What are our office business hours?
MicroSurgical Endodontics is open Monday – Friday from 9 am until 5 pm; however, due to Dr. Nasseh’s teaching duties and schedule at Harvard and his extensive lecture schedule nationally and internationally, patient treatment times are available on specific days of the week. Please call our office for specific times. We will schedule your appointment as promptly as possible. However, if you have pain or an emergency situation exists, every attempt will be made to see you the same day to relieve your pain.
Should I save my tooth?
Root canal therapy is an attempt to save a tooth that would otherwise be extracted. If the tooth is extracted a fake replacement can be fabricated by your restorative dentist in a fixed or removable bridge, a partial denture, or through a fixed, endosseous implant, all of which also have a success and a failure rate. However, should a reasonable success rate be expected with the root canal, it is always best to try to save the tooth. The alternatives will still be available if the root canal fails and the tooth is lost, however, when the alternatives fail the options are limited. Therefore, unless a poor success rate is expected from the tooth due to poor structural integrity of the remaining tooth structure, saving your own tooth should be a primary goal.
In a recent, randomized, large scale study of a million and a half teeth in over a million individuals across the U.S.A. by Delta Dental Insurance Plan it was determined that 97% of such teeth were retained in the oral cavity 8 years after initial non-surgical endodontic treatment. This is a higher success rate than any of the alternative treatments to root canal therapy. It is especially better to first attempt root canal therapy since modern endodontic techniques and principles have made the procedure virtually painless and completely comfortable. Since the procedure is now an efficient, routine visit to the dentist, no more uncomfortable than a simple filling, it is further recommended that the natural dentition be preserved as a primary goal of the restoring the dentition to proper health and function.
How long will the procedure take?
Although each tooth is unique and the time required to complete the treatment in each case dependant on the specific requirements for the best success rate in that case, you should plan on spending about 1 hour for your consultation appointment and 2 hours at our office during your treatment appointment. At MicroSurgical Endodontics, we understand that your time is valuable and we will do our best to render treatment as expeditiously as possible without compromising the quality of your care. In fact, we prioritize on efficiency for your sake, so your schedule is not disturbed by our services.
We also try our best to stay on schedule to minimize your waiting at our office. Due to the fact that practice provides surgical services, various circumstances may lengthen the time allocated for a procedure. Emergency cases may also arise and cause small delays. We appreciate your understanding and patience and do everything we can to accommodate you and your needs.
As a patient, what should I expect from Dr. Nasseh and his staff?
You should expect to be treated courteously and with respect. You should feel comfortable at all time with Dr. Nasseh and his staff’s competence and ability to handle your care professionally while being personable, friendly, and attentive. You have the right to a painless procedure and personal attention by Dr. Nasseh and his staff. The procedure is most often performed in a single visit, and is always painless while it is being performed. Depending on the kind of infection inside the tooth there may be anywhere from mild to moderate discomfort after the procedure or in between visits. This is due to the healing process at the end of the root. Taking an anti-inflammatory such as Advil or Motrin after the procedure for a couple of days will minimize this discomfort. Antibiotics maybe necessary depending on the case and will be prescribed if deemed necessary for your case.
Will I feel pain during the procedure?
Patients are often worried about the prospect of unexpected pain during a root canal procedure and while in the dental chair. This is why Dr. Nasseh’s promise to you as a patient is that you will always be in control and will experience no pain during the root canal procedure while in his chair. He has taught head and neck anatomy and anesthesia techniques for many years at local dental schools and has lectured extensively in the subject of painless dentistry. Dr. Nasseh believes strongly that consistent painless root canal therapy is possible with today’s technology and understanding of the anatomy and physiology of the oral neurovasculature.
The key to a painless root canal therapy is definitive local anesthesia. You will be completely numbed in the area with the latest anesthetic techniques and anesthesia will be confirmed before any procedure is begun. Promising a painless experience is now possible and we at MicroSurgical Endodontics are happy to offer you this painless experience. There will be no discomfort during the procedure while in Dr. Nasseh’s chair. This is Dr. Nasseh’s personal promise to you at our office.
Will it be painful after the procedure?
While you will feel no pain whatsoever during the procedure and while in our chair, depending on the amount of infection you had in your tooth when you presented to our office you may have anywhere from nothing to mild-moderate discomfort after the procedure when the numbness wears off. This is merely a healing response as your body tries to clean up the remaining infection from the bone. The pain is simply a result of local inflammation and is best controlled with anti-inflammatory medications such as Advil or Motrin. A post operative instruction form is provided to you at the end of the procedure (click here to see the form). In over 10,000 cases Dr. Nasseh has performed over the past ten years, the average discomfort after the root canal has been about 2 on scale of 10 according to the feedback surveys returned by those patients. This soreness will only last for a few days and is generally well controlled with Advil or Motrin. If you require prescription medication, this can be prescribed at the end of the appointment or if you call.
What is a root canal?
A root canal is one of the most common dental procedures performed, well over 14 million every year. This simple treatment can save your natural teeth and prevent the need of dental implants or bridges.
At the center of your tooth is the tooth’s pulp. Pulp is a collection of blood vessels that helps to build the surrounding tooth. Infection of the pulp can be caused by trauma to the tooth, deep decay, cracks and chips, or repeated dental procedures. Symptoms of the infection can be identified as visible injury or swelling of the tooth, sensitivity to temperature or pain in the tooth and gums.
How is a root canal performed?
If you experience any of these symptoms, your dentist will most likely recommend non-surgical treatment to eliminate the diseased pulp. This injured pulp is removed and the root canal system is thoroughly cleaned and sealed. This therapy usually involves local anesthesia and may be completed in one or more visits depending on the treatment required. Success for this type of treatment occurs in over 90% of cases. Depending on the specifics of each case, the success rates maybe lower. If your tooth is not amenable to endodontic treatment or the chance of success is unfavorable, you will be informed at the time of consultation or when a complication becomes evident during or after treatment. Occasionally, despite all our efforts a root canal treated tooth fails after the treatment (anywhere from a few weeks to a few years later) resulting into tooth loss. You will be able to drive home after your treatment, and you probably will be comfortable that same day and the following days, returning to your normal routine.
What happens after rooth canal treatment?
When your root canal therapy has been completed, a record of your treatment will be sent to your restorative dentist. You should contact their office for a follow-up restoration within a few weeks of completion at our office. Your restorative dentist will decide on what type of restoration is necessary to protect your tooth. It is rare for endodontic patients to experience complications after routine endodontic treatment or microsurgery. If a problem does occur, however, we are available at all times to respond. To prevent further decay, continue to practice good dental hygiene.
How much will a root canal cost?
The cost associated with this procedure can vary depending on factors such as the severity of damage to the affected tooth and which tooth is affected. In general, endodontic treatment is much less expensive than tooth removal and replacement with an artificial tooth. The costs will be discussed with you during your consultation visit.
Why would I need Endodontic Surgery?
Generally, a root canal is all that is needed to save teeth with injured pulp from extraction. However, this non-surgical procedure will occasionally be insufficient to eliminate the infection and the tooth may require surgical intervention if it is to be saved. Endodontic surgery can also be used to locate fractures or hidden canals that do not appear on x-rays but still manifest pain in the tooth. Damaged root surfaces or the surrounding bone may also be treated with this procedure. The most common surgery used to save failing root canal treated teeth is an apicoectomy, or root-end resection.
What is an Apicoectomy?
An apicoectomy involves removing the last few millimeters from the end of the roots of a failing root canal treated tooth. An incision is made in the gum tissue to expose the bone and surrounding inflamed tissue. The damaged tissue is removed along with the end of the root tip. A root-end filling is placed to prevent reinfection of the root and the gum is sutured. The bone naturally heals around the root over a period of months restoring full function.
Following the procedure, there may be some discomfort or slight swelling while the incision heals. This is normal for any surgical procedure. To alleviate any discomfort, an appropriate pain medication will be recommended. If you have pain that does not respond to medication, please call our office.
Who is an Endodontist?
An endodontist is a specialist in prevention, diagnosis, and the treatment of the diseases of pulpal origin. This field of study is called Endodontics and an Endodontist specializes in this area of dentistry. The pulp, which is the connective tissue inside the tooth, resides in the root canal space. Root canal therapy is cleaning the root canal spaces of diseased or infected teeth and filling that space with a plastic filling material to prevent its re-infection. Although the majority of root canals are done by general dentists across the nation, an endodontist is a formally trained specialist whose practice is limited to non-surgical and surgical root canal therapy and is experienced and equipped with treatment of the more complicated, challenging endodontic cases. He performs the procedure on daily basis and is highly trained for the best treatment outcome.
And Endodontist completes a two-three year postdoctoral fellowship and residency in the field of endodontics and gains further experience in this field. There currently are less than 4,000 practicing endodontists in the U.S. and even fewer worldwide.
Following Graduation from Northwestern University Dental School in Chicago, Dr. Nasseh completed a three year fellowship in Endodontics at Harvard School of Dental Medicine. He concurrently received a Masters in Medical Sciences in the area of Bone Physiology at Harvard. He has been on the faculty at Harvard Dental School for the past ten years and an adjunct professor at Tufts Dental School for the past two years.
What is endodontics?
Endodontics is a specialty of dentistry recognized by the American Dental Association involving treatment of the pulp (root canal) and surrounding tissues of the tooth. When you look at your tooth in the mirror, what you see is the tooth’s crown. The rest of the tooth, the portion hidden beneath the gum line, is called the root. The root is made of a hard tissue called dentin. In the middle of each root runs a hair-thin channel called “the root canal” which houses the pulp of the tooth. The pulp is made up of soft tissue, and nerves. The root canal space is normally sterile. When bacteria gets into this space as a result of tooth decay, gum disease, tooth fracture, or other problems, the sterile pulp gets infected and damaged. This infection is first confined to the root canal space. Inflammation here causes the severe pain associated with an infected tooth. If left untreated, the inflammation and infection which is confined to the root canal space spreads from the inside of the root into the surrounding bone and tissues causing a swelling and abscess. When the pulp is infected, there usually are only two options. Either the entire tooth has to be removed (extraction) or the infected root canal space must be cleaned and disinfected in order to save the tooth (root canal therapy). A root canal specialist (an Endodontist) has additional formal training after dental school (additional 2-3 years) and specializes in root canal therapy and root end surgery. The endodontist removes the diseased pulp and disinfects the root canal space in order to save the tooth and prevent further infection and inflammation from spreading. This is a fine and delicate procedure in a tiny space the size of a human hair. After successful endodontic treatment, the tooth continues to perform normally.
Techniques for root canal therapy procedures have changed drastically within the past 5-10 years. This intricate, delicate procedure is now completely painless. Advances in anesthesia and instrumentation techniques have rendered this procedure simpler than a filling. Dr. Nasseh is on the forefront of these technological advances and lectures extensively nationally and internationally on these topics to other dentists and endodontists. It is very important that your dentist/endodontist be up to date on these changes to render the highest quality care treatment. Dr. Nasseh recommends that you demand an absolutely painless procedure that is done efficiently and comfortably with a high success rate from any one performing these procedures on you.
I’m worried about x-rays. Should I be?
No. While x-rays will be necessary during your endodontics treatment, we use an advanced non-film computerized system, called digital radiography by Schick Technolgoies™ that produces radiation levels up to 90 percent lower than those of conventional dental x-ray machinery (approx. 9 digitals radiographs equal to a single film radiograph!) These digital images can be optimized, archived, printed and sent to your dentist via e-mail or diskette. For more information contact Schick Technologies, Inc.
What about infection?
We take infection control very seriously in our office. Our protocols and operational standards go beyond those recommended by the American Dental Association, Center for Disease Control, and state and local regulatory agencies. We adhere to the most rigorous standards of infection control for the safety of our patients, our staff and our doctors. We utilize autoclave sterilization, regular system audits, and full barrier techniques to eliminate any risk of infection.
What happens after treatment?
When your root canal therapy has been completed, a record of your treatment will be sent to your referring dentist. You should contact his/her office for a follow-up restoration within a few weeks of work completion at our office. Your dentist will decide on what type of restoration is necessary to protect your tooth. It is rare for endodontic patients to experience complications after routine endodontic treatment or microsurgery. However, depending on the condition of the tooth prior to the root canal or surgery (how much infection was already present) special instructions will be given to you at the completion of the procedure. We are available to answer any questions you have regarding any issues after the treatment and will respond quickly to your needs.
What new technologies are being used?
Operating Microscopes:
In addition to digital radiography, which reduces your x-ray exposure by up to 90% (ten digital x-rays equal one conventional film x-ray), we utilize special Operating Microscopes which magnify our field of view up to 30 times and illuminate the field with Xenon fiber optic illumination. This combination allows for exceptional diagnostic technical ability to treat the tiny root canal spaces inside your tooth. The microsurgical techniques have revolutionized endodontic care within the past ten years and allow for a far superior quality of care today than ever before. Today, problems such as cracks, root fractures, and calcified canals can better be visualized and therefore treated. Also, a tiny video camera on the operating microscope can record images of your tooth to further document the doctor’s findings. It is doctor Nasseh’s belief that root canal therapy should only be performed under these microscopes for the highest quality of care to be rendered.
Apex Locators:
Apex locators allow for electronic, accurate measurement of root lengths without exposing you, our valuable patient to additional x-rays and radiographs. They improve the quality of care and allow for more precision based endodontics.
Ultrasonics:
Electronic instruments are now available that create ultrasonic vibrations, which clean the root canals effectively and efficiently. These instruments increase the quality of care and allow for success in situations that were previously hopeless.
Nickle Titanium Instrumentation:
Today, the cleaning and shaping of root canals is no longer a brute procedure done with hand files. This job is now done with mechanized, engine driven rotary files that have made the procedure more efficient, predictable, quieter, and far more comfortable than before. These instruments have increased the quality of care and made the procedure much easier and more pleasant for the patient