Frequently Asked Questions (FAQs)

Dental anxiety is very common, and we understand that many patients feel nervous about dental procedures. We take time to explain each step, answer questions, and make sure you feel comfortable before beginning treatment.

For patients who would like additional help relaxing, we offer nitrous oxide and oral sedation options. Please ask our team about sedation if you feel it would help make your experience more comfortable.

Local anesthesia is used to thoroughly numb the treatment area so you can remain comfortable throughout the procedure. In most cases, patients are awake during treatment.

For patients who feel anxious or would like additional help relaxing, we also offer nitrous oxide and oral sedation. With oral sedation, you may become very drowsy and may remember little of the procedure.

Yes. We believe financial transparency is an important part of patient care. Before treatment, we always contact your insurance to get the most up-to-date information regarding your benefits, and then provide an estimate of your expected costs.

Our goal is to make sure you understand your treatment options and financial responsibilities before moving forward.

Yes. Not all pain that feels like a toothache originates from a tooth. Problems involving the jaw joint, muscles, nerves, or sinuses can sometimes create symptoms that feel dental in nature.

This is why our doctors perform detailed testing before recommending treatment. Accurate diagnosis is the first step toward providing the right care.

Our philosophy is to never treat a tooth unless we are confident it is the source of the symptoms. If the diagnosis is unclear, we may recommend additional testing, observation, or allowing symptoms to become more localized before treatment.

Taking the time to identify the correct tooth helps ensure that you receive the treatment you truly need.

We reserve time in our schedule each day specifically for dental emergencies, and those appointments are filled as the day goes on. If you are experiencing severe tooth pain, swelling, or a dental injury, call our office as early as possible, and we will make every effort to see you the same day.

Our goal is to provide prompt relief while still taking the necessary time to make an accurate diagnosis. Emergency care should not mean rushed care. We believe the right treatment begins with understanding the true source of the problem

Not necessarily. Tooth pain can have many causes, and every emergency visit begins with a careful evaluation. While many dental emergencies are caused by inflammation or infection inside the tooth and may require root canal treatment, some pain may come from other sources such as the jaw joint, chewing muscles, nerves, or sinuses.

Our doctors take time to test the tooth and confirm the diagnosis before recommending treatment. If you need a root canal, we will explain why and discuss your options. If we are not confident the tooth is the source of the pain, we may recommend monitoring or further evaluation before proceeding.

No. While symptoms from a tooth infection may temporarily improve, the underlying problem usually remains. In many cases, the source of infection is inside the tooth, where the blood supply no longer reaches the damaged or dead pulp tissue.

Prompt evaluation allows us to determine the appropriate treatment and helps prevent the infection from progressing. Depending on the situation, treatment may involve root canal therapy or another procedure intended to eliminate the source of infection and preserve your natural tooth.

Most tooth infections and dental emergencies are best evaluated by a dentist or endodontist because the source of the problem is often within the tooth itself.

However, you should seek immediate medical attention at an emergency room if you have difficulty breathing or swallowing, rapidly spreading facial swelling, uncontrolled bleeding, or symptoms affecting your overall health.

For most dental emergencies, an endodontist can diagnose the source of the problem and provide treatment focused on saving the tooth whenever possible.

Yes. A tooth that stops hurting does not always mean the problem has been resolved. Sometimes pain decreases because the nerve inside the tooth has become damaged or died. Although symptoms may improve, infection can continue to develop without obvious warning signs.

A thorough evaluation can determine whether the tooth is healthy, needs monitoring, or requires treatment. Addressing problems early often provides the greatest opportunity to preserve the natural tooth.

Root canal treatment is intended to relieve the pain caused by inflammation or infection. With effective local anesthesia and modern endodontic techniques, most patients remain comfortable during the procedure and often feel significant relief afterward.

Some soreness or sensitivity is normal for a few days as the tooth and surrounding tissues heal, particularly if considerable pain or infection was present beforehand. Contact us if pain is severe, worsening, persistent, or accompanied by swelling.

A root canal may be needed when the pulp inside a tooth becomes permanently inflamed or infected. Common causes include deep cavities, cracks, trauma, or previous dental procedures.

Symptoms that may suggest the need for treatment include lingering sensitivity to hot or cold, spontaneous tooth pain, pain when biting, swelling, or a recurring pimple-like bump on the gum. However, symptoms alone do not always determine whether a root canal is needed.

The only way to confidently know is through a comprehensive evaluation. Our doctors perform detailed testing to confirm which tooth is the source of your symptoms before recommending treatment.

Oral antibiotics can help control infections that have spread beyond the tooth into surrounding tissues, but they usually cannot eliminate the source of infection inside the tooth.

When a tooth's pulp becomes dead or partially dead, the blood supply inside the tooth is compromised. Because oral antibiotics travel through the bloodstream, they may not reach the infected tissue inside the root canal system effectively.

Root canal treatment removes the infected or damaged pulp tissue, cleans the inside of the tooth, and seals the space to eliminate the source of infection. Antibiotics may sometimes be recommended as part of treatment, but they do not replace removing the source of infection within the tooth.

At ARCS, we offer two appointment types. Some patients are scheduled for a consultation appointment first, while others may have a consultation and treatment appointment together.

Consultation appointments are typically scheduled for 45 minutes. Consultation and same-day treatment appointments are usually scheduled for approximately 90 minutes.

Most teeth can be treated thoroughly in one treatment appointment, but some complex teeth may require additional time or another visit to complete treatment properly.

For most patients, a root canal does not significantly change how the tooth feels or functions. The main difference is that the tooth will no longer respond to hot or cold because the nerve tissue has been removed. After healing, the goal is for the tooth to remain comfortable and function normally for everyday chewing.

A root canal-treated tooth can remain healthy for many years, but sometimes problems can develop later. Signs that a previously treated tooth may need evaluation include returning pain, tenderness when biting, swelling, a pimple-like bump on the gum, drainage, or changes around the tooth seen on an X-ray.

However, symptoms alone do not always tell the complete story. A thorough evaluation by an endodontist can determine whether the tooth needs retreatment, monitoring, or another approach.

A tooth requiring retreatment does not necessarily mean the original treatment was unsuccessful. Teeth have complex anatomy, and sometimes bacteria can persist in areas that are difficult to identify or access.

A second root canal, also called root canal retreatment, may be needed when a previously treated tooth does not heal as expected or develops a new infection.

Possible reasons include:

• A previously untreated canal
• New decay reaching the root canal system
• A leaking or damaged crown or filling
• Persistent bacteria inside the tooth

Retreatment involves carefully reopening the tooth, removing the previous filling material, cleaning the canal system again, and resealing the tooth.

Our goal is to address the source of the problem while preserving your natural tooth whenever possible.

Yes. Although root canal treatment is designed to last many years, a tooth can sometimes develop new problems long after the original procedure.

Over time, new decay, breakdown of a filling or crown, or changes within the tooth can allow bacteria to re-enter the root canal system. In other cases, complex anatomy may mean that an area of infection was difficult to detect or treat initially.

If symptoms return years later, an evaluation can determine whether retreatment, surgery, or another option is the best approach.

Root canal retreatment is performed using local anesthesia to ensure the tooth and surrounding tissues are comfortable during treatment. Most patients are surprised by how comfortable the procedure is.

Some soreness or sensitivity afterward is normal as the tooth begins the healing process. The amount of discomfort often depends on the amount of inflammation or infection present before treatment.

For patients who feel anxious, we offer nitrous oxide (laughing gas) and oral sedation options to help create a more comfortable experience

The length of retreatment depends on the complexity of the tooth and the condition of the previous root canal treatment.

Most retreatment cases can be completed in one treatment appointment, although some teeth may require additional time or another visit to complete treatment thoroughly. Most treatment appointments last about 90 minutes.

Before treatment begins, we will explain what we expect based on your specific tooth and provide a clear plan for care.

If a tooth does not heal after retreatment, there may still be options to preserve it. In some cases, a small surgical procedure called an apicoectomy may be recommended to treat infection around the tip of the root.

Our doctors will evaluate your tooth carefully and discuss all appropriate options before recommending the next step. The goal is always to make the best decision for your individual situation.

Unfortunately, no. Unlike a broken bone, a cracked tooth cannot repair itself. Once a tooth is cracked, the damage is permanent. Without treatment, the crack will typically get worse over time.

Why Tooth Cracks Don't Heal

Teeth can't regenerate the way other parts of the body can. A crack in the enamel or deeper tooth structure stays there. Chewing forces, temperature changes, and daily wear can all cause it to spread, often without warning.

Why Acting Quickly Matters

A crack caught early may need nothing more than a crown to stabilize it. Left untreated, the same crack can deepen into the root, reach the pulp, or split the tooth entirely—each of which requires more involved treatment and reduces the chances of saving the tooth.

What Treatment Can Do

While treatment can't make a crack disappear, it can stop it from spreading and relieve your symptoms. Most treated teeth go on to function normally for many years. The sooner you act, the more options your endodontist has to work with.

Advanced Root Canal Specialists offers same-day appointments for patients in pain. Call us at (410) 772-9600, and a team member will be happy to assist you.

We welcome patients from all over Maryland, including Columbia, Baltimore, Rockville, Laurel, and beyond.

Cracked teeth can be difficult to recognize because symptoms are often inconsistent. Common signs include:

• Sharp pain when biting or releasing a bite
• Sensitivity to hot or cold that comes and goes
• Pain when chewing certain foods
• Discomfort that is difficult to locate

Some cracked teeth have minimal symptoms, while others can cause significant pain. A thorough evaluation by an endodontist can help determine whether a crack is present and whether it is the source of your symptoms.

In many cases, a cracked tooth can be treated and continue functioning for many years. However, the outcome depends on several factors, including the location, depth, and direction of the crack.

Some cracks only require a protective restoration, while others may require root canal treatment before the tooth can be restored. If a crack extends into areas where the tooth cannot heal or function predictably, extraction may sometimes be necessary.

Our priority is always to preserve your natural tooth whenever possible while providing an honest assessment of the expected outcome.

Not every cracked tooth needs a root canal. Treatment depends on whether the crack has affected the pulp, which is the living tissue inside the tooth.

If the pulp becomes inflamed or infected because of the crack, root canal treatment may be needed before the tooth can be restored. If the pulp is healthy and the crack does not involve the inner tooth structure, a crown or other restoration may be sufficient.

An accurate diagnosis is essential before deciding on treatment.

A cracked tooth may continue to worsen over time. The crack can extend deeper, eventually affecting the pulp or surrounding structures.

As the crack progresses, treatment options may become more limited. Early evaluation provides the greatest opportunity to stabilize the tooth and preserve it whenever possible.

Not all cracks are the same. Common types include:

• Craze lines: Small cracks limited to the enamel that are common and usually do not require treatment.
• Fractured cusp: A break involving part of the chewing surface, often treatable with a restoration.
• Cracked tooth: A crack extending from the chewing surface toward the root, sometimes requiring root canal treatment if the pulp is involved.
• Split tooth: A crack that separates the tooth into segments. Whether it can be saved depends on the location of the split.
• Vertical root fracture: A crack that begins in the root and may require specialized evaluation to determine treatment options.

A knocked-out permanent tooth is a dental emergency. The first steps you take can affect the chance of saving the tooth.

If possible:

• Pick up the tooth by the crown, not the root
• Do not scrub the tooth or remove tissue from the root
• Gently rinse it if needed
• Try placing it back into the socket without forcing it
• If that is not possible, keep it moist in milk or inside your cheek

Contact an endodontist immediately. The sooner the tooth is evaluated, the better the chance of successful treatment.

Some injured teeth heal without treatment, while others develop problems later. The outcome depends on the type of injury, the extent of damage, and how the tooth responds over time.

Even when a tooth appears normal after an injury, the pulp inside the tooth may have been affected. Regular monitoring and appropriate testing help determine whether additional treatment is needed.

Not always. A traumatized tooth does not automatically require root canal treatment.

The need for treatment depends on factors such as:

• The type and severity of the injury
• Whether the pulp remains healthy
• Symptoms and testing results
• Changes seen on imaging

At ARCS, we carefully evaluate the tooth before recommending treatment. Our goal is always to provide the right treatment at the right time.

Yes. Trauma can sometimes damage the blood supply to the pulp, causing the tooth to lose vitality over time.

This process may happen immediately or develop gradually. A tooth that becomes darker, develops sensitivity, causes pain, or shows changes on dental imaging should be evaluated by an endodontist.

You should contact an endodontist as soon as possible after a significant dental injury, especially if the tooth is knocked out, displaced, fractured, or painful.

Early evaluation allows your doctor to identify problems that may not be visible and provide treatment recommendations that give the tooth the best possible chance.

Yes. Some teeth affected by trauma may appear healthy initially but develop complications months or years later.

Possible delayed problems include:

• Pulp death
• Infection
• Root resorption
• Changes around the root

If you have a history of dental trauma and notice changes in the tooth, an evaluation can help determine what is happening.

Tooth resorption can be triggered by several factors, including dental trauma, infection, and orthodontic treatment. In many situations, it develops without a clear reason, which is why early detection is important.

Can You Prevent Tooth Resorption?

Not always. Some causes of resorption, such as trauma, infection, or the body's response to orthodontic treatment, are difficult or impossible to prevent entirely. But there are steps you can take to reduce your risk and catch the condition early if it does develop.

Reducing the Risk of Tooth Resorption

While resorption can't always be prevented, certain habits and precautions can help protect your teeth:

• Protect your teeth from injury — Wear a mouthguard during contact sports or any activity where dental trauma is a risk. Trauma is one of the most common triggers for resorption in permanent teeth.
• Address infections promptly — Untreated dental infections can contribute to resorption. Getting timely care when a problem develops reduces that risk.
• Communicate with your orthodontist — Orthodontic treatment is a known contributing factor in some cases of resorption. Regular monitoring during treatment can help detect early signs.
• Avoid habits that stress the teeth — Grinding or clenching can put excessive force on teeth over time. If you grind at night, talk to your dentist about a protective nightguard.

Why Early Detection Matters Most

Resorption often develops without any symptoms in its early stages. By the time pain or visible changes appear, the condition may already be advanced.

If your dentist identifies resorption during a routine exam, they may refer you to an endodontist for a more detailed evaluation. Advanced Root Canal Specialists welcomes referrals and self-referrals for resorption evaluation. Call us at (410) 772-9600. 

We welcome patients from all over Maryland, including Columbia, Baltimore, Rockville, Laurel, and beyond.

Tooth resorption does not always cause symptoms, especially in its early stages. Many cases are discovered during routine dental X-rays.

When symptoms occur, they may include:

• Pink discoloration or a pink spot on the tooth
• Sensitivity or pain
• Swollen or irritated gums near the tooth
• A cavity-like area near the gumline
• A tooth that feels loose or changes position

If you notice any unusual changes in a tooth, an evaluation by an endodontist can help determine the cause and whether treatment is needed.

In many cases, treatment can stop or manage the progression of resorption, but the appropriate approach depends on the type, location, and extent of the condition.

The goal of treatment is to remove or address the affected area and preserve the remaining healthy tooth structure whenever possible.

Early diagnosis generally provides more treatment options. Once significant tooth structure has been lost, treatment becomes more challenging, and extraction may sometimes be necessary.

In many cases, yes. The goal of treatment is to preserve the natural tooth whenever possible.

The ability to save the tooth depends on several factors, including how much tooth structure has been affected, where the resorption is located, and whether the tooth can be predictably restored afterward.

Our specialists will evaluate your individual situation and explain whether saving the tooth is realistic and what treatment options are available.

Tooth resorption is usually not an emergency that requires same-day treatment, but it should not be ignored. Because resorption can progress over time and reduce treatment options, timely evaluation is important.

If your dentist identifies possible resorption on an X-ray, an evaluation with an endodontist can help determine the extent of the condition and the best next step.

There are two main categories of tooth resorption:

Internal resorption:
This begins inside the tooth and involves changes within the root canal space. Treatment often involves root canal therapy to remove the affected tissue and seal the tooth.

External resorption:
This begins on the outside surface of the root. Treatment depends on the location and severity and may involve monitoring, surgical treatment, root canal therapy, or a combination of approaches.

An accurate diagnosis is essential because treatment differs significantly depending on the type of resorption present.

An apicoectomy may be recommended when a tooth continues to show signs of infection or inflammation after root canal treatment, and retreatment is not the best option.

Reasons may include:

• Persistent infection near the root tip
• Complex root anatomy
• Previous restorations that make retreatment difficult
• Areas of infection that cannot be predictably reached from inside the tooth

Before recommending surgery, we carefully evaluate the tooth and discuss all available options.

An apicoectomy is performed using local anesthesia to ensure you are comfortable during the procedure. Many patients are surprised by how manageable the procedure is.

Some soreness, swelling, or tenderness after surgery is normal as the tissues heal. Most discomfort can typically be managed with recommended medications and following post-operative instructions.

For patients who feel anxious, we offer nitrous oxide and oral sedation options to help create a more comfortable experience.

Most patients experience mild to moderate discomfort and swelling for a few days after an apicoectomy. Swelling may be most noticeable during the first two to three days and gradually improves.

Many patients return to normal activities quickly, although the bone around the treated root continues healing over several months.

We provide detailed post-operative instructions and follow-up care to monitor healing and ensure the tooth is progressing as expected.

Intentional replantation is a tooth-saving procedure where a tooth is carefully removed, treated outside the mouth, and then placed back into its original position.

This approach may be considered when other treatment options are limited, such as when the problem area cannot be predictably accessed through traditional retreatment or surgery.

The procedure requires careful planning and precise technique to protect the tooth and surrounding tissues. When successful, intentional replantation allows patients to keep their natural tooth rather than moving directly toward extraction.

Intentional replantation is generally considered only in carefully selected cases when other options are not predictable.

• Examples may include:
• Complex root anatomy
• Difficult-to-access areas of infection
• Situations where traditional retreatment or apicoectomy may not provide the best solution

Our doctors will carefully evaluate your tooth and discuss whether intentional replantation is appropriate based on your individual circumstances.

A tooth may darken after root canal treatment due to changes inside the tooth over time.

Possible causes include:

• Breakdown of remaining tissue or blood products inside the tooth
• Materials from previous treatment
• Changes that occur as the tooth ages

A darkened tooth after a root canal does not always require treatment, but an evaluation can determine whether internal bleaching or another option is appropriate.

In some cases, yes. Internal bleaching may improve the appearance of a darkened tooth without removing additional tooth structure for a crown or veneer.

However, not every discolored tooth is a candidate. The cause of the discoloration, the health of the tooth, and the amount of remaining tooth structure all influence the best treatment option.

The number of visits depends on the degree of discoloration and how the tooth responds to treatment.

Many patients require multiple appointments because internal bleaching works gradually. During follow-up visits, we evaluate the progress and determine whether additional treatment is needed.

Before beginning treatment, we will provide a realistic expectation based on your specific situation.

Internal bleaching can provide long-lasting improvement, but the longevity of the result depends on several factors, including the cause of discoloration and the condition of the tooth.

Over time, some teeth may experience gradual color changes again. Regular dental care and proper restoration of the tooth can help maintain the result.

Internal bleaching is generally a comfortable procedure. The tooth is evaluated carefully beforehand to ensure there are no underlying problems causing symptoms.

If treatment involves accessing the tooth, local anesthesia can be used to ensure your comfort. Our team also offers sedation options for patients who feel anxious about dental treatment.

For most patients, sedation dentistry is very safe when performed with appropriate screening and monitoring.

Before recommending sedation, our team reviews your medical history, current medications, and individual needs to determine which option is appropriate for you.

Your safety is always our highest priority, and we will discuss any concerns before treatment begins.

At Advanced Root Canal Specialists, we offer two sedation options:

Nitrous oxide:
A mild inhaled sedation that helps you feel relaxed while remaining fully awake and able to communicate. The effects wear off quickly, and most patients can drive themselves home afterward.

Oral conscious sedation:
A prescribed medication taken before your appointment that provides a deeper level of relaxation. You will remain conscious but may feel very relaxed and remember little of the procedure. You will need someone to drive you to and form the appointment.

Yes. Sedation dentistry is not the same as general anesthesia. With both nitrous oxide and oral conscious sedation, you remain conscious and able to communicate with our team.

Sedation helps reduce anxiety and increase comfort, while local anesthesia is used to numb the tooth and treatment area so the procedure itself is comfortable.

Absolutely. Sedation is available for any patient who feels it would make their experience more comfortable.

Some patients choose sedation because they prefer a more relaxed appointment, have a sensitive gag reflex, or simply want additional peace of mind during treatment.

It depends on the type of sedation used.

After nitrous oxide, most patients can drive themselves home because the effects wear off quickly once the gas is stopped.

After oral conscious sedation, you will need a responsible adult to drive you home because the medication can affect your coordination, alertness, and ability to drive safely.

Dental anxiety is very common, and you are not alone. Our team understands that many patients feel nervous about dental procedures.

We take time to explain each step, answer your questions, and make sure you feel comfortable before treatment begins. Sedation options are available if additional help relaxing would make your experience easier.