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Dentistry/Removing root canal

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Question
My dentist found out that I have a bad root canal with an ongoing infection which never caused me any symptoms. He recommends pulling it, but told me he doesn't do it  and I need to go to a root canal specialist. This makes me wonder if this is more complicated than a regular extraction? What will happen exactly? Can it be done entirely with local anesthetics? don't want to do general. When I had the root canal done, I could sometimes feel pain when the gutta perka were put on even through the anesthesia, does this mean the extraction can be painful? Also, I heard some people starting to have pain after the extraction. Why does that happen? He also wants me to have extracted a root canal tooth that fell apart and there's only a few pieces of tooth left. So I am a bit worried about the whole procedure as it will be 2 extractions that day.

Answer
If your dentist wants you to have the tooth extracted, he would send you to an oral surgeon, not an endodontist (root canal specialist). If you have questions about the procedure, you should ask the dentist you are going to see. Extractions can be done with local anesthesia, but some patients have additional sedation because they are more comfortable that way. Again, this is something you need to discuss with your dentist. If you felt pain, you either were not adequately numb in the first place, or the anesthesia wore off. Pain after an extraction is to be expected - you had a tooth removed! Your dentist will prescribe pain medication for a few days and that should take care of it. If the root remnants are adjacent, it is much easier on you to have both done at the same time. If they are in different areas of your mouth, you can consider having them done separately. These are all things to discuss with your dentist.

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Frederick R. Liewehr DDS, MS, FICD

Expertise

I can answer your questions about root canal therapy in general. PLEASE DO NOT ask me to diagnose your particular problems or recommend treatment as I cannot do this without examining you and seeing your x-rays.

Experience

I am a Board-certified endodontist, former university department Chairman, teach dental residents, and have a private practice.

Organizations
ADA, AAE, ICD, AAOM, FDI, AMSUS, AAOB

Publications
J of Endodontics, Endodontics and Dental Traumatology, O,O,O, Military Medicine, Medical Bulletin, J of Dental Education

Education/Credentials
DDS, MS (Oral Biology), certificate in Endodontics

Awards and Honors
Surgeon General's "A" Designator, Fellowship ICD, Order of Military Medical Merit

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