Seattle Endodontic Arts

The Root Canal Procedure

What is a Root Canal? Put simply, a root canal is a treatment that is used to prevent or resolve infection of the jaws caused by a necrotic (“dead”) tooth. So, what’s a dead / necrotic tooth?

The formative tissue of a tooth is the dental pulp. It is composed of specialized cells that make tooth structure and it contains blood vessels and nerves to maintain these cells. As the tooth develops the amount hard tooth structure increases and the size of this tissue diminishes. Even in a very mature adult tooth, a small portion of dental pulp remains vital in the middle of the crown and roots of each tooth. It’s job of building the tooth is essentially done but it continues very slowly to make additional tooth structure.

It is this tissue that senses the cold when you bite into your favorite ice cream. Like all tissues, it is at risk of injury. Common culprits for injuring a dental pulp are decay, trauma, and cracks. Many insults to the pulp are minor and result only in minimal pulpal inflammation. An example of this is the short term mild sensitivity that often occurs following a new filling. A more severe injury to the pulp may result in inflammation it cannot survive. The pulp tissue becomes necrotic (dies) and the tooth becomes a “dead” tooth. This process of an injured/inflamed pulp turning into a necrotic pulp can to a variable degree, be uncomfortable.

Does it matter if the tooth is dead? It is already fully formed and it looks and can function as it did before it died. There’s just no feedback about your ice cream. Unfortunately, this newly necrotic tissue and space it occupied typically become immediately infected. The infection inside your tooth causes inflammation and infection of the surrounding bone which then results in bite sensitivity. As the infection spreads, there may even be swelling of the gums and face. Acute infections of the head and neck can have serious ramifications.

What to do? The infected tooth could be extracted which allows the adjacent bone and soft tissue infection to resolve. Or, often, we can maintain the tooth and just remove the dead and infected tissue from inside the tooth. This too results in resolution of the surrounding infection while allowing the tooth to return to normal function. The procedure of removing the infected tissue from the inside of a tooth then sealing that space to prevent reinfection of the tooth is commonly (and rather inappropriately) called “having a root canal done”.

A ‘root canal” is a technical, often time-consuming procedure that is as much art as it is science. It is also a procedure that is generally very easily tolerated and typically feels similar to having a standard filling done. Most patients are comfortable and able to go directly back to their daily activities. Except in Seattle when the sun is shining, then, we often jest a recommendation of taking the rest of day off!


This blog is intended to provide very general background information on a variety of dental and endodontic topics. It is not intended to be scientifically or clinically precise and should not be used as advice related to any particular situation.

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What is a Calcified Tooth Root

One of the most common discussions we have with patients revolves around the cause and treatment of a calcified tooth. The root canal in a calcified tooth is always more difficult to locate and treat. All teeth have the potential to become calcified. Calcification occurs slowly on healthy teeth as part of the natural aging process. This process can also occur more rapidly at a younger age secondary to pulpal inflammation. Common causes of pulpal information are trauma, dental decay, cracks in teeth and previous dental treatments.

So, what exactly is a calcified tooth? This means that the normal pulp chamber inside the tooth becomes reduced in size or even obliterated as the dental pulp (the formative organ of the tooth) produces more dentin (tooth structure). As the chamber and canal spaces become smaller, endodontic treatment becomes increasingly difficult. In some situations, conventional endodontic treatment is simply not possible. Often however with patience (yours and ours) and experience the root canal can be completed with a good prognosis. Our in-house 3-D imaging, operating microscopes, and experience help us immensely with these challenging teeth.

For more information on how endodontic retreatment can treat a calcified tooth root and save your tooth, contact Seattle Endodontic Arts
at 206-621-9730 or at [email protected].

What to Eat After Your Root Canal Surgery

One of the most common questions we get asked after a patient completes a root canal surgery is “What can I eat now?” The easy answer is lots of soft, cold food. But let us cover some of the basics first.

A root canal thoroughly cleanses the tooth from the inside, clearing out dead pulp, and replacing it with a strong filling material. The tooth is then sealed and secured with a crown, and continues to function as an effective tooth, free from decay. Sometimes, an additional surgery is required at the tip or apex of the tooth to remove all of the infected tissue and properly seal the tooth. This requires a small incision and a couple a stitches.

However, with a root canal, there are certain dos and don’ts, especially when it comes to what you should eat after your root canal surgery. When you eat something immediately after your root canal surgery, you should:

  • Eat on the opposite side of the treatment, that is, the side that is not numb. This is to prevent a bite or burn to yourself.
  • Eat only soft foods that don’t require a lot of chewing.
  • Eat slowly.
  • Avoid very hot food and drinks, such as hot soup, or hot tea or coffee.

What to eat and drink after your root canal surgery

The following are some foods that are recommended by Seattle Endodontic Arts.

  • Fruits, including bananas, mangos, pears, peaches, applesauce, and fruit smoothies
  • Soft cereals
  • Yogurt, milkshakes, and ice cream, free from chunks and nuts
  • Pudding
  • Eggs
  • Tofu
  • Soup
  • Tuna salad
  • Humus
  • Mashed vegetables, like potatoes and cauliflower
  • Pancakes
  • Sushi
  • Oatmeal and cream of wheat
  • Pasta and noodles

Some of these foods, such as fruit smoothies, yogurt and soft cereal you can eat immediately after your surgery, while there is still a swelling. They will not only satisfy your hunger but will also soothe the area of your mouth where the root canal has been done.

What NOT to eat and drink after your root canal surgery

The following are some foods that you should not eat after your root canal surgery.

  • Crunchy foods such as carrots, corn on the cob or apples, as they could damage the tooth or cause undue pain.
  • Chewy foods such as gum, most breads or candy, like taffy, as it could pull out the temporary filling.
  • Hard foods such as ice or nuts as they could damage the tooth or cause unnecessary pain and potentially damage the surgical site.
  • Avoid alcohol as it could increase bleeding.
  • Avoid food that is excessively hot as it could increase sensitivity.
  • Also avoid spicy food could cause unnecessary discomfort or sensitivity.

Hopefully you have a better understanding of what to eat and what not to, after your root canal. Following these food recommendations will help you heal faster with less pain. You can consult your dentist if you need further advice on what to eat after your root canal, as well as for any other precautions or call us anytime.

At Seattle Endodontic Arts, we specialize in root canal surgery. We would be happy to meet with you to discuss your treatment options. Being endodontic dentists, we use the latest technology for all procedures. Our staff are highly skilled and are always there to assist you. Today, at Seattle Endodontic Arts, getting a root canal treatment is as simple and painless as getting a filling.

To know more about root canal surgery or after care contact Drs. Freeman, Short, Odell, or Gill at 206-621-9730 or at [email protected].

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Is It a Cracked Tooth? The Source of Your Tooth Pain

If you’ve ever suffered from a cracked tooth, you know how uneasy you feel. Your cracked tooth may cause erratic pain, especially when chewing, or then acute discomfort when it is exposed to temperature extremes. However, this pain comes and goes, and it may be difficult for your dentist to pinpoint exactly which tooth is cracked.

A cracked tooth hurts because beneath the white enamel and a hard layer called the dentin is the soft pulp of the tooth. When your tooth is cracked, chewing can cause movement of the pieces and may irritate the pulp. If this continues, the pulp may become so damaged that it will not be able to heal itself. If not treated on time, extensive cracks can lead to infection of the pulp, which can spread to the gum and the bone surrounding the cracked tooth.

When it comes to a cracked tooth, prevention is definitely better than cure. Here are some ways you can prevent yourself from getting a cracked tooth:

  • Do not chew on hard objects, such as ice or a pen
  • Do not clench or grind your teeth
  • If you clench or grind your teeth during sleep, get a retainer or other mouthguard from your dentist to protect your teeth
  • Wear a mouthguard or protective mask when playing contact sports
  • Prevent yourself from falling, especially on your face
  • Treat cavities that can weaken your teeth

However, even if you have taken all precautions, you may still suffer from a cracked tooth. In that case, what should your treatment be? There are several types of tooth fractures and breaks, each of which require different endodontic treatment. In this article, that’s exactly what we are going to discuss.

  1. Minor cracks: These affect only the enamel of your tooth. These may not require treatment, but your dentist may lightly polish the tooth to remove any rough spots.
  2. Cracked tooth: This fracture involves the entire tooth, all the way to the nerve. The crack gradually spreads and is painful, especially when chewing. Filling material can be used to repair cracks, but the tooth will often need a crown to prevent the crack from getting worse. If the pulp is damaged you may need a root canal.
  3. Chips: These do not always need treatment. Your dentist may repair the damage with filling material or then, if the chip is very small, may polish the affected area to smooth it out.
  4. Broken cusp: This affects the pointed chewing surfaces of the teeth, also called cusps. These usually do not affect the pulp and may not be very painful. Your dentist may restore the tooth’s shape, using an onlay or a crown.
  5. Split tooth: This means that the tooth is split vertically into two separate parts. For this type of cracked tooth you will probably need a root canal and dental crown. Your dentist will also remove any roots that cannot be kept. You will also need a crown to cover the root and replace the tooth. In some cases, if the tooth cannot be saved, it has to be removed.
  6. Vertical breaks or split root: These cracks begin in the root of the tooth and spread upwards towards the chewing surface. These breaks are often painful, with the area around the root being inflamed and infected. In most instances, the tooth will have to be removed.
  7. Decay-induced break: This is caused by cavities that weaken the tooth from the inside out. You should visit your dentist who will recommend the right treatment for your tooth. In the cases where the cavity cannot be treated, the tooth may have to be removed.
  8. Serious breaks: These breaks go deep enough to expose the nerve. The tooth is usually painful and sensitive and the broken part of the tooth may bleed. In this case, you will need root canal treatment to remove the exposed nerve, as well as a crown to cover the tooth, so that you can eat and chew properly.

These are just some of the ways that a cracked tooth can present itself. Each type of cracked tooth needs a different kind of treatment. However, in all instances you should visit your dentist for endodontic treatment for your cracked tooth.

At Seattle Endodontic Arts we specialize in the treatment of cracked teeth and will be happy to advise you regarding your treatment options. You can consider visiting us for a consultation for different treatment options and recommendations.

To know more about your treatment options for a cracked tooth, or for a regular dental check-up, contact us at 206-621-9730 or at [email protected]

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How Endodontic Retreatment Can Save Your Tooth

When I see a patient that has undergone a root canal in the past but has since developed pain, they inevitably ask me “Why did the first root canal fail?” Although there are multiple reasons why the original treatment has not been successful, the more important issue is finding a successful outcome this time. In this article I want to address the “Why did my original root canal fail” and more importantly, how retreatment of the tooth can lead to long-term success.

Many teeth are treated with a root canal that will last a lifetime. Unfortunately, there are others that develop pain or disease months or years after treatment. There are multiple reasons why this can occur:

  • Complicated canals that were not detected during initial treatment
  • Curved or narrow canals that were not treated during initial treatment
  • The permanent restoration was not placed within the appropriate amount of time following the procedure
  • The permanent restoration did not prevent saliva from contaminating the inside of the tooth
  • The infection was not resolved due to a poor immune response
  • A tooth sustained a fracture

If your tooth is diseased or has not healed after the original endodontic treatment, you have a second chance…endodontic retreatment can save your tooth.

So, what is endodontic retreatment? The word “Endodontic” comes from two Greek words: “endo” meaning inside and “odont” meaning tooth. Endodontic retreatment treats the inside of your tooth months to years after the original endodontic treatment.

What happens during endodontic retreatment?

First, your endodontist will discuss your treatment options with you. If you both choose endodontic retreatment, your endodontist will reopen your tooth to gain access to the root canal filling material. Quite often, restorative materials that were put in place during the original endodontic treatment need to be removed. These materials could be crown, post, and core materials. Once these materials are removed, your endodontist now has access to your root canal.

After your endodontist has removed the canal filling, your endodontist can clean the canals and carefully examine the inside of your tooth using illumination and magnification. At this point, your endodontist will be searching for additional canals or any unusual anatomy that needs treatment.

After cleaning the canals, your endodontist will fill and seal the canals and place a temporary filling in the tooth. However, if the canals are unusually narrow or blocked, your endodontist may recommend endodontic surgery. This involves making an incision so that the other end of your root is sealed.

After cleaning the canals, your endodontist will fill and seal the canals and place a temporary filling in the tooth. However, if the canals are unusually narrow or blocked, your endodontist may recommend endodontic surgery. This involves making an incision so that the other end of your root is sealed.

Once your endodontist completes retreatment, you will need to go to your dentist to have a new crown or other restoration placed on the tooth to protect it and restore it to its full function.

Often, endodontic retreatment to save your tooth is the best choice for you. Seattle Endodontic Arts specializes in endodontic procedures, and surgery, including endodontic retreatment. Literally, this is all we do, all day long. Our goal is to help you maintain your teeth long-term.

Who performs endodontic retreatment?

While most dentists going through dental school are trained in root canal therapy, endodontic retreatment can be more challenging than providing first-time treatment. This is why most dentists refer their patients to trained endodontists. The latter are dentists with at least two additional years of advanced specialty education in diagnosis and root canal treatment and retreatment.

Endodontists are experts in performing non-surgical and surgical retreatment. They use their specialized training in treating difficult cases, such as teeth with narrow or blocked canals, or then, teeth with unusual anatomy. Endodontists also used advanced technology, such as operating microscopes, ultrasonics, and digital imaging.

One of the alternatives to endodontic retreatment or endodontic surgery, is the extraction of your tooth. We try to save your original tooth using endodontic retreatment. No matter how effective tooth replacements are, we believe there nothing is as good as your own natural tooth.

Hopefully this article has answered many of the questions surrounding endodontic retreatments. My partners and I are always available to discuss this with you more.

For more information on how endodontic retreatment can save your tooth, contact Dr. Mark A. Freeman or any of the partners at Seattle Endodontic Arts at 206-621-9730 or at [email protected]

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