Endodontics is the branch of dentistry specializing in the treatment of the dental pulp and tissues surrounding the roots of a tooth. Endodontists are dentists that are “root canal specialists”. Dr. David Meier with Western Nebraska Endodontics is our go-to Endodontist at our office. He is the only Endodontist on Western Nebraska. He practices in North Platte, Scottsbluff and Sidney. We had a bunch of questions from patients and wanted to ask the expert, so Dr. Haag sat down with Dr. David Meier to answer the most asked questions about Endodontics!
Dr. Haag: Tell me a little bit about yourself!
Dr. Meier: “I grew up on a farm in Illinois and went to college thinking I would become a dentist or a veterinarian. I was able to work in a dental office for a few years during undergrad and decided that was the choice for me. I then went to the University of Iowa for both dental and endodontic training over the next six years. The endodontic residency was two years following dental school. While in school, I met and married my wife, Mary Beth, who is an orthodontist. We have two young boys. I started Western Nebraska Endodontics in 2014 and am the only endodontist (root canal specialist) in the western half of Nebraska. I practice in North Platte 4-5 days a week, once a week in Scottsbluff and once a month in Sidney.”
Dr. Meier answers are some questions from our patients!
Why do we need to see a specialist as opposed to a general dentist? What do you have or what can you do that is different?
Although general dentists can do root canals, I am often referred the more difficult cases. Difficult teeth usually include teeth that are molars, have multiple roots, have smaller canals, or curvatures in the root. I have a surgical operating microscope that I use on every case that allows me to visualize everything I am cleaning in the tooth. We also have a 3D imaging machine to give us a roadmap of the internal anatomy of each tooth. These two pieces of equipment greatly reduce the chance of missed canals or anatomy that may lead to a failed root canal. The microscope also allows me to identify cracks or fractures that may alter our treatment plan for a tooth.
I also have extra training and experience to treat these teeth proficiently and as quickly as possible to give the patient the best experience. Root canal teeth are usually the toughest teeth to numb. We are used to this and take special care to make sure the patient is completely numb before starting. I do root canals all day, everyday, and am used to dealing with the most difficult teeth and can handle the complications that may arise during treatment. We mainly get the most difficult root canals from general dentists in the whole western half of the state. We also get a fair share of root canals that have been started and then referred because the general dentist could not find the canals, broke an instrument, can't get the patient numb, etc. General dentists not only trust us to care for their patients but oftentimes their families and even themselves.
Can I drive myself?
Yes. The procedure is very similar to a filling, usually takes a little longer. We numb up right around the tooth and do not put you to sleep.
How long will it last?
We typically schedule enough time to confirm that a root canal is appropriate for the tooth and have time for treatment. Most can be done in about an hour. Typically, most are completed in just a single visit. After a root canal is completed, our goal is that it will last you the rest of your life.
If I am nervous what are you able to do to help? Do you offer any sort of sedation?
It seems that most anxiety is due to fear- either of shots, noises, not being numb, or of previous horror stories of root canals. We usually talk through with you your concerns and address them during treatment. Before starting, we do several tests to make sure the tooth is numb. If you have any issues during treatment, just let us know and we will stop and resolve them. Some patients bring headphones to listen to their choice of music. Although we do not offer nitrous oxide or general sedation, a surprising number of our patients do fall asleep during treatment.
Will it be painful?
The worst part of the procedure is getting numbed up - nobody likes that. But beyond that, you should not feel anything. We use topical jelly and go slow during the injection to limit discomfort. During the actual procedure, you should not feel any pain. If you do, let us know and we will address it before moving forward. You then will be numb for the next few hours. This is a good time to get some pain medication on board as the tissues will be sore due to working inside the tooth and the injection site.
Why do I need a crown afterwards?
The crown holds the tooth together after the root canal is done. Unfortunately, we are usually doing root canals on compromised teeth - teeth that have large cavities, fillings, or cracks. Doing the root canal cleans out the nerve tissue of the tooth, but does not make the tooth stronger. Studies have shown that a crown placed on a root canal treated tooth gives the tooth a 6x better chance of surviving long term. The crown helps limit cracks or fractures of the tooth.
Why do root canals sometimes get reinfected?
Root canals have a high rate of success, 90+%, but they still can have issues. Typical reinfections can happen if the tooth is not cleaned out completely, meaning missed canals or anatomy. They also can become reinfected if they are cracked or fractured. Treating root canals with a microscope and 3D scan allows us to limit these problems for you in the future, leading to higher success and survival of your teeth.
Why would I want to save the tooth, isn’t it easier to pull the tooth and do an implant?
Root canals are typically the easiest and most cost efficient way to save your teeth. The investment in a root canal and crown is usually less than an implant and involves fewer steps. Saving your natural teeth also contributes to a more natural smile as sometimes the gum tissue around implants is not as esthetic as that of your natural teeth. Issues may arise that would disallow the use of implants. These include too close proximity to the maxillary sinus, not enough bone in the area, or an implant that becomes loose after placement in the bone. There are certain medications that also make healing of extractions more difficult and push us to save the natural tooth if at all possible. There are instances, however, where an extraction and implant may be a better option. We will review your options before treatment and guide you in making the best choice for you.
Anything else you would like patients to know or questions you get frequently?
Although root canals have been a dreaded procedure in the past, with today’s technology, they can be accomplished with ease and with little to no discomfort. As I mentioned earlier, a lot of our patients actually fall asleep during the procedure. Many patients that are anxious before treatment will remark on how easy the procedure actually was.
Thank you to Dr. David Meier with Western Nebraska Endodontics for sitting down and getting to the "root" of our questions!