Patient Information

I. INTRODUCTION

Thank you for your confidence in our office. We look forward to partnering with you toward exceptional patient care.

II. FIRST VISIT

Your initial appointment will consist of a comprehensive examination to help in making a diagnosis and to determine if root canal therapy is needed. If your referring dentist has provided us with initial radiographs or x-rays, we will review them at this appointment.  We also use this time to thoroughly explain both the diagnosis and recommended procedure. Questions about insurance coverage, payment, medications, and scheduling are typically addressed at this appointment.

Please assist us by providing the following information at the time of your consultation:

  • Your referral slip and any X-rays if applicable
  • A list of any medications you are currently taking
  • If you have medical or dental insurance, bring the necessary completed forms. This will save time and allow us to help you process any claims.

Please alert the office if you have a medical condition that may be of concern prior to dental procedures (i.e. diabetes, high blood pressure, artificial heart valves or joints, rheumatic fever, etc.) or if you are on any medication (i.e. heart medications, aspirin, anticoagulant therapy, etc.)

IMPORTANT: All patients under the age of 18 years of age must be accompanied by a parent or guardian at the consultation visit.

Top

III. SCHEDULING

We will schedule your appointment as promptly as possible. Please contact the office if you are having substantial dental pain to schedule an emergency appointment. For emergency treatment, we will guarantee that you will be seen on the same day! In other words, we will always have room in our schedule to see emergency cases.

IV. FINANCE & FINANCIAL POLICIES

We accept Visa, MC, Discover & Check (Personal / Business). Payment is due at the time service is rendered. Please remember that you are responsible for all fees charged by this office regardless of your insurance coverage. Any remaining balance after your insurance has paid is your responsibility. Your prompt remittance is appreciated.

We also offer payment plan through "Care Credit" and "Chase Health Advantage".

Petaluma Endodontics Office Finance
Petaluma Endodontics Office Finance

 

Top

V. INSURANCE

In-Network Providers of the following Insurance Companies:

petaluma Endodontist
  • Aetna (DMO / HMO)

  • Aetna (PPO)
  • petaluma Endodontist
  • Ameritas
  • petaluma Endodontist
  • Anthem Blue Cross (PPO)
  • petaluma Endodontist
  • Assurant
  • petaluma Endodontist
  • Cigna (PPO)
  • petaluma Endodontist
  • Delta Dental Premier

  • Delta Care USA / PMI
  • DenteMax
  • GEHA
  • Guardian
  • Lincoln Financial Group
  • Metlife
  • Premier Access
  • Principal Financial Group
  • Shirrell Consulting
  • Petaluma Endodontist
  • United Concordia
  • We are happy to verify and bill any insurance for the convenience of our patients.
    We offer NO INTEREST Payment Plans through "Care Credit" and "Chase Health Advantage".

    Top

    VI. PATIENT PRIVACY POLICY

    The Health Insurance Portability and Accountability Act (HIPAA) was enacted by the U. S. Congress in 1996. Title II of HIPAA, known as the Administrative Simplification (AS) provisions, requires the establishment of national standards for electronic health care transactions and national identifiers for providers, health insurance plans, and employers. It helps people keep their information private.

    North Bridge Endodontics takes the privacy of our patients’ information seriously. Below you will find a copy of our privacy practices for your review as well as an acknowledgement that you will need to sign prior to treatment.

    We welcome any questions you may have regarding our offices practices. For downloadable documents for patient see “Patient Privacy / HIPAA”

    Top

    VII. OUR SERVICES

    Conventional Root Canal Treatment

    Pulp is soft tissue made up of blood vessels and nerves that is located inside the root canal of your tooth. The pulp helps your tooth grow but is not needed once your tooth is fully developed. When the pulp gets infected then it needs to be removed. This procedure is referred to as conventional root canal treatment.

    Surgical Root Canal Treatment

    When conventional root canal treatment cannot be done or has not been successful then a surgical root canal procedure may need to be performed. Surgery may be done to check the end of the root for cracks, remove parts of the root that could not be removed during conventional root canal treatment, or to clear up an infection that has not healed after conventional treatment.

    Endodontic Re-treatment

    In some cases, a tooth that has received endodontic treatment fails to heal or remains painful. Occasionally, the tooth becomes painful or diseased months or even years after successful treatment. If your tooth has failed to heal or has developed new problems, you have a second chance. Another endodontic procedure may be able to save your tooth.

    Top

    VIII. FREQUENTLY ASKED QUESTIONS (FAQ)

    I'm worried about x-rays. Should I be?

    No. While x-rays will be necessary during your endodontic treatment, we use an advanced non-film computerized system, called digital radiography that produces radiation levels up to 90 percent lower than those of already low dose conventional dental x-ray machinery. These digital images can be optimized, archived, printed and sent via e-mail.

    Top

    Why would 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, a blow 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.

    Signs of pulp damage include pain, prolonged sensitivity to heat or cold, discoloration of the tooth, and swelling and tenderness in the nearby gums. Sometimes, 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 tooth, 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.

    Top

    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 your endodontist's instructions carefully.

    Your tooth may continue to feel slightly different from your other teeth for some time after your periodontics treatment is completed. However, if you have severe pain or pressure, or pain that lasts more than a few days, call your endodontist.

    Top

    What is involved in an periodontics procedure?

    Endodontic treatment can often be performed in one or two visits and involves the following steps:
    1. The endodontist examines and x-rays the tooth, then administers local anesthetic. After the tooth is numb, the endodontist places a small protective sheet called a "dental dam" over the area to isolate the tooth and keep it clean and free of saliva during the procedure.
    2. The endodontist makes an opening in the crown of the tooth. Very small instruments are used to clean the pulp from the pulp chamber and root canals and to shape the space for filling.
    3. After the space is cleaned and shaped, the endodontist fills the root canals with a bio-compatible material, usually a rubber-like material called "gutta-percha". The gutta-percha is placed with an adhesive cement to ensure complete sealing of the root canals. In most cases, a temporary filling is placed to close the opening. The temporary filling will be removed by your dentist before the tooth is restored.
    4. After the final visit with your endodontist, you must return to your dentist to have a crown or other restoration placed on the tooth to protect and restore it to full function. If the tooth lacks sufficient structure to hold the restoration in place, your dentist or endodontist may place a post inside the tooth. Ask your dentist or endodontist for more details about the specific restoration planned for your tooth.
    Top

    How much will the procedure cost?

    The cost varies depending on how severe the problem is and which tooth is affected. Molars are more difficult to treat and usually cost more. Most dental insurance policies provide coverage for endodontic treatment.

    Generally, endodontic treatment and restoration of the natural tooth are less expensive than the alternative of having the tooth extracted. An extracted tooth must be replaced with a bridge or implant to restore chewing function and prevent adjacent teeth from shifting. These procedures tend to cost more than endodontic treatment and appropriate restoration.

    Top

    Will the tooth need any special care or additional 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 happens, another endodontic procedure can save the tooth.

    Top

    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 very narrow or curved canals that could not be treated during the initial procedure.

    Top

    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.

    Top

    What are the alternatives to endodontic treatment?

    When the pulp of a tooth is damaged, the only alternative to endodontic treatment is extraction of the tooth. To restore chewing function and to prevent adjacent teeth from shifting, the extracted tooth must be replaced with an implant or bridge. This requires surgery or dental procedures on adjacent healthy teeth and can be far more costly and time-consuming than endodontic treatment and restoration of the natural tooth. No matter how effective modern tooth replacements are- and they can be very effective- nothing is as good as a natural tooth.

    Top

    What about infection?

    Again, there's no need for concern. We adhere to the most rigorous standards of infection control advocated by OSHA, the Centers for Disease Control and the American Dental Association. We utilize autoclave sterilization and barrier techniques to eliminate any risk of infection.

    Top

    What happens after treatment?

    When your Endodontic Therapy (root canal therapy) has been completed, a record of your treatment will be sent to your restorative dentist. You should contact their office for a follow-up restoration within 4 to 6 weeks of completion at our office. Your restorative dentist will decide on what type of restoration is necessary to protect your tooth. It is rare for endodontic patients to experience complications after routine endodontic treatment or microsurgery. If a problem does occur, however, we are available at all times to respond.

    Top

    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:

    1. Narrow or curved canals were not treated during the initial procedure.
    2. Complicated canal anatomy went undetected in the first procedure.
    3. The crown or other restoration was not placed soon enough after the procedure.
    4. The restoration did not prevent saliva from contamination the inside of the tooth.
    5. In other cases, a new problem can jeopardize a tooth that was successfully treated. For example:
    6. New decay can expose the root canal filling material to bacteria, causing a new infection in the tooth.
    7. A loose, cracked, or broken crown or filling can expose the tooth to new infection.
      Top

    What will happen during re-treatment?

    First the endodontist will discuss your treatment options. If you and your endodontist choose re-treatment, 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, searching for any additional canals or unusual anatomy that requires treatment.

    After cleaning the canal(s) the endodontist will fill and seal the canal(s) and place a temporary filling in the tooth. Post space may also be prepared at this time.
    After the final visit with your endodontist, you will need to return to you 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.
    If the canals are unusually narrow or blocked, you endodontist may recommend endodontic surgery. This surgery involved making an incision near the end of the root to allow the tip of the root to be sealed.
    Top
     

    Is re-treatment the best choice for me?

    Retreated teeth can function well for years, even for a lifetime. It's always best to save the tooth if your endodontist believes re-treatment is the best option for you.

    Advances in technology are constantly changing the way root canal treatment is performed, so your endodontist may even be able to use a new technique that was not available when you had your first procedure. If your tooth has unusual anatomy that was not cleaned and sealed during the first procedure, your endodontist may be able to resolve this problem with a second treatment.

    Of course, there are no guarantees with any dental or medical procedure. Your endodontist will discuss your options and the chances of success before beginning re-treatment

    Top

    How much will the procedure cost?

    The cost varies depending on how complicated the procedure will be. The procedure will probably be more complex than your first root canal treatment, because your restoration and filling material may need to be removed to accomplish the new procedure. In addition, your endodontist may need to spend extra time searching for unusual canal anatomy. Therefore, you can generally expect re-treatment to cost more than the initial endodontic treatment.

    While dental insurance may cover part or all of the cost of re-treatment, some policies limit coverage to a single procedure on a tooth in a given period of time. Check with your employer or insurance company prior to treatment to be sure of your coverage.

    Top

    What are the alternatives to re-treatment?

    For some patients considering re-treatment, endodontic surgery is also an option. This surgery involves making an incision near the end of the root to allow the tip of the root to be sealed. Endodontic surgery may be recommended in conjunction with re-treatment or as an alternative. Your endodontist will discuss your options and recommend appropriate treatment.

    The only other alternative 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 options require extensive surgery or dental procedures on adjacent healthy teeth, they can be far more costly and time consuming than re-treatment and restoration of the natural tooth.

    No matter how effective modern tooth replacements are- and they can be very effective- nothing is as good as your natural tooth. You've already made an investment in saving your tooth. The payoff for choosing re-treatment could be a healthy, functioning natural tooth for many years to come.

    Top

    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 gum to help the tissue heal properly.

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

    Top

    Are there other types of endodontic surgeries?

    Other surgeries endodontists might perform include dividing a tooth in half, repairing an injured root, or even removing one or more roots. Your endodontist will be happy to discuss the specific type of surgery your tooth requires.

    In very complex cases, a procedure called intentional replantation may be performed. In this procedure, a tooth is extracted, treated with an endodontic procedure while it is out of the mouth, and then replaced in its socket.

    These procedures are designed to help you save your tooth.

    Top

    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 postoperative instructions to follow. If you have questions after your procedure, or if you have pain that does not respond to medication, call your endodontist.

    Top

    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.

    Top

    When can I return to my normal activities?

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

    Top

    Does insurance cover endodontic surgery?

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

    Top

    How do I know the surgery will be successful?

    Your dentist or endodontist is suggesting endodontic surgery because he or she believes it is the best option for you. Of course, there are no guarantees with any surgical procedure. Your endodontist will discuss your chance for success so that you can make an informed decision.

    Top

    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.

    Top

    Why does a cracked tooth hurt?

    To understand why a cracked tooth hurts, it helps to know something about the anatomy of the tooth. Inside the tooth, under the white enamel and a hard layer called the dentin, is the soft tissue called the pulp. The pulp contains blood vessels, nerves, and connective tissue. When the outer hard tissues of the tooth are cracked, chewing can cause movement of the pieces, and the pulp can become irritated. When biting pressure is released, the crack can close quickly, resulting in a momentary, sharp pain. Irritation of the dental pulp can be repeated many times by chewing. Eventually, the pulp will become damaged to the point that it can no longer heal itself. The tooth will not only hurt when chewing but may also become sensitive to temperature extremes. In time, a cracked tooth may begin to hurt all by itself. Extensive cracks can lead to infection of the pulp tissue, which can spread to the bone and gum tissue surrounding the tooth.

    Top
    North Bridge Endo.