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Charter Oak Endodontics
404 East College Street Suites E,F
Dickson, TN 37055

Top 5 Ways to Pay for a Root Canal

The cost of a root canal can sometimes be subsidized by dental plans and other forms of insurance. Here are some ways to pay for your root canal:

  1. Dental Plans
  2. Financing – Care Credit, credit cards
  3. Flexible Spending Accounts
  4. Payment plans
  5. Automatic Cash Discounts

Top 5 Ways to Tell You Need a Root Canal

Think you need a root canal? Never had one before but experiencing some painful feelings in your teeth or gums? Here are some ways to tell if you may need a root canal:

  1. Lasting Tooth Pain to Cold
  2. Lasting Tooth Pain to Chewing
  3. Tooth Pain that Wakes You Up at Night
  4. Spontaneous Throbbing Tooth Pain
  5. A Bump or Pimple on Your Gums

Top 5 Ways to Avoid a Root Canal

We get asked this question a lot, so we figured why not make the answers available online and share it with everyone.

  1. Brush and Floss Every Day
  2. Visit Your Dental Hygienist Every 6 Months
  3. Do Not Chew Ice
  4. Do Not Use Your Teeth as Tools
  5. Wear a Mouthguard When Playing Contact Sports

Something for My Colleagues

It is reported antecdotally, that articaine (septocaine) causes gingival necrosis. Especially in the palate. I searched PubMed and the Journal of Endodontics for information. Currently, there are no published articles or case reports verifying that articaine causes gingival necrosis.

This is where I always advise colleagues to do what is comfortable and what works in their office. If a patient returns after treatment with sloughing of the palatal or lingual gingiva: 1) Reassure the patient. 2) Prescribe Peridex. Have the patient rinse twice a day for 1 week. 3) Pain medication may be warranted depending on the degree of discomfort.

We Can’t Treat What We Can’t See!

The media is covering a study that links dental radiographs (X-rays) to brain cancer. Dental care professionals are highly educated on the proper use of dental radiographs. Unlike some other parts of the body, most parts of the teeth are not visible. The problem is often inside the tooth, between teeth and/or under the gum tissue. Dental radiographs are required to show the areas of the teeth and jaw bones that are not visible to the eye. Dental radiographs are an essential part of dental diagnosis and treatment. We can’t treat what we can’t see!

I have attached information from the American Dental Association’s website.



Prescription Drug Abuse Epidemic

One of the challenges every dentist faces is how to manage patient pain. It is common for patients to experience post-treatment discomfort. The amount depends on the procedure. For example, extraction of teeth will result in more post-treatment discomfort than other dental procedures. The type of medication used to manage post-treatment pain is a decision made by the dentist. The dentist understands if the procedure was simple and non-traumatic or if it was very involved.

The best way to manage pain is to prevent it. At the end of the appointment, I give patients 600mg ibuprofen. If the patient can’t tolerate ibuprofen, then it is 500mg acetaminophen. Non-steroidal anti-inflammatory medications (NSAIDS) prevent the body from making inflammatory mediators. Inflammatory mediators are substances that tell the nervous system to have a pain response. The more inflammatory mediators you make, the more pain you will have. NSAIDS prevent the body from making these inflammatory mediators. NSAIDS along with root canal treatment will greatly reduce pain. I know this first hand. In 2011, I had two root canals. My first time being on the receiving end. Ibuprofen is all I needed for both. The root canal treatment removes the infected nerve tissue that is the source of pain. Then, the NSAIDS help the body to remove the inflammatory mediators so that the patient can finally have relief. There is no tolerance to NSAIDS. This means that it will always work as intended.

I attached this article from the Tennessean. Prescription drug abuse is a real problem. The science behind pain associated with endodontics (root canals) supports the use of NSAIDS as the drug of choice. Multiple studies (Menhinick et al 2004 is a great article) have proven the efficacy of NSAIDS to manage post-treatment discomfort. I also feel that is our duty to not add to the problem of prescription drug abuse. I encourage everyone to educate themselves on this issue. Have a blessed week!

Read this article

Tips for Finding a Dentist

If you are looking for a dentist I recommend asking your friends and families for referrals. Remember that personalities differ so get the names of  several dentists to research.  These are some things to consider:

1) Check out the website if available to determine if business hours work with your schedule.

2) Is the dentist a participating provider with your insurance?

3) If  dental insurance is not a concern, does the dentist offer payment plans?

4) Is the location convenient?

Saving Knocked out Teeth!

The 2011-2012 school year has started.  With school back in session, we have sports and other activities.  Knocked out teeth are an unfortunate side effect of physical activity. Quick thinking is crucial to save a tooth! Here are some guidelines (assuming that the medical needs have been attended to):

1) Find the tooth.  Try to touch only the crown (the part of the tooth that shows in the mouth).

2) Gently rinse the tooth with milk or Save- A – Tooth solution. Place the tooth back in the socket (the space where the tooth was).  Do not worry about whether the tooth is positioned correctly – that can be fixed at the dental office. If milk or Save-A-Tooth solution is not available, still put the tooth in the socket.

3) Do not force the tooth into the socket. If it will not fit, put the tooth in either milk, Save-A-Tooth or in the child’s mouth (if he won’t swallow it). Contact lens solution and saline are other alternatives. Finally, if nothing else – water. Water is an absolute last resort! It damages cells on the root of the toooth.

4) Go to a dentist immediately. Call while you are on the way to prepare the office.

The most important thing is to stay calm and seek help from a dentist as soon as possible. The best results are possible if treatment is received within 1 hour of the accident. The tooth can still be saved after longer periods of time, so still visit the dentist as soon as possible.

Red Heads Need More Anesthesia!

Due to a mutation on the melanocortin -1 receptor, natural red heads have an increased sensitivity to thermal pain and a decrease response to anesthesia. This information may not be news to red heads, but it is something that health care practitioners need to be aware of! Extra care must be taken to insure a comfortable procedure!

My recommendations: Take 600mg ibuprofen or 500 mg acetaminophen 1 hour before your dental appointment. Antianxiety medication like diazepam may be necessary to achieve profound anesthesia.

Remember to express your concern with your dentist so that your appointment will be drama free!

Liem EB, Joiner TV, Tsueda K, Sessler DI. Anesthesiology. 2005Mar;10(3):509-14.

Liem EB, Lin CM, Suleman MI, Doufas AG, Gregg RG, Veauthier JM, Loyd G, Sessler DI. Anesthesiology. 2004Aug;101(2):279-83.

Good teeth!

My opinion is often requested about whether or not a tooth should be extracted (pulled). “Is the tooth good or bad?” I believe that all teeth are good! The real question is whether or not the tooth will function normally for at least the next 5 years. Some of the things I will evaluate are how much decay is present, the tooth’s location in the mouth, and the bony support of the tooth.  All factors need to be considered before a tooth is extracted. Once a tooth is extracted (pulled) it is gone – forever!