Root Canal Treatment in Bellevue

What is a root canal?

Inside every tooth, under the hard enamel and dentin, is a soft core called the pulp: the nerve and blood supply that built the tooth as it grew and maintains it. A root canal is the treatment that removes that tissue when it is infected or badly inflamed, cleans and disinfects the narrow canals it ran through, and seals them. A fully formed tooth does not need its pulp to keep working, so the tooth stays in your mouth, anchored in the bone, and you keep chewing on it.

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Why would a tooth need a root canal?

The pulp gets into trouble when bacteria or an injury reach it. The usual causes are a deep cavity, a crack, a large or repeated filling on the same tooth, or a hard knock, sometimes years earlier. Once the pulp is infected or dying it cannot heal, because it is sealed inside hard tooth with nowhere to swell and no way for the body to clear the infection. Antibiotics can calm swelling for a while, but they do not reach the inside of the tooth. A root canal removes the source of the infection, which stops the pain, gives the bone around the root a chance to heal, and in most cases lets you keep a tooth that would otherwise have to come out.

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How do I know if I need a root canal?

A few signs point to the nerve: pain that lingers after something cold or hot instead of fading in seconds, a toothache that wakes you at night, pain when you bite down, swelling or a small pimple on the gum near one tooth, or a tooth that has darkened after an injury. Any one of these is worth a call. None of them is a diagnosis by itself.

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I test before I treat: a cold test on the tooth and its neighbors, a bite test, a digital x-ray, and when the picture is still unclear, a CBCT scan taken here in the office, which shows a cracked root or an infection that a flat x-ray can miss. Sometimes the answer is that you do not need a root canal. A deep filling, a high spot on a crown, or sinus pressure can all mimic nerve pain. I wrote about how I decide whether you truly need one, and when the tooth does not need it, I say so.

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What happens during a root canal?

We numb the tooth thoroughly and check that it is numb before we begin. A small rubber shield isolates the tooth and keeps everything clean. Through a small opening in the top of the tooth, I remove the inflamed or infected tissue from the canals, clean and shape them, disinfect them, and seal them with a rubber-like filling material. Then the opening is sealed. At that point the source of the pain is gone, and what remains is restoring the tooth so it can chew again. For the full play-by-play, read Root Canals, Explained.

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Does a root canal hurt?

The pain people associate with root canals is the infected tooth before treatment, not the treatment. With modern anesthesia, most people describe the visit as similar to getting a filling, and the relief when the pressure is gone is often immediate. If you are anxious, tell us. We build in time and explain each step as we go.

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Afterward the tooth and the gum around it may be sore for a few days, especially when biting. An over-the-counter pain reliever, taken as directed on the label, usually handles it. In exceptional cases the discomfort can persist or increase temporarily after treatment, this is a normal side effect but one that we would like to hear about so we can get you comfortable. Call if swelling or pain gets worse rather than better. More on what to expect for pain.

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Can you do the root canal and the crown in the same visit?

Often, yes. A back tooth that has had a root canal is hollowed out and more brittle than it was, and a crown is what protects it from cracking. Because we mill CEREC crowns in the office, I can finish the root canal, shape the tooth, scan it, and bond the final crown in the same appointment, so you leave with the tooth done instead of wearing a temporary. Front teeth and some premolars need less: a bonded filling or an onlay may be enough, and I will say so. The restoration follows what the tooth needs, not a default.

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Do I need a specialist?

Most of the time, no. I do most root canals here, and take the imaging prior to diagnosis so we can get you started on the right path the first time. Some teeth are harder or have already been treated with a root canal, and I refer those to an endodontist. An Endodontist is a specialized dentist who limits their practice to root canals: canals that are unusually curved, narrow or calcified, a root canal done years ago that has failed, or a root that may be cracked below the gum. The scan usually tells us which situation we are in before we start. Sending a difficult tooth to the right hands is part of treating each tooth on its own merits. If your tooth needs a specialist, I will tell you plainly, help you get in, and take care of the crown afterward here.

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What are the alternatives?

When the nerve is infected there are two real choices: save the tooth with a root canal, or remove it. Waiting is not a third option, because an infection inside a tooth does not heal on its own. It spreads into the bone and eventually becomes an abscess or a lost tooth. I wrote about what happens if you put it off. If the tooth can be restored, saving it is almost always the conservative choice. If it cannot, we can remove it here, graft the socket, and plan a dental implant when you are ready. Either way, you get both paths laid out, with costs, before you choose.

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What does a root canal cost in Bellevue?

It depends on which tooth it is (front teeth have one canal, molars have three or four, so they take longer and cost more), whether the tooth needs a crown afterward, and what your plan covers. Plans vary: some list root canals under basic services and others under major, with different percentages. We check your benefits and give you a clear estimate for the root canal and the restoration together before we start. We are in-network with Delta Dental Premier, Delta Dental PPO, Regence and Premera, and we accept most other PPO plans. If you are in pain and uninsured, we diagnose, get you out of pain, and give you the number before any treatment beyond the exam.