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Root Canal Before and After Images of Our Patients

tooth nerves
Connections between nerves and teeth.

Did you know? No two teeth that ever existed in the entire history were ever exactly alike.

  The shape and its nerve structure is unique for every tooth.  No two teeth were ever created to be exactly the same.  When looking at these root canals it’s easy to see how that’s possible.  Each tooth has unique contours.  When a doctor performs a root canal, we are not creating something.   We work within the tooth to follow what nature created. 

Ever wonder how a tooth can cause so much pain? The oral cavity is an extremely well innervated network.

Does a Root Canal hurt?

Root canals wrongly have a terrible reputation.  We’ve all seen on TV actors having a painful dental root canal.  The amount of jokes about painful root canals are endless.  Contrary to their terrible reputation, root canals are actually NOT painful.   A root canal is more likely to help get the patient get out of pain.  Many people come to our office in pain needing a root canal.  These patients are often surprised by how much relief they feel once a root canal is completed.  

The root canal procedures on this page were performed in our midtown Manhattan dental office by our dentists.  Patients were anesthetized with Lidocaine for a painless root canal.  Sedation is only necessary for root canals in cases of extreme dental phobia or dental neglect.

Keys to a successful Root canal

The goal of a root canal procedure is to remove soft tissue (nerves and blood vesesls) and infection from the roots of the tooth effectively. 

Our doctors uses rotary instruments to perform root canals. This helps us do our job efficiently and faster than hand filling.  Another factor important to our success is that we do NOT re-use root canal files.  We believe it’s important to use brand new root canal files for every patient to ensure best outcomes.  

Most root canals can be performed in about an hour in a single visit. We recommend patients return to get a crown on the root canal tooth shortly after, usually in 1-2 weeks.  Root canal teeth should usually get a crown soon after treatment.

Central Incisor root canal (Front Tooth)

16 year old patient suffered trauma two years ago falling off a bicycle.  The nerve tissue in one of the front teeth died (necrotic) and became infected.  Tooth was disinfected with a root canal.  patient was put on antibiotics.  He’s going to start orthodontics.  Eventually his front teeth will be restored with crowns.

Patient was asymptomatic, complained that her front tooth was turning dark.  The x-ray showed a dark circle at the apex of her front tooth.  This dark circle usually tells us there’s infection in the tooth.

It’s very rare for a tooth to become necrotic with a dead nerve without having a history of dental work.  Patient doesn’t report any facial trauma that she may have had causing the nerve to die in the tooth.  Our best guess is that from severe tooth grinding at night may have caused the nerve to go necrotic due to the amounts of pressure. 

Root canal has guarded prognosis due to long standing infection.  A crown will be made, after which this dark tooth will match in color to patient’s remaining teeth.

Infected Front Tooth

Patient experienced no pain but had some pus coming from his upper front tooth.  The CBCT scan revealed bone loss at the tip of his front tooth, signifying an infection.  

Root canal treatment was performed to disinfect the front tooth.  patient was also placed on antibiotics to help clear up the infection.

Infected lower front teeth

31 year old male Patient was experiencing severe pain.  The 2 dimensional x-ray showed infection on two front lower incisors.  The 3D CT scan showed the severe bone destruction caused by the infection.  The two front teeth were disinfected with root canal treatment and the patient was placed on antibiotics.

Infected Incisor causing pain

Patient came in for a consultation, complaining that he was having a lot of pain on his front tooth.  X-ray revealed a large tooth infection in his lateral incisor.  Patient states he was in a bike accident about 5 years ago.  It’s not uncommon for a tooth nerve to die off from trauma.  Patient was put on antibiotics and a root canal was performed to disinfect the tooth. 

Three root premolar root canal

Patient was having pain on this premolar tooth.  Recurrent tooth decay was discovered under an existing large filling in the tooth.  This tooth was unusual, premolars usually have just two canals.  This tooth had a very calcified third canal.  All three canals were cleaned, disinfected, and filled with medication.  Patient returned to fabricate a crown a week later.

A 26 year old female patient presented with pain, discomfort and sensitivity to cold and heat.  Her upper premolar had a large cavity extending all the way to the nerve. The bacteria from the tooth cavity entered the nerve of the tooth causing her discomfort.

A successful root canal was performed on this curvy premolar tooth.  The roots were cleaned, shaped, and disinfected.  Patient felt much better after the root canal.  A crown will be placed on the tooth shortly to keep the tooth strong for many years to come.

29 year old female patient was having tooth pain and gum inflammation.  She was told by prior dentist who placed the deep filling that there was a chance the tooth will require a root canal in the future.  The nerve had died due to the deep filling causing infection.  The root canal was performed in a single visit.   The tooth was well disinfected and patient placed on antibiotics.  The tooth will require a crown.

Two Premolar Root canals in one visit with Long Roots

Patient was having discomfort due to cavities in both of his lower premolars.  He’s been neglecting his oral hygiene for a while.  Both root canals were done simultaneously in one dental visit.  The roots in this patient are a bit longer than most. 

Premolar with decay under crown

Patient was experiencing pain because of recurrent decay under a dental crown.  The crown was removed and the decay cleaned out.   Root canal was performed to clean and disinfect the tooth.  A post was placed and impression was taken for a new crown.  Patient left the office feeling much better.

Premolar Root Canal caused by cavities

Patient was experiencing tooth pain due to cavities in premolar tooth.  Root canal procedure was pain free.  The tooth was disinfected and cleaned thoroughly.  A post with a filling was also placed on top of the root canal.  Patient will return to fabricate a crown for this tooth.

Same patient with two Premolar Root Canals caused by cavities

Our patient had deep cavities on two premolars.  One of these cavities had caused pain as it infected the nerve inside of his tooth.  Each root canal was done one at a time, to clean out the infected nerve tissue.  Once the teeth were disinfected the root canal space was permanently sealed.

Premolar infected Tooth

Patient presented with an unexplainable “bump” in the gum.  The fistula was traced to reveal the offending tooth in the infection.  The never inside the tooth became necrotic at some point creating the infection.  Root canal was performed to clean and disinfect the tooth.  A few weeks after the “bump” completely disappeared as the infection went away.

Filling too close to the nerve

When a dental filling is placed too close to the nerve, the nerve may die off sometime in the future.  This is exactly what happened in this situation.  Patient was experiencing discomfort due to the infection caused by a dying nerve.  The root canal was successfully performed in one visit to get our patient out of pain.

Premolar root canal

Our patient presented with deep tooth decay in a premolar tooth.  The nerve in this tooth had already died off.  Our patient was not experiencing any discomfort. Molar root canal was performed painlessly in a single visit.   Patient will return for the tooth to get crowned at next visit.

Root canal in a very infected premolar tooth

Patient came in for a dental emergency with severe facial swelling on his left side.   A prior dentist had placed a filling too close to the nerve of the tooth causing the nerve to eventually become necrotic.  The infected nerve became a source for bacterial growth, causing severe facial swelling. 

 A root canal was performed to disinfect the tooth.  Patient was placed on antibiotics.  He experienced a fever after getting the root canal that lasted for about 12 hours.  A fever is a common complication when a tooth is very infected.  His facial swelling got better after about 3 days.

Patient presented in severe pain because a large cavity has reached the nerve in her molar tooth.  Dr. Peter Mann performed the root canal procedure painlessly.  In about an hour the tooth was completely disinfected and cleaned.  We then sealed the root with medication preventing bacteria from re-entering the tooth.  A post with a filling was placed as well.  The patient will return to fabricate a crown for this tooth.

Upper second molar Root Canal

Patient was suffering from severe pain in upper molar tooth.  Large cavity in the tooth has reached the nerve pulp causing bacteria to infect the nerve.  The tooth was disinfected and cleaned with a root canal.  A post and a filling were placed.  Patient will return to start work on a dental crown shortly.

Molar Tooth Pain caused by Teeth Grinding

Once in a while patient will present with severe tooth pulpitis (nerve inflammation) caused by teeth grinding at night.  A week prior to this root canal, we made this patient a night guard and adjusted the bite to give his molar a chance to recover.  The tooth wasn’t able to recover and caused the patient significant discomfort.  A molar root canal was performed to get our patient out of pain. 

Deep Tooth Decay |
Molar root canal

This patient presented with deep decay.  The nerve in this tooth had already died off.  Our patient was not experiencing any discomfort. Molar root canal was performed in a single visit.   Patient to return for the tooth to get crowned at next visit.

Molar root canal with Long Roots

Patient neglected his tooth after a filling fell out.  As deep decay developed the nerve died off as well.  Luckily, he didn’t experience any pain.  The root canal procedure disinfected the tooth after we removed all of the tooth decay.  He returned the following week to start making a crown for this molar.

Molar Root canal with long roots

First upper molar was causing patient discomfort because of recurrent decay.  The dental filling must have been leaking for many months causing tooth decay under the dental filling.  The patient started feeling discomfort when the tooth decay reached the pulp chamber where dental nerves reside.

Our patient presented with pain in her upper first molar tooth.  The dark area in the tooth is extensive tooth decay.   Over time the bacteria in the tooth decay grew into the pulp chamber of the tooth which ended up killing the nerve tissue causing immense pain.  Our patient felt much better after her root canal treatment

Upper Molar Root canal

4 Canal upper Molar Root canal

Patient came in for a dental emergency due to pain in his upper second molar.  Tooth Cavity had reached the nerve in this tooth causing discomfort. 

An interesting fact, is that sometimes upper molars have a hidden canal called the MB2 canal.  If this canal is not cleaned during the root canal procedure, the root canal tooth will likely fail in the future.  Dr. Peter Mann was able to locate the MB2 canal in this tooth, which was very tiny and calcified.  The MB2 canal was disinfected and sealed along with the other three canals.

Infected upper Molar

This upper molar tooth was causing our patient a lot of discomfort because it developed a large infection as the nerve inside died off.  The large filling placed close to the nerve may have caused the nerve to die off creating conditions for bacteria to grow.  The tooth was disinfected with a root canal. Our patient was placed on antibiotics to help clear up the large infection.

Painful Molar Calmed with a Root Cnal

Patient was experiencing pain as the nerve in his upper first molar was acting abnormally.  Most likely the deep filling close to the nerve affected the nerve in a negative way.  After the root canal was performed the patient felt much better. 

Root Canal with nice apical seal

This first upper molar was causing a lot of pain.  Extensive tooth decay has penetrated the pulp chamber of this tooth causing pulpitis (inflammation of the nerve.) The tooth decay was excavated.  The root canal system was disinfected and sealed well.  Notice the beautiful cloud created in the apical canal signifying a great apical seal.

Second Molar with Deep Cavity

Patient was having pain because of a deep cavity in his upper second molar.  Root Canal was done to disinfect the tooth roots.  Notice the curvature of the roots.  After his root canal treatment, the patient returned to put a porcelain crown on his tooth. 

Upper Second Molar with long roots

Patient was having pain because a deep cavity in her upper second molar.  The tooth has very long roots.  The three canals in the tooth were all disinfected and sealed.  Our patient achieved significant pain relief from the root canal procedure.

Patient was having severe pain when a cavity, under and existing filling, reached the pulp of his tooth.  A root canal was performed to remove the infected nerve tissue and disinfect his tooth.  A total of four canals were located and cleaned in this tooth.  Our patient felt much better after his root canal.

Patient had pain for several days because his molar was badly infected.  This infected was likely caused by heavy grinding at night which killed off the nerve inside the molar.  A molar root canal was performed to disinfect the tooth.  Patient was also placed on a course of antibiotics to get rid of this severe tooth infection.  The root canal was completely painless and our patient felt much better after the treatment.

Patient presented with pain due to an infected molar.  The x-ray revealed a large infection in lower first molar evident by the darkness between the roots.   The infection is the result of the nerve dying inside the tooth.  As the nerve is rotting, bacteria will grow resulting in a tooth infection.  

The cause for this nerve dying is most likely due to bruxism or teeth grinding at night.  The strong amounts of pressure on the tooth from teeth grinding can cause the nerve to die off.  A simple night guard can prevent this tooth damage from occurring.  

Large Cavity in Molar Tooth requiring Root Canal

Patient was having pain due to a large cavity in his lower molar tooth.  Interesting to note the roots are were longer than normal in this tooth.  There were four canals, all of which were disinfected and sealed during the root canal procedure.  patient felt immediate pain relief the same day after his root canal was performed.

This young patient had tooth pain and headaches for weeks because a large cavity in her molar reached the nerve.  The root canal procedure was painless. During which we disinfected and cleaned out the infection and nerve tissue in the roots.  The tooth roots were then sealed with medication preventing bacteria from getting inside the tooth.  A post was placed along with a filling to restore the tooth.  Patient did not experience pain during the procedure, just mild soreness once the anesthesia wore off.  Our patient will return to start a crown next week.

Molar Tooth Root Canal

Patient presents with pain on molar tooth.  X-ray shows a filling placed very close to the nerve.  The nerve in the tooth became infected and inflamed. 

Our painless root canal treatment disinfected the tooth.  Post and filling were also placed.  And an impression was taken for a new crown on the same visit.

Molar Tooth Root Canal

Patient was having slight discomfort on his tooth. The x-ray reveals a cavity extending to the pulp chamber which houses the nerves.  Once the decay was excavated, the nerve was exposed.  An emergency root canal was performed painlessly. 

Large filling close to the nerve caused the nerve to become painful

patient was having pain on her lower molar tooth.  The large filling in the tooth was close to the nerve.  This can sometimes cause the never in the tooth to become necrotic.  The root canal was performed pain free.  All the roots were cleaned and disinfected in one visit.  Patient will return next week to start working on the crown.

Molar root canal with calcified canals

Patient was experiencing pain because of cavities in her molar tooth that reached the nerve tissue.  The canals in this tooth are very thin and calcified.  The root canal procedure was successful in that we were able to clean out the calcifications in the roots and disinfect the tooth fully.  Patient will return to start fabricating a metal-free crown for this tooth.

Curvy Molar root canal

Patient presented for emergency in pain due to large cavity extending to the nerve of this molar tooth.  A root canal was performed to disinfect and clean the tooth.  A post and a filling were placed on top of the root canal.  The patient will return to start fabricating a crown for this tooth.

Molar Root canal

Patient presented with severe pain on molar tooth.  Large filling is present in close proximity to the nerve.  A filling close to the nerve may cause the nerve to die off (or become necrotic.)  The canals are extremely thin and calcified in this tooth.   The painless root canal was performed.  All three canals in this molar were disinfected and cleaned well.  A post and a filling were placed.  Patient will return to fabricate a crown on this tooth.

Molar Root canal

Patient presented in pain.  X-ray revealed a large filling placed in the pulp chamber of the molar.  Root canal was done to disinfect and seal the tooth.  Patient was put on antibiotics to clear up the rest of the infection around the molar.  A crown was fabricated for the tooth shortly after.

Patient was having discomfort because of deep recurrent decay on lower first molar.  The tooth cavity was cleaned leaving healthy tooth structure.  The root canal procedure disinfected the roots in the tooth.  The tooth had very long roots and interesting anatomy at the apex of the roots. Patient will return for a porcelain crown.

Patient was suffering from unexplainable pain.  Upon examination it was found the nerve inside the tooth died (necrotic) because of bruxism.  In some situations heavy grinding and clenching at night can lead to the nerve inside the tooth dying (necrotic.)  Tooth was disinfected with a root canal.  A night guard was fabricated for the patient. And a crown was made for the tooth as well.

Tooth Infection caused by a deep filling

This patient presented in pain because his second molar was infected.  The tooth had a filling that was placed very closed to the nerve due to deep tooth decay.  Placing a filling on top of the nerve can cause the nerve to die off over time.  This dead nerve is an area for bacteria to grow causing a large infection.  The tooth was disinfected with a root canal and our patient was put on antibiotics to clear up his tooth infection. 

Root Canal on a 5 Canal Molar Tooth

Patient presented for a dental emergency visit with a lot of pain due to severe infection in his molar.  This molar had a crown on it.  Sometimes when a tooth is prepared for a crown it can cause the nerve to die off.  The root canal was done by making a small hole in the crown to be able to access and disinfect the infected canals.  In this tooth 5 canals were found.  Most molars only have 3 or 4 canals.  It’s very important for a successful root canal that every canal is found and disinfected.

Follow-up on a root canal after 1 year | Infection Resolved

When a tooth has a large infection, the results often maybe unpredictable because the infection may return.  Dr. Peter Mann performed a root canal on this infected molar.  We followed up on this tooth 9 months later.  Amazingly, the bone had filled in around the tooth were it was missing, due to the infection, just 9 months prior.  Since this root canal was successful, we proceeded with making a porcelain crown for this tooth.

Large infection in Molar | root canal completed

patient presented with a severe abscess due to an infected molar.  Large filling was present close to the nerve pulp which was the likely cause for the nerve to die off and become (necrotic) infected.  The tooth was sterilized with a painless root canal procedure.  Patient was placed on antibiotics.

lower Second Molar Root canal

Our patient presented with pain in his lower second molar tooth.  Originally the wisdom tooth behind the second molar caused extensive tooth decay.  A dentist placed a filling very close to the nerve which over time ended up killing the nerve tissue which caused immense pain.  Our patient felt much better after his root canal treatment

 

Patient was having severe pain for 5 days due to deep cavities extending to the nerve in his second molar.  Root canal procedure was performed to disinfect the tooth and remove the infected nerve from the tooth.  The procedure took about an hour and the patient left the office feeling significant relief.

Second molar root canal

Deep Cavity in a Molar

Patient was having discomfort for a week in his lower second molar due to a deep cavity that reached into the pulp chamber.  Notice at the tip of the root, the sealer is escaping through many different openings called foramen.  It’s amazing to see the anatomy of this molar.  Patient left the office feeling much better.

Patient was in pain because the cavity extended to the nerves in the molar tooth.  The roots in this molar are very long and thin.  The roots also were partially calcified.  During the root canal procedure Dr. Peter Mann shaped the canals, disinfected the tooth and filled them with sealer. Our patient felt much better afterwards.

Long Thin Molar Roots

Patient was experiencing pain, due to a deep cavity which extended to the nerves in his second molar.  The tooth was disinfected and sealed during the root canal procedure giving patient much needed relief from pain.   

Deep tooth Cavity in Second Molar

Curvy Molar Roots

Patient came in with a big hole in his molar tooth.  The tooth decay had extended in the roots.  Patient reports having severe lingering sensitivity to cold for a while until it stopped as the nerve died off.  The roots were a bit calcified in this tooth due to long standing infection.  After additional effort we were able to completely clean the tooth and seal the entire root.

Deep Decay on Molar with Long Roots

Patient had a large cavity behind his lower second molar.  He arrived in our office experiencing severe pain. A root canal treatment was performed to get our patient out of pain

Second molar with Deep Tooth Decay

Patient had a long existing cavity that eroded her tooth.  The cavities were cleaned out.  Then the tooth was disinfected with a root canal procedure. The patient will return to place a porcelain crown on this second molar.

Patient came in to our office with  “Hot Tooth.” A hot tooth is a dental emergency because the patient is having severe pain because the infection has been in the nerve for a prolonged period of time. This patient hasn’t been able to get a good night sleep for several days.  The pain finally forced him to see a dentist.  Shortly after the tooth was anesthetized, our patient fell asleep.  He even slept through the root canal procedure 🙂

The three long canals were disinfected during the root canal treatment.  A post was then placed to support the tooth filling.  Patient will be able to sleep much better after the root canal procedure.  He’ll return to start working on a porcelain crown for this molar in about a week.

Hot Molar Tooth

Molar root canal to get out of pain

Patient had a large cavity that he neglected for many months.  When he got to the dentist, we tried to prevent a root canal by cleaning out decay and placing a large filling.  Unfortunately, placing a filling close to the nerve can cause inflammation of the pulp (pulpitis.)  In this case patient was having pain, we started a root canal.  

During the root canal we discovered that the roots were super thin and curvy.  It took about 3 hours of hand filling to clean the tooth properly.  The final image shows a successfully completed root canals with all 3 canals cleaned and disinfected.