Endodontics

An endodontist is a dental specialist in what happens inside a tooth. MedlinePlus describes the pulp as the nerves, blood vessels, and connective tissue that sit inside the tooth and run in canals down to the jaw bone, and it describes a root canal as the procedure that removes dead or dying nerve tissue and bacteria from inside a tooth in order to save it. When an infection affects the pulp, MedlinePlus says a dental specialist known as an endodontist should examine the area, and that whether the tooth can be saved depends on the source of the infection and how severe the decay is. Without treatment, it says, the tooth may become so damaged that it has to be removed.

Some people are referred by a general dentist who finds deep decay, an infection, or a tooth that keeps hurting; others call an endodontist directly. Your dental plan can tell you whether it wants a referral first, and the practice itself can tell you what it treats and how soon it could see you. Credentials and contact details are on every ProviderQuoHealth profile, so you can compare before you call.

Go to an emergency department, or call 911, if facial swelling is spreading toward the eye or down into the neck, if there is fever with a swollen jaw, or if breathing or swallowing is becoming difficult. Do not wait for an appointment slot for any of those, and do not spend the time searching a directory. On breathing difficulty MedlinePlus says the same thing in its own voice. Writing about Ludwig angina, an infection of the floor of the mouth that it says often develops after an infection of the roots of the teeth or a mouth injury, it says the infected area swells quickly and that this may block the airway or prevent you from swallowing saliva, and that breathing difficulty is an emergency situation: go to the emergency room or contact the local emergency number, such as 911, right away.

The wider instruction, the one that covers spreading facial swelling and fever with a swollen jaw, is ours rather than MedlinePlus's, and we would rather label it than let it read as sourced. MedlinePlus routes a throbbing toothache that does not go away, or a bubble or pimple on the gums, to contacting your dentist, and it routes trouble swallowing, drooling, tongue swelling, and neck swelling to contacting your provider. Both of its pages give reasons to be less patient than that. It calls a swollen area of the upper or lower jaw a very serious symptom and lists fever and swollen glands of the neck alongside it; it says an untreated abscess can spread to soft tissue, to the jaw bone, and to other areas of the body, and can lead to life-threatening complications; and it says the swelling of Ludwig angina can close the airway. Your clinician is the right person to confirm that line. Short of the emergency signs above, treat any swelling of the jaw, face, or neck, or a severe toothache that will not stop, as care needed that day rather than at the next open slot.

A broken or knocked-out tooth is urgent in a different way. MedlinePlus says a knocked-out permanent, adult tooth can sometimes be put back in place, that in most cases only permanent teeth are replanted, and that baby teeth are not replanted. Either way it says to contact your dentist right away, to save the tooth and bring it with you, and that the longer you wait the less chance there is of fixing it. How you handle the tooth matters: hold it only by the crown, the chewing edge, and do not scrape or wipe the root, do not brush it or clean it with alcohol or peroxide, and do not let it dry out. For a permanent tooth it says you can try placing it back in the socket level with the other teeth and biting gently on gauze to hold it there, taking care not to swallow it, or put it in a container covered with a small amount of cow's milk or saliva, or hold it between your lower lip and gum or under your tongue. If you cannot close your upper and lower teeth together, MedlinePlus says your jaw may be broken, and that needs medical help right away at a dentist's office or hospital.

MedlinePlus says a dentist places numbing medicine around the tooth before a root canal, and that you may feel a slight prick as the needle goes in. It says you may have some pain or soreness afterward, that most people can return to their normal routine the same day, and that you should avoid rough chewing in the area until the tooth is permanently filled or covered with a crown. A root canal, in its account, is what is done when an infection affects the pulp of a tooth, which generally brings pain and swelling in the area.

Before booking it is fair to ask a practice what a visit will cost, to confirm coverage with your plan, and to ask how quickly it can see someone whose tooth is painful. Credentials and contact details for every practice listed here are on the profile, so you can compare that much before you pick up the phone.