity restrictions.

You can eat once the numbness wears off (2–4 hours), starting with soft foods. Light exercise is fine; just skip the strenuous workout for 24–48 hours. If you only had local anesthesia (no sedation), you can drive immediately.

For best healing, avoid smoking (it slows healing and doubles your risk of needing additional treatment), skip alcohol for 24 hours, don’t chew on the treated side until you have your permanent crown, and stay away from hard, sticky, or crunchy foods until you’ve healed. Most patients feel fully recovered within 2–3 days.

Do I need a crown after my root canal?

For back teeth like molars and premolars, the answer is almost always yes. For front teeth, sometimes a filling is enough.

Crowns matter for several reasons. The tooth becomes more brittle without the living pulp providing nutrients. A crown distributes biting forces evenly across the tooth, protects against fractures and cracks, seals the tooth against reinfection, and restores both appearance and full function.

The numbers make a strong case: teeth with crowns have a 92% survival rate compared to just 35% for teeth without crowns in long-term studies.

How soon after my root canal should I get a crown?

Ideally within 1–2 weeks, and definitely no longer than 4 weeks.

The temporary filling we place after your root canal is meant for short-term protection only. Delaying your crown increases your risk of problems. Teeth that get crowned within 4 months are three times less likely to eventually need extraction compared to teeth where the crown was delayed.

Schedule your crown appointment with your general dentist before you leave our office. Don’t let the investment you made in your root canal go to waste by putting off this step.

How long will my root canal-treated tooth last?

With proper care, a root canal-treated tooth can last the rest of your life.

Long-term research shows excellent durability: 93–97% success rate at 10 years, 85% at 20 years, and 81% at 30 years.

The factors that matter most for longevity are getting your crown placed promptly (within 4 weeks), wearing a night guard if you grind your teeth, maintaining excellent oral hygiene, keeping up with regular dental checkups, and avoiding chewing on hard objects like ice and hard candy.

Can a root canal fail years after treatment?

While it’s rare (only 2–14% of cases), yes—root canal failure can happen months or even years later.

It might occur because new decay developed around the restoration, a crack formed in the tooth, the internal sealing material broke down over time, or there were canals that weren’t detected and treated initially.

Signs to watch for include pain or sensitivity returning, pain when biting or chewing, gum swelling, a pimple or bump on the gums near the tooth, tooth discoloration, or a bad taste in your mouth.

If this happens, the tooth can often still be saved through retreatment or apicoectomy. Contact our office if you notice any of these symptoms with a tooth that’s had root canal treatment.

What happens during a follow-up visit, and why is it important?

Follow-up appointments let us monitor how you’re healing and catch any potential problems early.

We check how the surrounding bone and tissues are healing (which shows up on X-rays), confirm there’s no infection present, make sure you’re comfortable and the tooth is functioning well, and look at the condition of your restoration.

The typical schedule is 6 months after treatment, 12 months after treatment, and then during your regular dental checkups going forward. Catching any issues early gives us the best chance of addressing them successfully.

Most follow-up visits simply confirm that everything is healing well and your tooth is on track for long-term success.