Thank you for your interest in Golden State Endodontics. We are specialist members of the American
Association of Endodontists. We look forward to being of service to you. Our expert team, led by
respected endodontic specialists Dr. Cohen, Dr. Stevenson and Dr. Gulden, includes an experienced
endodontic staff. We provide the highest standard of professional care in a friendly, comfortable
environment.
Dr. A. Scott Cohen is fluent in Japanese, Spanish and has a basic knowledge of Russian and American Sign Language. He is an avid skier, and he enjoys tennis, scuba diving, running, and photography. Dr. Cohen has 4 children, Mia, Zachary, Skylar, and new baby Shayna. His wife, Siena, speaks four languages.
For patients who prefer additional comfort during treatment, Dr. Cohen is trained to administer sedation in the form of nitrous oxide sedation or oral sedation.
Dr. Cohen is a board-certified endodontist. He became a Diplomat of the American Board of Endodontics in 2000. He has been an assistant clinical professor at the University of the Pacific School of Dentistry since 1995.
Dr. Lim is originally from Myanmar, formerly Burma, and is fluent in Burmese and English, while also having basic skills in Mandarin. She received a Bachelor of Science in Human Biology from UC San Diego. Following that, she completed dental school at New York University. Upon graduation, she joined the US Navy. She received an AEGD from Camp Pendleton along with the Navy Achievement Medal in 2013 and 2016.
After five years of service in the Navy, she went to the University of the Pacific for her specialty training in endodontics. She was working in private practice as an endodontist for the past two years. She is an outstanding doctor and a caring endodontist. We are honored to welcome her to Golden State Endodontics.
Dr. Lim and her family will be moving to East Bay from their current home in San Francisco. They have one son who will be starting first grade this year. He is full of energy and keeps Dr. Lim on her toes.
A root canal is one of the most common dental procedures performed, well over 14 million every year. This simple treatment can save your natural teeth and prevent the need of dental implants or bridges.
At the center of your tooth is the pulp. The pulp is a collection of blood vessels, nerve tissue and connective tissue. Infection of the pulp can be caused by trauma to the tooth, deep decay, cracks and chips, or repeated dental procedures. Symptoms of the infection can be identified as visible injury or swelling of the tooth, sensitivity to temperature or pain in the tooth and gums.
If you experience any of these symptoms, your dentist will most likely recommend non-surgical treatment to eliminate the diseased pulp. This injured pulp is removed and the root canal system is thoroughly cleaned and sealed. This therapy usually involves local anesthesia and may be completed in one or more visits depending on the treatment required. Success for this type of treatment occurs in about 90% of cases. If your tooth is not amenable to endodontic treatment or the chance of success is unfavorable, you will be informed at the time of consultation or when a complication becomes evident during or after treatment.
Cracked Teeth
Cracked teeth demonstrate many types of symptoms, including pain when chewing, temperature sensitivities, or even the release of biting pressure. It is also common for tooth pain to come and go, making it difficult to diagnose the cause of discomfort.
Chewing can cause movement of the cracked pieces of your tooth, and the pulp within the tooth becomes irritated. At the same time, when biting pressure is released, the crack can close quickly, resulting in sharp pain. Eventually, the pulp will become damaged and tooth will consistently hurt, even when you are not chewing. It is possible that cracks can lead to infection of the pulp tissue, which can spread to the bone and gum surrounding the problematic tooth.
Endodontic Retreatment
With the appropriate care, your teeth that have had endodontic treatment will last as long as other natural teeth. Yet, a tooth that has received treatment may fail to heal or pain may continue to exist. Sometimes, the pain may occur months or years after treatment. If so, Endodontic Retreatment may be needed.
Improper healing may be caused by:
Curved or narrow canals were not treated during the initial treatment.
Complicated canals went undetected during the initial treatment.
The crown or restoration was not placed within the appropriate amount of time following the procedure.
The crown or restoration did not prevent saliva from contaminating the inside of the tooth.
In some cases, new problems can influence a tooth that was successfully treated:
New decay can expose a root canal filling material, causing infection.
A cracked or loose filling or crown can expose the tooth to new infection.
Once retreatment has been selected as a solution to your problem, we will reopen your tooth to gain access to the root canal filling material. This restorative material will be removed to enable access to the root canal. We will clean your canals and carefully examine the inside of the problematic tooth. Once cleaned, we will fill and seal the canals and place a temporary filling in the tooth.
Apicoectomy
Generally, a root canal is all that is needed to save teeth with injured pulp from extraction. Occasionally, this non-surgical procedure will not be sufficient to heal the tooth and Dr. Grant will recommend surgery. Endodontic surgery can be used to locate fractures or hidden canals that do not appear on x-rays but still manifest pain in the tooth. Damaged root surfaces or the surrounding bone may also be treated with this procedure. The most common surgery used to save damaged teeth is an apicoectomy or root-end resection.
WHAT IS AN APICOECTOMY?
The video above illustrates this simple procedure. An incision is made in the gum tissue to expose the bone and surrounding inflamed tissue. The damaged tissue is removed along with the end of the root tip. A root-end filling is placed to prevent reinfection of the root and the gum is sutured. The bone naturally heals around the root over a period of months restoring full function.
Apexogenesis
This procedure encourages the root to continue development as the pulp is healed. Soft tissue is covered with medication to encourage growth. The tip of the root (apex) will continue to close as the child gets older. In turn, the walls of the root canal will thicken. If the pulp heals, no additional treatment will be necessary. The more mature the root becomes, the better the chance to save the tooth.
Apexification
In this case, the unhealthy pulp is removed. The doctors place medication into the root to help a hard tissue form near the root tip. This hardened tissue provides a barrier for the root canal filling. At this point, the root canal walls will not continue to develop, making the tooth susceptible to fractures. So it is important to have the tooth properly restored by your dentist.
