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What is an endodontist?

An endodontist is a dental surgeon that has a specialized and limited practice, performing root canals (endodontics), some surgical and ancilliary procedures. Becoming an endodontist is a difficult task, involving a minimum of two extra years of full-time study and patient care at an accredited dental school in the USA or Canada, in addition to the 4 years of professional study in dental school after college.

Endodontists are exacting perfectionists who like the challenge of working in miniscule spaces inside teeth that can be instantly gratifying and provide the patient with almost immediate and long-lasting relief from pain. After practicing in Moscow for 10 years, Dr. Johnson studied at Nova Southeastern University in Fort Lauderdale, FL., graduating in 2009 and has been providing Tulsans with compassionate care ever since.

What is endodontics (root canals)?

Endodontics is the advanced specialty involved with treating and preservation of the pulp of a tooth and its surrounding tissues. “Endo” is the Greek word for “inside” and “odont” is Greek for “tooth.” Endodontic treatment treats the inside of the tooth. Root canal treatment is one type of endodontic treatment.

Inside of a tooth

To understand endodontic treatment, 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 a soft tissue called the pulp. The pulp contains blood vessels, nerves, and connective tissue and creates the surrounding hard tissues of the tooth during development.

The pulp extends from the crown of the tooth to the tip of the roots where it connects to the tissues surrounding the root. The pulp is important during a tooth’s growth and development. However, once a tooth is fully mature it can survive without the pulp, because the tooth continues to be nourished by the tissues surrounding it.

Why do I need a root canal?

Endodontic treatment is necessary when the pulp, the soft tissue inside the root canal, becomes inflamed or infected. The inflammation or infection can have a variety of causes, such as repeated dental procedures on the tooth, a crack or chip in the tooth, but it is usually the result of deep tooth decay (cavity). In addition, trauma, an injury 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. When the pulp can no longer repair itself, the only two options are extract the tooth, or save the tooth through having root canal treatment.

A common misconception that root canals cause pain is outdated. By performing root canal treatment, you will have almost immediate pain relief. With anesthetics and advanced techniques, your comfort is greatly improved and not at all how people expect.

What are typical symptoms of root canal infection?

Depending on the cause, symptoms can be numerous and varied, including:

  • Sharp, acute and intense pain, which is difficult to pinpoint
  • Sharp pain when biting down on your tooth or on food
  • Lingering pain after eating hot or cold foods
  • Dull ache and pressure
  • Tenderness (accompanied by swelling) in the nearby gums

How does endodontic treatment save my tooth?

The treatment begins by administering a local anesthetic to relieve pain. This will numb the tooth and surrounding area so that the treatment is no more uncomfortable than a filling. A common misconception is that root canal treatment is a painful experience when in actuality, it's quite the opposite. Ask Dr. Johnson’s team about sedation options.

A small opening in the chewing surface of your tooth is created to gain access to the pulp. Very small instruments are used to remove dead and dying tissue and clean the pulp from the inside, allowing the root canals to be cleaned and disinfected. The canals are specially enlarged and prepared so disinfecting solutions can clean all the way throughout the root canal system and dissolve dying pulp tissue and kill any bacteria that remain.

If your tooth has a particularly bad infection, Dr. Johnson may choose to put a disinfecting medication inside the tooth and seal it with a temporary filling and reappoint you for a second visit. This dressing kills bugs that may have persisted inside the tooth for some time and need extra time to respond to treatment.

Completed root canal treatment

Dr. Johnson may elect to seal your canals with a biocompatible filling material at the same appointment as it is becoming increasingly common for root canal specialists to use microscopes for these intricate and detailed procedures making the cleaning and shaping process more precise and efficien.

The biocompatible gutta-percha filling materials are coated with an adhesive cement to ensure that they are completely sealed in the canals to prevent future infection. Dr. Johnson may put a permanent or temporary filling in your tooth before referring you back to your general dentist.

For a posterior tooth, generally any tooth behind the canines or “eye teeth,” your referring dentist will likely prepare the tooth for a crown, that covers the whole tooth, like a thimble, ensuring the integrity and longevity of the treatment.

What can I expect following the procedure?

For the first few days after treatment, your tooth may feel tender or sensitive, especially if there was pain or infection before the procedure. Most discomfort can be relieved by over-the-counter medication like aspirin or Advil (ibuprofen). If you have discomfort or pain that lasts more than a few days, or if there are other increasing symptoms, you must call Dr. Johnson’s office (918-994-6000). Prescription medications, such as antibiotics and stronger pain medications, may be indicated.

You should not chew or bite on the treated tooth until you have seen your referring dentist, particularly if part of the tooth has been lost to decay, has a large filling or undergone trauma. A crown or other restoration is usually needed to further protect and restore the tooth to full function and is extremely important in ensuring long-term success. Contact your referring dentist as soon as possible to arrange for any necessary treatment.