Our Services
Our practice specializes in using the restorative procedure of root canal therapy to help extend the life of your natural teeth. We have invested in the most state-of-the-art technology and advanced techniques to deliver the best results for our patients.

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Endodontic Treatment (Root Canal)

What is endodontic treatment?

"Endo" is the Greek word for "inside" and "odont" is Greek for "tooth." Endodontic treatment treats the inside of the tooth.

To understand endodontic treatment, it helps to know something about the anatomy of the tooth. Inside the tooth, under the enamel and a hard layer called the dentin, is a soft tissue called pulp. The pulp contains blood vessels, nerves and connective tissue, and creates the surrounding hard tissues of the tooth during development.

The pulp extends from the crown of the tooth to the tip of the roots where it connects to the tissues surrounding the root. The pulp is important during a tooth's growth and development. However, once a tooth is fully mature it can survive without the pulp, because the tooth continues to be nourished by the tissues surrounding it.


Why might I need an endodontic procedure?

Endodontic treatment is necessary when the pulp 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 lead to an abscess.


What are the signs of needing endodontic treatment?

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


How does endodontic treatment save the tooth?

The endodontist 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 the tooth to protect and restore it to full function. After restoration, the tooth continues to function like any other tooth.


Will I feel pain during or after the procedure?

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 our doctor'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, call our office.

Will the tooth need any special care or additional treatment after the endodontic treatment?

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 fails to 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.

What causes an endodontically treated tooth to need additional treatment?

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

Can all teeth be treated endodontically?

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. And, when endodontic treatment is not effective, endodontic surgery may be able to save the tooth.

Read more about root canal treatment from the American Association of Endodontists.

Information provided courtesy of the American Association of Endodontists. Copyright© 1995-2016.

Endodontic Retreatment

Why do I need another endodontic procedure?

As occasionally happens with any dental or medical procedure, a tooth may not heal as expected after initial treatment for a variety of reasons:
•  Narrow or curved canals were not treated during the initial procedure
•  Complicated canal anatomy went undetected in the first procedure
•  The placement of the crown or other restoration was delayed following the endodontic treatment
•  The restoration did not prevent salivary contamination to the inside of the tooth


In other cases, a new problem can jeopardize a tooth that was successfully treated. For example:
•  New decay can expose the root canal filling material to bacteria, causing a new infection in the tooth
•  A loose, cracked or broken crown or filling can expose the tooth to new infection
•  A tooth sustains a fracture


What will happen during retreatment?

First, the endodontist will discuss your treatment options. If you and your endodontist choose retreatment, the endodontist will reopen your tooth to gain access to the root canal filling material. In many cases, complex restorative materials—crown, post, and core material—must be disassembled and removed to permit access to the root canals.


After removing the canal filling, the endodontist can clean the canals and carefully examine the inside of your tooth using magnification and illumination, searching for any additional canals or unusual anatomy that requires treatment.


After cleaning the canals, the endodontist will fill and seal the canals and place a temporary filling in the tooth. If the canals are unusually narrow or blocked, your endodontist may recommend endodontic surgery. This surgery involves making an incision to allow the other end of the root to be sealed.


After your endodontist completes retreatment, you will need to return to your dentist as soon as possible to have a new crown or other restoration placed on the tooth to protect and restore it to full function.


Is retreatment the best choice for me?

Whenever possible, it is best to save your natural tooth. Retreated teeth can function well for years, even for a lifetime.

Advances in technology are constantly changing the way root canal treatment is performed, so your endodontist may use new techniques that were not available when you had your first procedure. Your endodontist may be able to resolve your problem with retreatment.

As with any dental or medical procedure, there are no guarantees. Your endodontist will discuss your options and the chances of success before beginning retreatment.

What are the alternatives to retreatment?

If nonsurgical retreatment is not an option, then endodontic surgery should be considered. This surgery involves making an incision to allow access to the tip of the root. Endodontic surgery may also be recommended in conjunction with retreatment or as an alternative. Your endodontist will discuss your options and recommend appropriate treatment.

What are the alternatives to endodontic retreatment and/or endodontic surgery?

The only other alternative is extraction of the tooth. The extracted tooth must then be replaced with a bridge, removable partial denture or implant to restore chewing function and to prevent adjacent teeth from shifting. Because these options require extensive surgery or dental procedures on adjacent healthy teeth, they can be far more costly and time consuming than retreatment and restoration of the natural tooth.

No matter how effective tooth replacements are—nothing is as good as your natural tooth. You've already made an investment in saving your tooth. The payoff for choosing retreatment could be a healthy, functioning natural tooth for many years to come.

Read more about endodontic retreatment from the American Association of Endodontists.

Information provided courtesy of the American Association of Endodontists. Copyright© 1995-2016.

Endodontic Surgery

Why might I need endodontic surgery?

Surgery can help save your tooth in a variety of situations:
•  Surgery may be used in diagnosis. If you have persistent symptoms but no problems appear on your x-ray, your tooth may have a tiny fracture or canal that could not be detected during nonsurgical treatment. In such a case, surgery allows your endodontist to examine the root of your tooth, find the problem and provide treatment.
•  Sometimes calcium deposits make a canal too narrow for the cleaning and shaping instruments used in nonsurgical root canal treatment to reach the end of your root. If your tooth has this "calcification," your endodontist may perform endodontic surgery to clean and seal the remainder of the canal.
•  Usually, a tooth that has undergone a root canal can last the rest of your life and never need further endodontic treatment. However, in a few cases, a tooth may not heal or become infected. A tooth may become painful or diseased months or even years after successful treatment. If this is true for you, surgery may help save your tooth.
•  Surgery may also be performed to treat damaged root surfaces or surrounding bone.

Although there are many surgical procedures that can be performed to save a tooth, the most common is called apicoectomy or root-end resection. When inflammation or infection persists in the bony area around the end of your tooth after a root canal procedure, your endodontist may have to perform an apicoectomy.


What is an apicoectomy?

In this procedure, the endodontist opens the gum tissue near the tooth to see the underlying bone and to remove any inflamed or infected tissue. The very end of the root is also removed.

A small filling may be placed to seal the end of the root canal, and a few stitches or sutures are placed in the gingiva (gums) to help the tissue heal properly.


Over a period of months, the bone heals around the end of the root.


Will the procedure hurt?

Local anesthetics make the procedure comfortable. Of course, you may feel some discomfort or experience slight swelling while the incision heals. This is normal for any surgical procedure. Your endodontist will recommend appropriate pain medication to alleviate your discomfort.

Your endodontist will give you specific post-operative instructions to follow. If you have questions after your procedure, or if you have pain that does not respond to medication, call our office.

Can I drive myself home?

Often you can, but you should ask your endodontist before your appointment so that you can make transportation arrangements if necessary.

When can I return to my normal activities?

Most patients return to work or other routine activities the next day. We will be happy to discuss your expected recovery time with you.

Does insurance cover endodontic surgery?

Each insurance plan is different. Check with your employer or insurance company prior to treatment.

How do I know that the surgery will be successful?

Your dentist and endodontist is suggesting endodontic surgery because they believe it is the best option for saving your own natural tooth. Of course, there are no guarantees with any surgical procedure. We will discuss your chances for success so that you can make an informed decision.

What are the alternatives to endodontic surgery?

Often, the only alternative to surgery is extraction of the tooth. The extracted tooth must then be replaced with an implant, bridge, or removable partial denture to restore chewing function and to prevent adjacent teeth from shifting. Because these alternatives require surgery or dental procedures on adjacent healthy teeth, endodontic surgery is usually the most cost-effective option for maintaining your oral health.

No matter how effective modern tooth replacements are—and they can be very effective—nothing is as good as a natural tooth. You've already made an investment in saving your tooth. The pay-off for choosing endodontic surgery could be a healthy, functioning natural tooth for the rest of your life.

Read more about endodontic surgery from the American Association of Endodontists.

Information provided courtesy of the American Association of Endodontists. Copyright© 1995-2016.

Cracked Teeth
There are many different types of cracked teeth. Cracked teeth show a variety of symptoms, including erratic pain when chewing, possibly with release of biting pressure, or pain when your tooth is exposed to temperature extremes. In many cases, the pain may come and go, and your dentist may have difficulty locating which tooth is causing the discomfort. If you are experiencing these dental symptoms or suspect a cracked tooth, see an endodontist, who specializes in saving cracked teeth.

The treatment and outcome for your tooth depends on the type, location and extent of the crack. If you think you have a cracked tooth, it's important to seek treatment quickly, before the problem gets worse. Once treated, most cracked teeth continue to function and provide years of comfortable chewing.

Read more about treatment of cracked teeth from the American Association of Endodontists.

Information provided courtesy of the American Association of Endodontists. Copyright© 1995-2016.

Traumatic Dental Injuries
Traumatic dental injuries often occur in accidents or as sports-related injuries. Chipped teeth account for the majority of all dental injuries. Dislodged or knocked-out teeth are examples of less frequent, but more severe injuries. Treatment depends on the type, location and severity of each injury. Sometimes, neighboring teeth suffer an additional, unnoticed injury that will only be detected by a thorough dental exam.

Any dental injury, even if apparently mild, requires examination by a dentist or an endodontist immediately. Endodontists are dentists who specialize in treating traumatic dental injuries. With their advanced skills, techniques and technologies they can often save injured teeth. If you have a cracked or injured tooth, find an endodontist near you right away! Most endodontists offer tremendous flexibility in accommodating emergency cases, including weekends in some cases, so your pain can be relieved quickly.

Read more about treatments for traumatic dental injuries from the American Association of Endodontists.

Information provided courtesy of the American Association of Endodontists. Copyright© 1995-2016.






Mt. Scott Endodontics
Matthew R. Baumgarth, DDS, MS


10365 S.E. Sunnyside Road
Suite 260
Clackamas, OR 97015



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