What a root canal is, and what happens if it doesn't hold

Inside every tooth is soft tissue called pulp, in narrow channels that run down each root. When the pulp is inflamed or infected, a root canal takes it out, cleans and shapes the channels, then fills and seals them. Your general dentist usually follows with a crown or a filling.

A hard outer layer of enamel, a softer layer of dentin under it, and the pulp at the center. Front teeth usually have one canal, molars often have three or four, and some have more. The canals are thinner than a strand of hair in places, which is why finding them takes light and magnification.

Only an exam and X-rays can tell. Lingering pain with hot or cold, pain when you bite, swelling, a bump on the gum or a tooth that darkens can be signs. Some teeth give no signs at all, so your dentist may find the problem on an X-ray.

A tooth can have a canal that wasn't found the first time, a canal that was hard to clean, or a crown or filling that let bacteria in later. Sometimes a root canal heals slowly. It doesn't mean anyone did something wrong.

We open the tooth, take out the old filling in the canals, clean them again under the microscope, and fill and seal them. If a crown is in the way, we may go through it or take it off, and we'll tell you before we do. Your general dentist then restores the tooth.

No. Some teeth have a crack that runs into the root, or too little tooth left to hold a crown. We look first, and if retreatment is unlikely to help, we say so and go through the other options.

Root-end surgery, which cleans the tip of the root through the gum, or taking the tooth out and replacing it with an implant or a bridge, or leaving the space. Each has trade-offs. Dr. Abe explains them and what happens if you wait, and the decision is yours.

Most retreatments take one or two visits, and some take three. A tooth with hard-to-reach canals, or one that needs time between visits to settle, takes more. Each visit usually runs 60 to 90 minutes. After we've looked at your tooth, we tell you the range for it.

We numb the tooth before we start, and if you feel anything, raise your hand and we stop. Afterward the tooth is often sore for a few days. Dr. Abe tells you what to take for it and when to call us. No one can promise you won't feel anything, and we won't.

We numb the tooth with a local anesthetic, which Dr. Abe gives herself. We don't offer other kinds of sedation in this office. If you're anxious about the visit, tell us when you call. Breaks, headphones and a talk beforehand help many people.

Swelling that spreads, or trouble breathing or swallowing, needs the emergency room or 911. A toothache that won't quit, a broken tooth or a swollen gum means calling us right away. Our urgent tooth pain page has the details.

We work with dental plans by type. Our how fees work page lists them, and says where we stand on each. Call with the name of your plan and we'll tell you before your visit.

You pay the visit fee yourself, and you get a written estimate before any treatment. Our how fees work page explains the options.

Our how fees work page says where we stand, in one place. If we can't see you under your plan, we'll help you find an office that can.

Yes. You can ask for one when you schedule or at your first visit. It lists what we expect to do and the fee for each step.

No. Many patients come from their dentist, and you can also call us yourself. If your dentist sent you, we'll ask for their name so we can send them a report.

We take the X-rays we need to look at your tooth, and sometimes a 3D scan. We don't do cleanings, exams or fillings. Your general dentist keeps doing those, and gets a report from us.

We treat adults and teenagers. For a younger child, call us; a pediatric dentist may be the better first call.

Damaris Chacon, who runs our front desk, speaks Spanish. Dr. Abe's visits are in English.

Call us as early as you can, and we'll find another time. A cancelled visit gives another patient the chair.