This procedure will be performed using local anesthesia. There is typically no restrictions after the procedure concerning driving or returning to work. Emergency contact number will/is provided to you should any problems arise following treatment, please refer to the blue pamphlet.

Continue all medications for blood pressure, diabetes, thyroid problems and any other conditions as recommended by your physician. If there is a question, please call our office prior to your appointment.
Please eat a full breakfast or lunch as applicable.

If you have been advised by your physician or dentist to use antibiotic pre-medication because of Artificial heart valves, history of congenital heart defects, history of endocarditis, or have prosthetic joints, such as knee or hip. Please make sure you are on the appropriate antibiotic on the day of your appointment. If there is a question, please call our office at least a day prior to your appointment.

Many root canal treatments can be completed in a single appointment, but a much larger number are best treated over two visits. This is very common and does not mean anything is wrong—it simply allows us to provide the safest and most predictable result for your tooth.

There are several reasons a second visit may be recommended, including:

• The need for additional time to carefully clean and shape canals.
• Active drainage or bleeding inside the tooth
• Complex anatomy or case difficulty
• Significant infection/inflammation
• Patient tolerance
• Insurance allowance/restrictions

Teeth that require root canal therapy contain high levels of bacteria. When treatment is completed in two visits, we are able to place medicated dressing inside the canals and allow it to work between appointments. This extra step helps disinfect the tooth more thoroughly and creates a healthier environment before the canals are permanently sealed.

A two-visit approach also allows us to confirm that you return comfortable and symptom-free before final completion. Your long-term success and comfort are always our top priority, and spacing treatment when needed often provides the most predictable healing.

WHAT TO EXPECT BETWEEN VISITS

• A temporary filling will protect the tooth
• Mild tenderness is normal within the first few days following treatment and should gradually improve
• Avoid chewing hard, sticky, and chewy food on the treated tooth
• Contact us if you experience swelling, pain that is unmanageable by over-the-counter medications, or loss of the temporary

Our goal is to complete your treatment as efficiently as possible while giving your tooth the best chance for long-term health.

AFTER COMPLETION

Endodontic treatment has now been completed. The root canal system has been permanently sealed. However, the outer surface may be sealed with a temporary restoration. A follow-up restoration must be placed to protect your tooth against fracture and decay. Please telephone your restorative dentist for an appointment. A complete report of treatment will be sent to your restorative dentist.  You will be informed if a recall/follow up visit is advised to evaluate the progress of healing. Typically, this recall is done one year following completion of endodontic treatment. Our office will contact you closer to the recall date to schedule.

Your tooth is more prone to fracture immediately after endodontic treatment. You should chew on the other side until your restorative dentist has placed a core build-up and a protective restoration, usually a crown. If your tooth's strength is compromised, your endodontist or restorative dentist may place a post and core build-up inside the tooth. Your restorative dentist and endodontist will determine the appropriate restoration to best protect your tooth.

If you have any questions, please call our office at 336-448-0840.

What is an orifice barrier?

An Intraoffice barrier is a small protective layer (2-3mm) of dental materials placed over the root canal orifices, beneath your final filling or temporary restoration to function as a secondary seal, reinforcing the cervical dentin, and aiding in prevention of bacterial leakage into the root canal system. This protective barrier is typically composed of materials such as Mineral Trioxide Aggregate (MTA), Resin-Modified Glass Ionomer Cement (RMGIC), and flowable composite.

Why is this used?

Even after successful root canal treatment, the long-term health of the tooth depends on preventing bacteria from re-entering the canal space. Everyday factors such as temporary restorations, delays in permanent crowns, or normal wear can sometimes allow microscopic leakage over time.

By placing an orifice barrier, we add an extra level of protection to help reduce this risk.

Benefits of an Orifice Barrier

• Provides an additional seal against bacteria and contamination.
• Helps protect the root canal treatment during healing process.
• Increases fracture resistance of root canal treated teeth
• Adds support if there is a delay before final restoration (such as a crown)
• May improve long term success of the treated tooth
• Offers added peace of mind for both patient and provider

** This technique is recognized by the American Association of Endodontics for its role in preventing root canal failure

Inside every tooth is a small space called the root canal that contains the nerve and blood supply. In some cases, that canal can become narrowed, or blocked resulting in difficult access and treatment. This is referred to as Calcification or Obstruction

An obstruction simply means something is preventing clear access to the natural canal pathway.

Common Causes of calcification:

Calcification occurs when the body deposits additional hard tissue inside the canal over time. This is often a natural protective response the body takes and may happen due to: Previous Dental Trauma (even years ago), deep decay or large restorations, Long-term irritation or inflammation, orthodontic movement, and even natural aging… As this hard tissue builds up, the canal becomes extremely narrow- and in some cases nearly invisible on x-rays.

Other types of canal obstruction: while calcification can be more common, it is not the only cause of obstruction. Other possible obstructions may include: A separated or broken instrument from a previous root canal procedure, post or pins placed inside the tooth for support, existing restorative materials blocking canal access, internal resorption or irregular anatomy. Each situation is unique and requires careful evaluation and treatment planning.

WHY DOES THIS MATTER?

When a canal is obstructed, performing root canal treatment becomes more complex. The challenge is safely navigating around and/or through the obstruction while preserving healthy tooth structure. In some cases, the obstruction can be removed. In others, we may carefully work around it. Occasionally, alternative treatment options may need to be discussed depending on specific circumstance

HOW WE APPROACH OBSTRUCTED CANALS:

Our practice utilizes High-powered magnification and enhanced illumination, advanced imaging, and specialized ultrasonic and micro-instrumentation techniques. These tools allow us to manage complex anatomy with precision and care.

WHAT DOES THIS MEAN FOR YOU?

If your tooth has a calcified or obstructed canal, it does not automatically mean it cannot be treated. It simply means your case requires a higher level of precision and specialized care. This could equivalate additional chair time, visits, and imaging assuring the adequate time/care is provided.