Dr. Rhoades has 30 years of experience practicing dentistry.  There is a certain level of success in endodontics that goes with experience.  Not all teeth fall under the same "mold".  Often you and your tooth will have unique circumstances and this is where you will gain the reward of Dr. Rhoades' experience.  This experience also allows him to fully evaluate your tooth and determine if it is savable.  He will evaluate you fairly and honestly, taking into consideration your overall full mouth individual dental needs.  When you are our patient we devote ourselves totally to you, we do not bounce from room to room.  You and your time are our priority.

Endodontics is a branch of dentistry recognized by the American Dental Association involving treatment of the pulp (root canal) and surrounding tissues of the tooth.  The portion of the tooth hidden beneath the gum line is called the root.  The outer portion of the root is a hard tissue called dentin, the inside channel or "root canal" contains a pulp of soft tissue, blood vessels and nerves.  Bacteria that are introduced into the pulp as a result of tooth decay, periodontal disease, tooth fracture or other problems, can severely damage the pulp.  When that happens, an endodontic specialist removes the diseased pulp to save the tooth and prevent further infection and inflammation.  After successful endodontic treatment, the tooth continues to perform normally.

Signs to look for include pain, prolonged sensitivity to heat or cold, tenderness to touch and chewing, prolonged symptoms of sinus trouble, discoloration of the tooth, and swelling, drainage, and tenderness in the lymph nodes as well as nearby bone and gingival tissues.  Sometimes, however, there are no symptoms.

Endodontic treatment is necessary when the pulp, the soft tissue inside the root canal, becomes inflamed or infected.  The inflammation or infection can have a variety of causes:  deep decay, repeated dental procedures on the tooth, or a crack or chip in the tooth.  In addition, an injury to a tooth may cause pulp damage even if the tooth has no visible chips or cracks.  If pulp inflammation or infection is left untreated, it can cause pain or can lead to an abscess.

Dr. Rhoades removes the inflamed or infected pulp, carefully cleans and shapes the inside of the canal, then fills and seals the space.  Afterwards, you will return to your dentist, who will place a crown or other restoration on or in the tooth to protect and restore it to full function.  After restoration, the tooth continues to function like any other tooth.

Most teeth can be treated.  Occasionally, a tooth can't be saved because the root canals are not accessible, the root is severely fractured, the tooth doesn't have adequate bone support, or the tooth cannot be restored.  However, advances in endodontics are making it possible to save teeth that even a few years ago would have been lost.  When endodontic treatment is not effective, endodontic surgery may be able to save the tooth.

A typical visit to our office begins with completing paperwork, which includes your medical history, pain history, and consent forms, all of which can be done online prior to your appointment from the comfort of your home.  It is advisable to bring a list of all the medications (over-the-counter and prescription) that you take regularly/have taken within the past month.  Once all forms are complete, an assistant will review and chart your chief complaint, referring dentist's information and history of the tooth pain before taking x-rays of your teeth.  Once your x-rays are complete, the assistant will perform various tests on your tooth and a few of the surrounding teeth.  You will then be greeted by Dr. Rhoades, who will review your paperwork and evaluate your symptoms, your x-rays, and your test results.  After his review is complete, a diagnosis will be given to determine the best treatment care and prognosis.  Possible post-treatment decisions such as a crown on the treated tooth will be addressed.  Dr. Rhoades will make you aware of the benefits, options, and risks involved involved in order for you to understand how endodontic treatment is a way of saving your tooth.  If you decided to receive treatment, the procedure may start immediately.  Before treatment begins, you will receive local anesthesia to numb any sensations you may feel during the procedure.  If the procedure is unable to be completed within one visit, medicine may be placed inside the tooth between appointments.  One your procedure is complete, more x-rays are taken to track the success of the treatment.  You will be provided with an information packet that includes your post-operation instructions and what to expect over the next few days.

The use of a high magnification microscope greatly increases the chance of success in endodontic therapy.  As you can imagine, the inner canals of a tooth are extremely tiny tunnels; they can even be smaller than the width of a hair.  Often times where we used to find 3 canals, we are now finding 4, 5, and even 6.  The more we can visualize the internal and external aspects of the tooth, the higher the percentage of success for that individual tooth.

During your exam, the dentist is only able to examine the visible surfaces of the tooth and the soft tissue.  Dental x-rays allow the dentist to see areas between the teeth where larger problems maybe forming.  These x-rays also allow the dentist to examine the mandible and maxilla area for any abnormalities.  As an endodontic practice, it is absolutely imperative that we have the films we need to thoroughly diagnose and treat your root issues, an area not visible without the use of x-rays.

No.  X-rays will be necessary during your endodontic treatment and we use an advanced non-film computerized system, called digital radiography.  These digital images can be optimized, archived, printed, and sent to you and your doctor via e-mail.

Only the patient and treatment team is allowed in the consultation room during any x-rays and testing.  Family members can join us later for the consultation and discussion.  If treatment is initiated, they will need to wait in the reception area.

Our office uses the more modern digital x-rays and the amount of radiation that one digital x-ray gives off is 0.1 mrem.  Standard dental x-rays give off 0.5 mrem.  To put these figures into perspective, we have radiation levels available for some common activities:

• 620 mrem/year = the average level of radiation per person in the US
• 50000 mrem/year = the safe allowable does for people that are exposed to radiation in their work
• 1 mrem = two hours in a plane
• 7 mrem/year = from living in a brick home
• 10 mrem/year = from cooking with natural gas
• 2 mrem/year = from sleeping next to someone
• 35 mrem/year = from smoking one pack of cigarettes per day
• 42 mrem = breast mammogram per breast
• 700 mrem = abdominal x-ray
• 0.1 mrem = one of our dental x-rays

Operating Microscopes:  In addition to digital radiography, we utilize special operating microscopes.  Magnification and fiber optic illumination are helpful in aiding Dr. Rhoades to see tiny details inside your tooth.

We also have access to a CBCT 3-D imaging machine to aid us in difficult diagnosis of teeth, retreatment or consideration of moving forward with treatment.

We adhere to the most rigorous standards of infection control advocated by OSHA, the Centers for Disease Control, and the American Dental Association.  We utilize autoclave sterilization and barrier techniques to eliminate any risk of infection.

At Cape Endodontics we use local anesthetic.  Dr. Rhoades uses a combination of different anesthetics administered in a gentle yet effective way in order to provide our patients with a comfortable and relaxing treatment.  For more anxious patients we are able to offer oral sedation medication, however a complete consultation with Dr. Rhoades would be required first.

We usually schedule treatment appointments for nearly 2 hours.  This allows us adequate time to test and diagnose your problem tooth/teeth and still have time left to initate and often complete treatment.  Simpler or single rooted teeth may take less time overall.

The cost varies depending on how complex the problem is and which tooth is affected.  Molars are more difficult to treat, therefore the fee is usually more.  Most dental insurance policies provide some coverage for endodontic treatment.  Generally, endodontic treatment and the restoration of the natural tooth are less expensive than the alternative of having the tooth extracted.  An extracted tooth must be replaced with a bridge or implant to restore chewing function and prevent adjacent teeth from shifting.  These procedures tend to cost more than endodontic treatment and appropriate restoration.  With root canal treatment you save your natural teeth and money.

We will take every measure to ensure that your procedure is in no way uncomfortable or painful. If treatment is needed, we will inject local anesthesia to gently numb a concentrated area of your mouth. For most patients, the feeling of numbness usually subsides after 2-3 hours.

Many endodontic procedures are performed to relieve the pain of toothaches caused by pulp inflammation or infection.  With modern techniques and anesthetics, most patients report that they are comfortable during the procedure.  For the first few days after treatment, your tooth may feel sensitive, especially if there was pain or infection before the procedure.  This discomfort can be relieved with over-the-counter or prescription medications.  Follow Dr. Rhoades's instructions carefully.  Your tooth may continue to feel slightly different from your other teeth for some time after your endodontic treatment is completed.  However, if you have severe pain or pressure or pain that lasts more than a few days, please call our office.

Unless you have been prescribed an oral sedative prior to the appointment you will be perfectly fine to drive home.  An additional benefit of only using local anesthetic is that our patients are free to continue on with their daily routine as soon as they leave our office.

When your root canal therapy has been completed, a record of your treatment will be sent to your restorative dentist.  You should contact his office for follow-up restoration within a few weeks of completion at our office.  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.

The root canal system inside your tooth has been thoroughly cleaned, and the irritated tissue and bacteria that have caused you to need the root canal treatment are gone.  It is normal to feel some tenderness in the area over the next few days as your body undergoes the natural healing process.  You may also feel some tenderness in your jaw from keeping it open for an extended period of time.  These symptoms are temporary and usually respond very well to over-the-counter pain medications.  It is important for you to follow the instructions on how to take these medications.  Remember that narcotic medications, if prescribed, may make you drowsy, and caution should be exercised in operating dangerous machinery or driving a car after taking them.  Your tooth may continue to feel slightly different from your other teeth for some time after your root canal treatment has been completed.

You should not chew or bite on the treated tooth until you have had it restored by your dentist.  The unrestored tooth is susceptible to fracture, so you should see your dentist for a full restoration as soon as possible.  Otherwise, you need only practice good oral hygiene, including brushing, flossing, and regular checkups and cleanings.  Most endodontically treated teeth last as long as other natural teeth.  In a few cases, a tooth that has undergone endodontic treatment does not heal or the pain continues.  Occasionally, the tooth may become painful or diseased months or even years after successful treatment.  Often when this occurs, redoing the endodontic procedure can save the tooth.

Yes, for most root canal treatments, we recommend that patients return to the office 1 year ( perhaps more) after the procedure was finished. Our office will call or send a reminder notice to you when you are due for a recall appointment.

New trauma, deep decay, or a loose, cracked or broken filling can cause new infection in your tooth.  In some cases, Dr. Rhoades may discover additional very narrow or curved canals that could not be treated during the initial procedure.

Unfortunately the only dental procedure that can be guaranteed is an extraction.  Root canal therapy is not 100% successful, however success rates for routine cases are very high (95%+).  A small amount of root canals fail, and although there is no absolute indicator of which root canals will fail and which ones will succeed, there are some things we can look for to give you the best recommendations we can. This being said, endodontic therapy cannot be guaranteed.  However, we strive to research your tooth thoroughly and to provide our patients and their dentist with the most complete prognosis of your tooth that we can.  We will not hesitate to let you know if your tooth has a poor or guarded chance of survival.  With some cases it is difficult if not impossible to determine the survivabilty of a tooth until endodontic therapy has been started.  We are aware that in some situations, the tooth may fail regardless of how much information we have obtained prior to beginning treatment and/or how well the root canal was performed.  To be fair to our patients, we will offer a 1 year warranty on most of our cases. *  In order to maintain this warranty we will require you to return promptly for all follow up check requests (usually at the 6 and 12 month marks.)  The tooth should also be restored properly and in a timely manner ** for many cases will fail due to restorative breakdown and recontamination. 

*We will rebate 1/3 of the root canal fee if the tooth is extracted due to unforeseen reasons in this 1 year time frame.

**We will include our restorative recommendations with each patient's final treatment letter.  Our usual recommended time frame is within 2-4 weeks after the completion of the root canal.