Is crown lengthening painful?

During the procedure you should feel no pain at all. Local anesthesia ensures the surgical site is completely numb, and sedation is available if needed. After the procedure, you may experience some tenderness in the treated gums, bone, and teeth. Over-the-counter pain medication is typically sufficient to manage any post-operative discomfort.

Who performs crown lengthening?

Crown lengthening is performed by a periodontist. At Rockland Dental Specialists, Dr. Shalom Mintz, our board-certified periodontist and implantologist, performs crown lengthening for both cosmetic and restorative indications.

How long does crown lengthening recovery take?

The gums and bone require at least four to six weeks to heal fully before any further dental work can take place. Some cases may require a longer healing period depending on the extent of tissue removed.

What is a gummy smile and can crown lengthening fix it?

A gummy smile occurs when excess gum tissue is visible above the upper front teeth when smiling. Crown lengthening exposes the full anatomical crown of the teeth, creating a more balanced and proportionate smile.

Can crown lengthening be done on a single tooth?

Yes. When performed for restorative reasons it is typically done on a single tooth. Cosmetic crown lengthening often addresses multiple front teeth at once to create a balanced result.

When is crown lengthening necessary before a dental crown?

Crown lengthening is needed when decay or a fracture extends below the gumline, leaving insufficient tooth structure for a crown to grip securely. Removing gum and bone tissue creates the access needed to place a well-fitting, durable restoration.

What are the different types of dental implants?

Dental implants can replace a single tooth, support a multi-tooth bridge, or anchor a full-arch restoration using as few as four to six implants. They can also stabilize removable dentures and partials.

Why should I choose a periodontist for dental implants instead of a general dentist?

Periodontists complete three additional years of specialized training in bone, gum tissue, and implant placement. At Rockland Dental Specialists, Dr. Shalom Mintz and Dr. David Peto are board-certified periodontists and implantologists.

What happens during the dental implant procedure?

The process begins with 3D imaging and a consultation, followed by surgical implant placement into the jawbone under local anesthesia. After several months of osseointegration, a crown is attached to complete the restoration.

Do I need a bone graft before getting a dental implant?

Not every patient requires a bone graft. It is needed when there is insufficient jawbone volume to securely anchor the implant. Our team evaluates bone density using cone beam CT imaging during your consultation.

What is osseointegration, and why does it matter?

Osseointegration is the process by which the jawbone fuses to the titanium implant, creating a stable permanent anchor. This biological bond gives implants their strength and distinguishes them from bridges or dentures.

Can dental implants fail, and what causes failure?

Dental implants have a high success rate, but failure can occur due to insufficient bone, uncontrolled gum disease, smoking, or poor oral hygiene. Early intervention by a periodontist can often prevent full failure.

How do I care for a dental implant once it is placed?

Care for an implant like a natural tooth: brush twice daily, floss around the crown, and maintain regular periodontal cleanings. Monitoring for peri-implantitis is essential for long-term implant health.

Are dental implants in New City covered by insurance?

Coverage varies by plan. Some plans provide partial coverage, particularly for teeth lost due to injury or medical conditions. Rockland Dental Specialists offers complimentary insurance verifications and custom payment plans.

What are the signs of periodontal disease?

Common signs include red, swollen, or bleeding gums, persistent bad breath, receding gums, loose teeth, and deep pockets between the teeth and gums. In smokers, visible signs may be minimal even when disease is present.

Can periodontal disease be reversed?

Early-stage gum disease (gingivitis) can be fully reversed with professional cleaning and improved home care. More advanced periodontal disease cannot be reversed, but it can be controlled and stabilized through periodontal treatment and ongoing maintenance.

Will a gum infection go away on its own?

No. Periodontal infections do not resolve without treatment. Without intervention, the infection progresses, destroying the bone and tissue that support the teeth, and can contribute to systemic health conditions.

How is periodontal disease connected to overall health?

Periodontal disease is associated with increased risk for heart disease, stroke, diabetes complications, and has been linked to Alzheimer's disease. The bacteria and inflammation from untreated gum disease can enter the bloodstream and affect the rest of the body.

What are the stages of periodontal disease?

Periodontal disease progresses from gingivitis (reversible gum inflammation) through mild, moderate, and severe periodontitis, each involving increasing levels of bone and tissue loss around the teeth.

Can a periodontist place dental implants?

Yes. Periodontists are among the most qualified providers for dental implant placement because of their specialized training in the bone and gum tissue that support implants. At Rockland Dental Specialists, Dr. Shalom Mintz and Dr. David Peto are board-certified periodontists and implantologists.

Do I need a referral to see an oral surgeon?

No referral is required in most cases. You can contact Rockland Dental Specialists directly to schedule an oral surgery consultation.

Does a tooth extraction remove the root?

Yes. A standard tooth extraction removes the entire tooth including the root. The root is not left behind in the jaw.

What is wisdom teeth removal, and when is it necessary?

Wisdom teeth removal is the surgical extraction of the third molars. It is recommended when they are impacted, causing crowding, pain, infection, or damaging adjacent teeth.

What is IV sedation, and is it safe for dental procedures?

IV sedation delivers sedative medication through a vein, producing a deeply relaxed state during the procedure. It is safe when administered by trained oral surgeons and is commonly used for wisdom tooth removal and implant procedures.

What is an oral biopsy, and should I be concerned?

An oral biopsy removes a small sample of abnormal tissue for laboratory analysis. Most oral growths are benign, but biopsy is the only definitive way to rule out cancer. Early evaluation is always recommended.

What should I expect during recovery from oral surgery?

Recovery varies by procedure. Most patients experience some swelling and discomfort for several days. Following post-operative instructions — including rest, soft foods, and prescribed medications — supports faster healing.

When should I see an oral surgeon instead of my general dentist?

You should see an oral surgeon when a procedure requires advanced training, hospital privileges, IV sedation, or management of complex medical conditions. Impacted teeth, facial trauma, and atypical infections are examples.

LANAP stands for Laser-Assisted New Attachment Procedure. It is an FDA-cleared laser treatment for periodontal disease that uses a specific wavelength of laser energy to target diseased tissue while leaving healthy tissue intact.

How is LANAP different from traditional gum surgery?

Traditional gum surgery requires cutting the gums with a scalpel and suturing them back. LANAP uses laser energy instead, with no cutting, no sutures, and significantly less post-operative pain and recovery time.

Can LANAP treat advanced periodontal disease?

Yes. LANAP is specifically designed for moderate to advanced periodontal disease. It can address deep pockets and bone loss that have not responded adequately to scaling and root planing alone.

Who is a good candidate for LANAP?

Most adults with chronic periodontal disease are candidates for LANAP. It is particularly beneficial for patients who are medically compromised, on blood thinners, or who have anxiety about traditional surgery.

What should I expect during a LANAP procedure?

The procedure is performed under local anesthesia. The laser fiber is inserted into the periodontal pocket to remove diseased tissue and bacteria. Most patients return to normal activity within a day or two.

Can LANAP regenerate lost bone?

Yes. LANAP is one of the few periodontal treatments with clinical evidence supporting bone regeneration around treated teeth, not just stabilization of existing bone.

How does LANAP compare to osseous surgery for treating gum disease?

Both treat periodontal disease but through different approaches. LANAP is minimally invasive with faster recovery. Osseous surgery involves cutting and reshaping bone. The right choice depends on disease severity, anatomy, and patient health.

How do I know if I need LANAP or scaling and root planing?

A periodontal evaluation including X-rays and pocket depth measurements determines the extent of disease. Scaling and root planing is the first-line treatment. LANAP is typically recommended when disease is moderate to advanced or has not fully responded to non-surgical care.

Endodontic Retreatment

Female doctor in sterile gloves using dental mirror and dental care equipment while doing teeth treatment in stomatology clinic

When a root canal doesn’t heal as expected or complications arise months or years after treatment, endodontic retreatment offers a second chance to save your tooth. This procedure addresses persistent infection, inadequate sealing, or new decay that compromises the initial root canal work. At Rockland Dental Specialists, our endodontists use advanced techniques and technology to perform retreatment procedures that preserve your natural tooth structure while restoring your oral health.

Our team of endodontists includes Dr. Lisa Nava Cohen and Dr. George Ilenikhena, who perform endodontic retreatment with precision and care. Led by Dr. Shalom Mintz and Dr. David Peto, our practice has provided comprehensive periodontal, implant, and endodontic services to patients throughout Rockland County and the broader New York region for over 24 years.

Why Does Endodontic Retreatment Become Necessary?

Most root canals heal successfully, but certain factors can prevent proper healing or cause new problems to develop. A tooth may fail to heal if narrow or curved canals were missed during the initial treatment, making complete cleaning difficult. Sometimes complex canal anatomy goes undetected despite the dentist’s best efforts.

New problems can emerge after successful treatment. An abscessed tooth can occur when new decay develops and allows bacteria to enter the canal system, or a crack or fracture in the tooth creates a pathway for infection. Delayed placement of a crown or inadequate restoration can expose the tooth to contamination. Even a well-treated tooth can become reinfected if the restoration breaks down over time.

What Are the Signs You Might Need Endodontic Retreatment?

Your body provides clear signals when a previously treated tooth needs attention. Persistent pain or sensitivity when biting, chewing, or applying pressure suggests complications with the root canal. Prolonged sensitivity to hot or cold temperatures, lasting beyond brief contact, indicates the nerve space may be compromised.

Visual changes also signal problems. Swelling or tenderness in the gum tissue near the treated tooth points to active infection. A pimple-like bump on the gums, called a fistula, allows pus to drain from an infected area. Some patients notice discoloration of the tooth or changes in how it feels compared to adjacent teeth.

Many infections remain symptom-free for extended periods. Regular dental examinations with X-rays can identify issues before they cause discomfort, giving you more treatment options.

How Does the Retreatment Procedure Work?

Endodontic retreatment follows a similar process to initial root canal treatment but requires additional steps to access the canal system. Dr. Cohen begins by administering local anesthesia to ensure your comfort throughout the procedure. She then reopens the tooth to access the root canal filling material from the previous treatment.

After removing the old filling material, Dr. Cohen carefully examines the canals using magnification and specialized lighting. This inspection helps identify any missed canals, unusual anatomy, or narrow canal branches that may have contributed to the initial treatment’s failure. She thoroughly cleans and shapes the canals, removing any remaining infected or damaged tissue. If the damage is too sever, a root amputation might be neceessary.

Once the canals are cleaned, disinfected, and shaped properly, Dr. Cohen fills them with a biocompatible material called gutta-percha. A temporary filling seals the opening until your general dentist can place a permanent restoration. The tooth requires a crown or other restoration to protect it from future damage and restore full function.

What Should You Expect During Recovery?

Most patients experience mild discomfort for a few days following retreatment. Over-the-counter pain relievers typically manage any tenderness effectively. Your tooth and surrounding gum tissue may feel sensitive, particularly when chewing, but this sensitivity gradually decreases as healing progresses.

Following post-treatment instructions helps ensure successful healing:

Take all prescribed medications as directed
Avoid chewing on the treated tooth until your dentist places the permanent restoration
Maintain excellent oral hygiene around the treated area
Attend all follow-up appointments to monitor healing progress
Contact our office immediately if you experience severe pain or swelling

Your endodontist will schedule a follow-up examination to confirm the tooth is healing properly. X-rays taken several months after treatment show whether the infection has resolved and bone is regenerating around the tooth roots.

What Are the Alternatives to Retreatment?

While endodontic retreatment has a high success rate, you should understand all available options. Extraction followed by dental implant placement represents one alternative. Implants function like natural teeth and don’t require modification of adjacent teeth, but they involve a longer treatment timeline and surgical procedures.

Bridge placement offers another replacement option after extraction. This restoration uses adjacent teeth as anchors to support a prosthetic tooth in the gap. Bridges restore function and appearance but require alteration of healthy neighboring teeth.

Many patients choose retreatment to preserve their natural tooth when possible. Natural teeth maintain bone density in the jaw, provide better biting force than prosthetic alternatives, and continue to perform their original function without modification of surrounding teeth.

Schedule Your Consultation at Rockland Dental Specialists

If you’re experiencing discomfort in a previously treated tooth or have questions about endodontic retreatment, our team can evaluate your situation and recommend appropriate treatment options. Dr. Cohen, Dr. Mintz, Dr. George Ilenikhena, and Dr. Peto work together to provide comprehensive care in our comfortable, high-end office environment.

We offer complimentary insurance verifications and create custom payment plans tailored to your needs. Our 24/7 availability ensures you can reach us whenever concerns arise. Contact us online today to schedule your appointment and learn more about preserving your natural smile.

CONTACT

If you have any questions or comments please complete the form below. Thank you and we look forward to hearing from you.

VISIT

873 ROUTE 45 SUITE 201 NEW CITY, NY 10956

CORNER ROUTE 45 & NEW HEMPSTEAD ROAD

DIRECTIONS

CALL

(845) 259-2500

FAX

(845) 406-4048

Frequently Asked Questions About Endodontic Retreatment

Why might a tooth need endodontic retreatment after an initial root canal?

A root canal can fail to heal for several reasons, including narrow or curved canals that were missed during the initial procedure, breakdown of the internal seal over time, new decay that allows bacteria to re-enter the canal system, or a crack that creates a new pathway for infection. Retreatment addresses these issues to give the tooth a second chance at healing.

What are the signs that a previously treated tooth may need retreatment?

Warning signs include persistent pain or sensitivity when biting, visible swelling or tenderness near the treated tooth, a pimple-like bump on the gum, or darkening of the tooth. In some cases, there are no visible symptoms and the problem is detected only through routine X-rays, which highlights the importance of regular dental check-ups.

How is endodontic retreatment different from the original root canal?

Retreatment follows a similar process but requires additional steps to access the canal system. The existing crown or restoration is typically removed, old filling material is taken out, and the canals are thoroughly re-examined with magnification and specialized lighting. Missed canals or unusual anatomy are addressed before the canals are cleaned, shaped, and resealed.

Is endodontic retreatment painful?

The procedure is performed under local anesthesia, so you should experience minimal discomfort during treatment. Post-procedure soreness is common for a few days and is typically managed with over-the-counter or prescribed pain medication. Most patients find the experience comparable to their original root canal treatment.

What is the alternative to retreatment?

The main alternative is extraction, followed by tooth replacement with a dental implant, bridge, or partial denture. However, preserving your natural tooth through retreatment is generally preferred when possible, as natural teeth maintain jaw bone density, provide superior biting function, and do not require adjacent teeth to be altered for support.

How long does a retreated tooth typically last?

With proper restoration and ongoing dental care, a successfully retreated tooth can last many years, in many cases indefinitely. The outcome depends on factors including the amount of remaining tooth structure, the quality of the permanent crown placed after retreatment, and consistent preventive care through regular check-ups.