What is an endodontist?

An endodontist is a dentist who specializes in saving natural teeth. After dental school, endodontists complete two or more additional years of advanced training focused on diagnosing tooth pain and treating the inside of the tooth: the soft tissue called the pulp, and the roots that anchor the tooth in the jaw.

Because this is all we do, we perform root canal treatment every day and are equipped for cases that are complex, unusual, or difficult to diagnose.

Why did my dentist refer me to a specialist?

A referral is a sign that your dentist wants you to have the best possible outcome. General dentists often refer patients when a tooth has complicated anatomy, when the source of pain is unclear, when a previous root canal needs attention, or simply because a specialist can complete the treatment more predictably and comfortably.

We work closely with your dentist throughout. We treat the specific tooth, send a full report and images back to their office, and you return to them for your ongoing care.

What is the dental pulp, and why does it matter?

Inside every tooth, beneath the hard enamel and dentin, is a small space containing nerves, blood vessels, and connective tissue. This is the pulp. It is essential while a tooth is developing, but a fully formed adult tooth can function well without it because the tooth continues to be nourished by the tissues around the root.

When the pulp becomes inflamed or infected, it cannot heal on its own. Common causes include deep decay, repeated dental work on the same tooth, a crack, or an injury.

Do I need a referral to be seen?

Most patients come to us through their dentist, but a referral is not required. If you are in pain or have a concern about a tooth, you are welcome to call us directly. We offer a range of solutions designed to meet your needs—whether you're just getting started or scaling something bigger. Everything is tailored to help you move forward with clarity and confidence.

What is a root canal?

A root canal is a procedure that removes inflamed or infected pulp from inside a tooth so the tooth itself can be kept. After numbing the area, we make a small opening in the top of the tooth, clean and disinfect the narrow canals inside the roots, and then fill and seal them to prevent bacteria from returning.

The goal is simple: relieve pain, clear infection, and preserve your natural tooth.

How do I know if I need one?

Only an examination can say for certain, but these are common signs:

• Lingering sensitivity to hot or cold that continues after the source is removed

• Pain when biting or chewing

• A spontaneous or throbbing toothache, especially one that wakes you at night

• Swelling or tenderness in the gums, or a small pimple-like bump near the tooth

• A tooth that has darkened in color

Some teeth that need treatment cause no symptoms at all and are found on a routine X-ray. That is why your dentist may recommend a visit even if the tooth feels fine.

Does a root canal hurt?

This is the question we hear most, and the honest answer is that the procedure has a far worse reputation than it deserves. With modern anesthetics and techniques, most patients find it comparable to having a filling placed.

The pain people associate with root canals usually comes from the infection itself, before treatment. The procedure is what relieves it.

How successful is root canal treatment?

Root canal treatment has a high success rate, and a properly treated and restored tooth can last a lifetime. Long-term success depends on several things: the condition of the tooth beforehand, a good final restoration from your dentist, and continued care at home.

No medical procedure can be guaranteed. We will always give you a candid assessment of your particular tooth before you decide.

Is a tooth "dead" after a root canal?

Not in any way that matters for function. The tooth no longer has a nerve inside, so it will not feel hot or cold, but it remains anchored in living bone and gum tissue. You will still feel pressure when you bite, and the tooth works like any other.

I have read that root canals can cause illness elsewhere in the body. Is that true?

No. This idea traces back to research from roughly a century ago that has never been reproduced and does not hold up to modern scientific standards. There is no valid evidence linking root canal treated teeth to disease elsewhere in the body.

Treating an infected tooth removes a source of infection. Leaving it untreated is the greater risk.

What happens at my first appointment?

We begin with a thorough evaluation. We will review your medical and dental history, talk through your symptoms, and examine the tooth and the area around it. This usually includes X-rays and a few simple tests that tell us how the tooth responds to temperature and pressure.

Once we have a diagnosis, we will explain what we found, what your options are, and what we recommend. In many cases treatment can begin the same day. In others, we will schedule a separate visit.

How long does treatment take?

Some root canal treatments are completed in one visit of about 60 to 90 minutes. Many teeth, particularly molars with several canals, teeth with significant infection, or retreatments, may need a second visit. We will let you know what to expect for your tooth before we begin.

What technology do you use?

Every treatment is performed under a surgical operating microscope, which provides the magnification and light needed to see fine details inside the tooth. We also have a cone-beam CT scanner in the office. It produces a 3D image of the tooth and surrounding bone, taken and interpreted during your appointment, at a much lower radiation dose than a medical CT.

These tools allow us to find anatomy that would otherwise be missed and to make more accurate diagnoses.

I am very anxious about dental treatment. Can you help?

Yes, and you are far from alone. Please tell us when you schedule so we can plan your visit around your comfort. We take our time, explain each step before it happens, and you can ask us to pause at any point.

We also offer Nitrous Oxide aka “Laughing Gas” for patients who would like additional help relaxing.

What if I have trouble getting numb?

Some teeth, especially those that are very inflamed, are harder to numb. This is something endodontists manage routinely. We have additional anesthetic techniques available, and we will not begin until you are comfortable.

Can I drive myself home and go back to work?

With local anesthetic alone, yes. Most patients drive themselves and return to work or normal activities the same day. Your lip, cheek, or tongue may stay numb for a few hours.

Should I eat before my appointment? Should I take my usual medications?

Unless we tell you otherwise, eat a normal meal beforehand and take your regular medications as prescribed. Please bring a current list of your medications, and let us know about any allergies or changes in your health.

What should I expect afterward?

It is normal for the tooth and surrounding gum to feel tender for a few days, particularly when chewing. This is the body's healing response and it generally improves steadily. Most patients manage well with over-the-counter pain relievers, and we will give you specific instructions before you leave.

Please call us if you have swelling, pain that worsens rather than improves, a reaction to a medication, or a bite that feels uneven.

When can I eat?

Wait until the numbness has worn off so you do not bite your cheek or tongue. Until your dentist places the permanent restoration, avoid chewing hard or sticky foods on the treated tooth. Otherwise, brush and floss as you normally would.

Will I need a crown?

Often, yes. Back teeth in particular absorb heavy chewing forces, and a tooth that has had a root canal is more prone to fracture without full coverage. A crown protects the tooth and seals it against bacteria. Some front teeth with little damage can be restored with a filling instead.

Your general dentist places the final restoration. The temporary filling we place is not designed to last, so please schedule that visit promptly, ideally within a few weeks. Delaying it is one of the most common reasons a successful root canal later fails.

Will I need to come back to your office?

We may ask you to return for a brief follow-up visit, typically several months to a year after treatment, so we can take an X-ray and confirm the area is healing as expected. There is no charge for this visit.

Can a tooth that has had a root canal still get a cavity?

Yes. The tooth is still natural tooth structure and can decay like any other, and because it has no nerve, it may not warn you with sensitivity. Good home care and regular checkups with your dentist remain important.

I already had a root canal on this tooth. Why is it bothering me again?

Most treated teeth last for many years, but occasionally one does not heal fully or becomes painful or infected again, sometimes long after the original treatment. Possible reasons include narrow or curved canals that were not fully treated the first time, a delayed or leaking crown or filling, new decay, or a crack.

This is not a reflection of anything you did wrong, and in many cases the tooth can still be saved.

What is endodontic retreatment?

Retreatment means reopening the tooth, removing the earlier filling material, cleaning and disinfecting the canals again, and resealing them. It gives the tooth a second opportunity to heal. From a patient's perspective, the experience is similar to the original root canal.

What is an apicoectomy?

An apicoectomy, also called endodontic surgery or root-end surgery, is a minor surgical procedure used when infection persists at the tip of a root and cannot be resolved by treatment through the top of the tooth. Through a small opening in the gum, we remove the infected tissue along with the very end of the root, then seal the root tip.

It is performed with local anesthetic in our office, and most patients return to normal activities the next day.

What about a cracked tooth?

Cracks are common and can be difficult to detect because many do not appear on X-rays. Typical symptoms are sharp pain on biting or releasing, or sensitivity that comes and goes.

Treatment depends on where the crack is and how far it extends. Some cracked teeth need only a crown, some need a root canal and a crown, and some unfortunately cannot be saved. Early evaluation gives the best chance of keeping the tooth.

Do you treat dental injuries?

Yes. Teeth that have been knocked loose, pushed out of position, fractured, or knocked out entirely often need care from an endodontist. Time matters with these injuries, so please call us as soon as possible.

If a permanent tooth is knocked out, handle it by the crown and not the root, gently place it back in the socket if you can, or keep it in milk, and seek dental care immediately.

Would it be easier to just have the tooth pulled?

Extraction can seem simpler, but it is rarely the end of the story. A missing tooth usually needs to be replaced with an implant or a bridge to preserve your bite, prevent neighboring teeth from shifting, and maintain the bone. That typically means more appointments, more time, and greater overall cost than saving the tooth.

When a tooth can be predictably saved, keeping it is generally the best choice. Nothing functions or feels quite like your natural tooth.

Are implants not just as good?

Implants are an excellent treatment when a tooth cannot be saved, and we will tell you plainly if we believe that is your situation. They are a replacement for a missing tooth, though, not an improvement on a healthy natural one. Our role is to give you an honest assessment of your tooth's long-term outlook so you can make an informed decision with your dentist.

What happens if I wait or do nothing?

An inflamed or infected pulp does not recover on its own. Pain may come and go, and it sometimes disappears altogether when the nerve dies, which can feel like the problem has resolved. The infection, however, typically continues quietly and can spread into the surrounding bone.

Waiting can lead to an abscess, swelling, bone loss, or the loss of a tooth that could have been saved earlier.

Will antibiotics clear up the infection?

Not on their own. Antibiotics travel through the bloodstream, and an infected tooth no longer has a blood supply inside it, so the medication cannot reach the source. They can help control an infection that is spreading and are sometimes prescribed for that reason, but the tooth itself still needs treatment.

Are dental X-rays safe?

Yes. Digital dental X-rays use a very small amount of radiation, comparable to what you receive from natural background sources over a day or so. We take only the images needed to diagnose and treat your tooth safely.

Why might I need a 3D scan?

A standard X-ray flattens a three-dimensional tooth into a two-dimensional picture, which can hide important details. A cone-beam CT scan lets us see the number and shape of the canals, the extent of an infection, and nearby structures such as nerves and sinuses. We recommend it only when it is likely to change the diagnosis or improve your treatment.

I am pregnant. Can I have a root canal?

Yes. Treating a dental infection during pregnancy is considered safe and is preferable to leaving it untreated. Please let us know that you are pregnant and how far along you are. We will take appropriate precautions with X-rays, choose anesthetics and medications that are suitable during pregnancy, and coordinate with your obstetrician if needed.

I have a medical condition or take blood thinners. Is treatment still possible?

In almost all cases, yes. Root canal treatment is one of the more conservative dental procedures and is routinely performed for patients with heart conditions, diabetes, joint replacements, and those taking blood thinners. Please do not stop any medication on your own before your visit.

Share your full medical history and medication list with us. If you have been told to take an antibiotic before dental appointments, let us know, and we will consult with your physician when appropriate.

Can children and teenagers be treated?

Yes. We see younger patients, most often after a sports injury or a fall. Teeth that are still developing need a specialized approach, and timely care can make a significant difference in the long-term outcome.

I am in pain right now. How quickly can I be seen?

We keep time in our schedule for patients in pain and do our best to see emergencies the same day or the next business day. Please call us at (908) 517-3455 as early in the day as you can.

If you have facial swelling that is spreading, a fever, or any difficulty swallowing or breathing, do not wait. Go to the nearest emergency room or call 911.

What can I do for the pain until my appointment?

Over-the-counter pain relievers taken as directed on the label help many patients, provided they are safe for you to take. Avoid chewing on the affected side and avoid very hot or cold foods and drinks if they trigger pain. Do not place aspirin directly against the gum, as it can burn the tissue.

These measures offer temporary relief only. They do not treat the underlying problem.

How much does treatment cost?

The fee depends on which tooth is involved and how complex the treatment is. Molars have more canals than front teeth and take longer to treat, and retreatment is more involved than a first-time root canal. After your examination, we will give you a clear estimate before any treatment begins.

Do you accept my insurance?

We are in network with these dental PPO plans: Aetna, Careington, Cigna, Delta Dental, Guardian, Horizon, Humana, and MetLife. Please have your insurance card with you when you call to schedule, and we will make every effort to verify your coverage before your visit.

Payment is due at the time of service. We accept major credit cards, Apple Pay, and Google Pay.

What should I bring to my first visit?

• Your referral slip and any X-rays from your dentist, if you were given them

• A list of your current medications and any allergies

• Your dental insurance card and a photo ID

• Any questions you have. We are glad to answer them.

I have a question that is not answered here.

Please call us at (908) 517-3455 or email office@boutiqueendodontics.com. There are no unimportant questions, and we would much rather you ask than worry.