Procedures & Services

Endodontic consultation

Dr. Manasco will thoroughly diagnose and determine if root canal treatment is needed. If so, he will focus on the tooth causing pain. Often, tooth pain is vague, and pain may be referred to other areas such as the jaw, ears, or sinuses. Endodontists are expertly trained to identify the source of tooth pain. Occasionally, treatment may be performed on the same day as the consultation. Generally, a consultation leads to a second appointment to provide treatment on another day, allowing Dr. Manasco to prescribe antibiotics before treatment.

Endodontic treatment

A patient may have experienced tooth pain, prolonged sensitivity to heat or cold, discoloration to a tooth or swelling and tenderness in nearby gums or the face. Infection or inflammation can have a variety of causes: deep decay, repeated dental procedures on the tooth, a cracked or chipped tooth or a blow or trauma to the tooth. Root canal treatment involves the removal of the infected or inflamed pulp, carefully cleaning and shaping the inside of the tooth, then filling and sealing the space to relieve pain. Dr. Manasco will utilize a state-of-the-art surgical operating microscope to carry out this procedure.

It is important for the patient to return to his or her regular dentist one to four weeks after endodontic treatment for a crown or other restoration to protect the treated tooth.

Endodontic Treatment
Endodontic Treatment
Endodontic Treatment
Endodontic Treatment
Endodontic Treatment
Endodontic Treatment

Endodontic re-treatment

With proper care, most teeth that have had endodontic (root canal) treatment can last as long as other natural teeth. In some cases, a tooth that has received endodontic treatment fails to heal, suffers from a broken, cracked or loose crown or filling, or never receives a crown after initial treatment. The tooth may become painful or diseased months or even years after successful treatment. If a patient’s tooth has failed to heal or developed new problems, another endodontic procedure may be able to save the tooth. After discussing the available options with Dr. Manasco, a patient may choose re-treatment. Dr. Manasco will utilize a surgical operating microscope to remove the canal filling, diagnose the cause of the problem, and clean, shape and fill the inside of the tooth.

It is important for the patient to return to his or her regular dentist one to four weeks after endodontic treatment for a crown or other restoration to protect the treated tooth.

Endodontic Re-Treatment

Removal of post or separated instruments

Posts are occasionally placed in the canals of teeth to provide retention to better hold a crown in place. Sometimes posts need to be removed to provide access for re-treatment or because the post has broken and part of it is still inside the canal. Dr. Manasco can remove the post utilizing the surgical operating microscope.

In rare instances, a shaping instrument may separate inside the canal, leaving tiny pieces behind. This may or may not cause a problem, depending on whether the canal was already clean and the location of the instrument. Dr. Manasco can sometimes remove these instruments, gaining access to untreated portions of the canal.

Repair of perforations or resorptive defects

A perforation is a hole in the floor of a tooth communicating with the ligament and bone. Resorption is an autoimmune response brought on by previous trauma. The tooth removes its own tooth structure from the inside out or the outside in. Depending on the size of the perforation or resorptive defect, the area sometimes can be sealed and function normally. Dr. Manasco can clean and seal the defect under the surgical operating microscope.

Internal bleaching

Sometimes a tooth needing a root canal will be discolored if the infected pulp stains it from the inside. Other times, a tooth with a previous root canal can become discolored. These teeth can effectively be whitened by internal bleaching. After endodontic treatment, Dr. Manasco places bleaching material inside the tooth and closes it with a temporary filling. The patient returns in 10 – 14 days and, if satisfied with the color, then a permanent filling can be placed by his or her regular dentist. If more whitening is needed, Dr. Manasco replaces the bleaching material and the process is repeated until a favorable color is achieved.

Regenerative endodontics

This exciting addition to the endodontic field is used with a tooth that has abscessed and died during formation. The formation of the roots stops as soon as the tooth dies, leaving the end of root wide open. The tooth is opened, the large canal space is cleaned and triple antibiotic paste is left in the space for three weeks. When the patient returns the canal is sealed with a restoration. In many instances, the root continues to form and the patient has no need for further treatment.

Regenerative Endodontics
Internal Bleaching

Cone Beam CT

The Cone Beam CT machine allows Dr. Manasco to view, diagnose, and treat patients more confidently with the 3D images provided by the dental cone beam.

During your consultation, Dr. Manasco may recommend our dental CT scan to achieve a more precise treatment plan. This is an additional cost and will be discussed in advance.

Nitrous oxide (laughing gas)

Nitrous oxide is offered at Eastern Shore Endodontics to help patients relax during the procedure. This will be an additional charge which is not usually covered by any dental insurance.