FAQS

WHAT IS AN ENDODONTIST?

Endodontists are root canal specialists. In practical terms, they are specialists in saving teeth. They perform root canals by disinfecting and sealing the inner most chambers of your tooth and are committed to ensuring that your tooth will last as long as biologically possible. They have advanced academic and clinical training, state-of-the-art technology, and utilize specialized techniques to ensure that you receive the highest standard in care with the best results. The goal is to ensure a lifetime of healthy natural teeth! Dr. Alen Jakob has the been in private practice for 4+ years and only treating and diagnosing root canal patients for the past 6 years.

WHY SEE AN ENDODONTIST?

There is no substitute to your natural tooth. First-rate endodontic care is the holistic approach. It is highly effective in keeping your tooth and body healthy and in relieving you of your pain. It belongs to you and was designed to function optimally for you. Any replacement has its own potential issues and is simply foreign to your body no matter how well it is made. Alternative options such as dental implants, flippers, and bridges, should be reserved for teeth that are hopeless in saving. A simple diagnostic examination can answer your questions. Talk to our specialist before extracting any tooth!

WHEN TO SEE AN ENDODONTIST?

If you have sensitivity to hot or cold, pain to biting, an abscess, or an injured tooth visit an endodontist. Often a chronic infection can develop and go unnoticed for many months! Prolonging root canal treatment will further increase infection and is a ticking time bomb for pain to erupt. A general dentist will refer you to an endodontist to diagnose and treat dental emergencies, difficult to manage pain, technically and biologically complex root canals, difficulty with anesthesia, or any other condition that presents a particular root canal or surgically related challenge.

HOW DO I KNOW IF MY TOOTH NEEDS A ROOT CANAL TREATMENT?

The need for root canal treatment is determined by your endodontist through a series of tests and X-Ray and/or CT scan (3D imaging) readings. One of the first obvious subjective signs is the onset of pain. Tooth pain can range in intensity from mild to severe, and oftentimes there is no pain at all. It can have a sudden or gradual onset, can be constant or intermittent in frequency, spontaneous or exacerbated when biting, and/or sensitive to temperature changes such as to hot or cold. Referred pain down the side of your jaw or up to the temple region is common for inflamed and temperature sensitive teeth that have had recent deep fillings or from older and decayed fillings. Regional swelling and pain to touch and/or biting is a common sign of a failing older root canal treatment.

WHY SHOULD I SAVE MY TOOTH?

There is no substitute to your natural tooth. High quality endodontic treatment is highly effective in allowing you to keep your own tooth for a very long time. It belongs to you and was designed to function optimally for you. Any replacement has its own potential issues and is simply foreign to your body no matter how well it is made. Alternative options such as dental implants, flippers, and bridges should be reserved for teeth that are hopeless in saving. A simple diagnostic examination can answer your questions. Just because a tooth has failing older root canal does not mean that root canals don’t work. Proper and thorough disinfection and sealing of a tooth should allow your root canal treatment to last pain and infection free for decades. Talk to your endodontic specialist before extracting any tooth!

IS ROOT CANAL TREATMENT PAINFUL?

The answer is NO. However, there are two factors that contribute to stories and tales of painful root canal experiences, but this doesn’t have to be the case!

  1. Experience and training of the treatment provider in administering local anesthetic: To have the most comfortable and pain-free root canal procedure, it is crucial that your treatment provider be able to administer the right type, right location, right order, and right amount of anesthetic specific to your tooth infection. Understanding the differences in types of infections (the endodontic diagnosis) will dictate the anesthetic protocol needed to achieve maximal comfort and a pain free root canal experience.


  1. Pain prior to your visit: The duration and pain level of the tooth’s infection at the time you seek care will determine how uncomfortable the treatment is likely to be. This is the reason we always stress early endodontic intervention.

WILL IT HURT AFTER TREATMENT?

Pain after treatment is dependent upon your pain level prior to your visit. If you’re coming in with pain, the greater the chance pain will persist for a few days afterwards. Again, another reason why early intervention is to your benefit! However, have no fear, as the goal at Midtown Root Canal is to help you get out of pain and fast! The procedure itself would be virtually painless and with proper management and following the doctor’s prescription plan (pain medication and/or antibiotics), maximal post treatment pain relief can be achieved.
The general rule is that if you know that you need a root canal, do not delay treatment longer than you need to! The onset of pain from an already known infected tooth can occur at any time without notice. If you receive root canal treatment prior to the onset of pain, you’ve done yourself a great service. In this instance, the chance for post-op pain is reduced to mild or no pain at all in the majority of cases.

MY GENERAL DENTIST DOES ROOT CANALS, CAN'T I JUST SEE THEM FOR THE PROCEDURE? WHY DOES IT MATTER WHO I SEE FOR ROOT CANAL TREATMENT?

Experience. Training. Knowledge. This makes all the difference. Only 4% of dentists are trained endodontists. What this means is that they’ve completed an additional 2-3 years of residency beyond dental school and their focus is primarily ROOT CANALS. In many cases, you can save your tooth, and the specialist who can save your tooth is an endodontist.
Approximately, 50% percent of the cases seen in our office are repairing failing root canals non-surgically (Root Canal Retreatment) or surgically (Apicoectomy). Therefore, you want to get it done right, the first time! Endodontists with their extensive training can treat the most complicated to the more straightforward root canals more predictably and comfortably.
It should be stressed that even the more straightforward of root canals require patience and diligence to accomplish total disinfection of the tooth for the purpose of maximizing long term results. Check to make sure that your endodontic specialist has the latest in equipment and technology in their office. Microscopes and CT scans are essential tools used in modern endodontics. It will provide the most accurate diagnosis and the clearest visual of the operating field to ensure a thoroughly treated tooth. See the technology section for more information on the latest technology at Midtown Root Canal.

WHY ARE SOME ROOT CANALS MORE COMPLICATED TO TREAT THAN OTHERS?

Root Canal anatomy represents an extreme and rugged environment that needs to be cautiously navigated even by the most masterful of navigators. Some variances include canal calcifications, obstructions, and sharp canal curvatures. Tough tissue contents may also impede the path along the length of the root canal space that needs to be cleaned. Other times canals may join or split from each other. These factors make each root canal treatment highly variable and personal.

HOW MANY VISITS DOES IT TAKE TO DO A ROOT CANAL?

Root canals typically take 1-2 visits. At Midtown Root Canal we provide evidence-based care. What this means is that we adhere to principals of biology, bacteriology, and wound healing to determine the optimal number of treatment visits. About 50% of cases, should be performed in one visit while the other 50% require 2-3 visits. With advanced infections or retreatment of root canals it is often in the patients' best interest to have the treatment split into 2 visits to allow for additional disinfection protocols that will increase the chances for successful outcomes (disinfecting the tooth two times is better than doing it one time in advanced infections).  In addition, Dr. Jakob places a special calcium-based medication in between visits that can enhance the tooth's level of disinfection.

HOW ARE ROOT CANALS PERFORMED?

With love, tremendous patience, and the determination to disinfect the heck out of your tooth so that the infection will not return. We know that our root canals can serve you as well as any healthy tooth in your mouth. This can only be achieved by employing the highest standards in disinfection, and with extreme diligence in locating, cleaning, and sealing ALL of the canals in your tooth. 
Diagnosis is the first step. If root canal treatment is deemed necessary after a thorough clinical exam, the first phase of treatment is administration of a local anesthetic. We gently get you numb so you don’t feel a thing throughout the entire procedure. Dr. Jakob has extensive training and experience in getting the most difficult and painful teeth numb enough to make any root canal procedure painless. In fact, the majority of our patients report being bored or falling asleep. That’s how painless the whole procedure is! A small opening is then made through the top part of the tooth to gain access to the root canals. The infected pulp is removed with specialized instruments. Disinfecting solutions are then utilized to ensure that the canals are thoroughly cleaned of infected tissue. Once the canals are completely disinfected, they are then sealed with a biologically compatible sealer to prevent reinfection. A strong temporary filling is then placed, and your tooth is now ready for your general dentist to restore with a core buildup and/or crown.

WHY DO ROOT CANALS FAIL?

Root canals will fail due to many different factors. The main cause is poor disinfection of the root canal space. The most important step is locating all of the canal spaces in the tooth. If any canal passageway is left untreated, the infection will invariably return (often you will only notice the problem a few years after a poorly done job). Poor instrumentation and the inability to reach down to the very end of the root canal will leave bacteria and infected tissues in the tooth that are primed to then infect the bone surrounding your tooth. In addition, poor disinfection techniques will not get the infection out in its entirety. At Midtown Root Canal Dr. Jakob spends the majority of the treatment time cleaning out the tooth in its entirety and completely removing the source of infection.

DO YOU HAVE TO BE PUT TO SLEEP FOR A ROOT CANAL?

Not at all! Most patients doze off on their own during our root canal procedures. All that is necessary is a simple local anesthetic injection.

CAN I GO TO WORK AFTER A ROOT CANAL TREATMENT?

Yes. Most patients have no issue returning to work following treatment. The numbness in your jaw will typically dissipate in 1-2 hours following treatment. Any numbness should not prevent most people from continuing with their work day. Pain is typically minimal and if needed can be alleviated with over the counter pain medication.

WHAT CAN I EAT AFTER A ROOT CANAL TREATMENT?

After each appointment when anesthetic has been used, your lips, teeth and tongue may be numb for several hours. Avoid chewing on the side of the treated tooth until the numbness has completely worn off.  A hard-temporary filling is usually placed in between appointments or after completion of the root canal. The tooth is usually reduced in height to protect the tooth from fracturing between completion of treatment at our office and the time that a crown (and or composite buildup) is placed on the tooth by your general dentist. To help keep your temporary in place, avoid chewing sticky foods (especially gum) and avoid eating very hard foods and hard substances such as ice, nuts, fingernails, and pencils. If possible, chew only on the opposite side of your mouth.

CAN YOU TELL ME ABOUT MY TOOTH AND IT'S STRUCTURE?

The human tooth consists of one or more roots and a crown that make up the entire tooth's structure. The roots contain small passageways called root canals that contain nerves, blood vessels and connective tissue, that make up the pulp, the live innermost part of the tooth.
In a healthy tooth, the natural bacteria that live inside your mouth does not invade the pulp. However, when someone has a deep cavity or a microcrack in the tooth, these bacteria can invade and inflame the pulp. When this occurs, symptoms such as pain, sensitivity to hot and/or cold, and pain to biting can develop. When these symptoms arise, it is time to see an endodontist.