Frequently asked questions

An endodontist is a dentist who completed two to three additional years of specialty residency focused entirely on the inside of the tooth. General dentists may perform a handful of root canals a month; our doctors perform them all day, every day, and have done many thousands. That volume matters most on the difficult cases: unusual canal anatomy, calcified canals, retreatments, and teeth that other treatment hasn’t resolved.

We also use equipment most general offices don’t have, including a surgical operating microscope, CBCT 3D imaging, electronic apex locators, and the Biolase laser. Your general dentist remains your primary dentist; we handle the endodontic portion and send you back to them for the final restoration.

No. Most of our patients are referred by their general dentist, but you can call us directly and schedule. If you don’t currently have a general dentist, we’ll help you find one for the permanent restoration afterward.

Almost always we start with a consultation, and it is a short visit. We need to confirm which tooth is the problem — referred pain is common, and the tooth that hurts is not always the tooth at fault — and we need to see the anatomy before committing to a plan. It also lets us check your insurance timing, because under some plans benefits are lower when treatment happens on the same day as the evaluation.

Pain is the exception. If you are in pain now, call us. We hold time every day for urgent cases, and emergency patients may be treated at that first visit when the evaluation confirms it and there is time.

Not every patient, but many. A CBCT scan is a focused three-dimensional X-ray of the tooth and the bone around it. A regular two-dimensional X-ray flattens everything into one picture, so roots overlap and small problems hide behind them. A 3D scan separates them.

That is how we count canals before we start, find a canal that was missed in a previous root canal, identify a crack or a root fracture, measure how close a root sits to a nerve or a sinus, and tell healing bone from a spreading infection. We scan only the few teeth in question rather than your whole head, so the dose is a small fraction of a medical CT scan and on the order of a conventional panoramic dental X-ray. If your doctor recommends one, they will show you what they are looking at.

Often yes, and please send it or bring it in. A recent CBCT from your dentist may be all we need. Sometimes we still take our own: the field of view may not include the tooth in question, the resolution may be too coarse for the detail we need, or the scan may predate the symptoms that brought you in, in which case it no longer shows the current situation. Your doctor will tell you which it is before taking anything new.

The goal of every root canal is disinfection. Traditional technique relies on chemical irrigation and mechanical cleaning with files, which works well but is limited by physics: irrigating solution doesn’t easily reach into lateral canals or the apical third, the deepest part of the root, which is where most treatment failures originate.

The Biolase laser drives energy through the irrigating solution, creating cavitation bubbles and much stronger fluid dynamics. That pushes disinfectant into the small spaces files and syringes can’t reach, and lets us specifically target the apical third. In practice it means more thorough disinfection without removing additional tooth structure. We are the leading Biolase provider in Washington State, and it’s part of our routine treatment rather than an upcharge.

The tooth pain that brings people in usually hurts far more than the treatment that fixes it. The procedure is performed under local anesthesia using an ultra-gentle numbing technique, and most patients report little to no pain during treatment. Our handpieces are virtually silent with minimal vibration, which removes a lot of what people actually dread. Mild soreness for a few days afterward is normal and usually managed with over-the-counter anti-inflammatories.

Many root canals here are completed in a single visit. More difficult cases, more heavily infected teeth, and teeth with a more guarded prognosis may do better with a second, staged appointment, which gives medication inside the tooth time to work before we seal it. Your doctor will tell you which applies at your consultation.

Most root canals are needed because the pulp inside the tooth is infected or irreversibly inflamed, usually from deep decay, a crack, or an old injury. An infection in a tooth does not resolve on its own, and the evidence is consistent that letting it run longer works against you: more bacteria, more damage to the bone around the root, and lower success rates once treatment finally happens. Treating it early is the straightforward way to protect the outcome.

Tell us when you call, before your appointment, so we can plan for it. We offer nitrous oxide and moderate oral conscious sedation, and we partner with an anesthesiologist for in-office IV sedation if you’d prefer to be fully asleep. Many of our patients arrive with significant dental anxiety; it’s one of the most common things our reviews mention.

In almost all cases where the tooth is a reasonable candidate, saving it is the better first choice. Your natural tooth preserves the bone around it, maintains your bite, and requires no ongoing maintenance beyond normal hygiene. Extraction leaves a gap that needs to be addressed with a bridge or implant, which typically costs considerably more overall and takes months. That said, some teeth genuinely have a poor prognosis, and when that’s the case our doctors will tell you honestly rather than treating a tooth that can’t be saved.

Cost varies with the tooth: molars have more canals and take longer than front teeth, and retreatments and surgery differ again. Rather than guess, we present a written estimate that includes your insurance benefits before treatment begins. Provide us your current insurance information and we’ll handle the verification.

No. This claim traces back to poorly designed research from the 1920s that has been thoroughly discredited, and it continues to circulate online. There is no valid scientific evidence linking root canal treatment to disease elsewhere in the body. The American Association of Endodontists addresses this directly, and the actual health risk lies in leaving an infected tooth untreated.

Eat a normal meal beforehand unless you’re being sedated, and take any regular medications as usual. Bring your insurance card, a list of current medications, and any X-rays or notes from your referring dentist if you have them. Plan on one to two hours.

With local anesthesia alone, yes. If you’re having oral or IV sedation, you’ll need someone to drive you home, and you shouldn’t drive for the rest of the day.

Call us. Minor congestion is usually fine, but an active fever or difficulty breathing through your nose can make treatment uncomfortable, and we’d rather reschedule than have you struggle.

If you’re already in pain, an over-the-counter anti-inflammatory an hour before your visit is fine and often helps. Tell us what you took and when. Avoid aspirin if you may be having surgery, unless you take aspirin or a blood thinner every day on a doctor’s orders; in that case keep taking it and tell us.

Tenderness when biting and some soreness are expected for a few days, occasionally up to a week or two if the tooth was very inflamed beforehand. Numbness lasts two to four hours. What’s not normal is swelling, pain that gets steadily worse after day three, or a bite that feels noticeably off. Call us for any of those.

Eat once the numbness has fully worn off so you don’t bite your cheek or tongue. Chew on the other side until your permanent restoration is in place. Softer foods for the first day or two make things easier.

Promptly. A root canal isn’t finished until the permanent crown or filling is placed, and the temporary isn’t built to last. Waiting too long is one of the most common reasons an otherwise successful root canal later fails. Your dentist will have our report the same day.

It depends on the tooth, but on back teeth the answer is usually yes. Some teeth are more fragile after root canal therapy, and it is the standard of care to place a crown or an onlay for fracture resistance. The restoration does two jobs: it holds the tooth together, and it seals the root canal space against reinfection.

This is the step patients most often postpone, and it is the step that most often costs them the tooth. Delaying or skipping the final restoration can lead to a root fracture that cannot be treated, or to reinfection of the canal we just cleaned. You have invested real time and money in saving this tooth, and the crown is what protects that investment.

We do not place crowns ourselves. We do the root canal and send your general dentist a report the same day, and we strongly recommend following through with them promptly.

Not always, and our goal is to keep the crown you already have. In most cases we can treat the tooth right through the existing crown: a small access opening, patched afterward with a filling, without destroying the crown.

If we find the crown is leaking, or that it is itself contributing to the infection, then it has to be replaced, and we will recommend your dentist help you with a new one.

Usually not. Root canal treatment removes the source of infection directly, which is more effective than antibiotics alone. If your doctor prescribes them, it’s for a specific reason, and you should finish the course.

Call us at (206) 633-3636. We hold time for urgent cases and aim to see patients in pain the same day. Emergency patients may receive treatment on that first visit if the evaluation confirms it and time allows.

Act immediately; minutes matter. For a permanent tooth, pick it up by the crown, rinse it briefly in milk or saline if it is dirty, and if you can, put it straight back into the socket and bite gently on a clean cloth. If you can’t, keep it moist in cold milk (or saline, or inside your cheek if you’re an adult), never in water or a tissue, and get to a dentist, endodontist, or emergency room right away. Within 30 minutes is best; after 60 minutes out of the mouth, outcomes decline sharply. Baby teeth are not replanted. Our trauma page has the full guidance.