Top procedures we perform at our Fort Worth practice
TL;DR: West Fort Worth Endodontics offers expert endodontic care in Fort Worth, TX, including root canal therapy, dental pain diagnosis, apicoectomy and cracked tooth management. Led by board-certified endodontists Dr. Nieves and Dr. Fitzhugh, our practice uses advanced technology like CBCT imaging to relieve pain and save natural teeth for patients across Fort Worth and surrounding communities.
Tooth pain has a way of taking over your life. It's hard to focus at work, hard to enjoy a meal and hard to sleep through the night when your mouth is throbbing. If you're dealing with that kind of pain right now, you're not alone—and more importantly, you don't have to keep suffering.
At West Fort Worth Endodontics, we specialize in diagnosing and treating the kind of dental pain that doesn't go away on its own. Our board-certified endodontists, Dr. Nieves and Dr. Fitzhugh, have helped hundreds of patients across Fort Worth, Benbrook, Crowley, Aledo, Weatherford, Willow Park, White Settlement and beyond get back to living pain-free. And we do it while saving your natural teeth whenever possible.
Here's a look at the top procedures we perform at our Fort Worth practice—and how each one can help you.
Root canal therapy: The cornerstone of endodontic care
What is a root canal and when is it necessary?
Root canal therapy is the most common procedure we perform, and it's also one of the most misunderstood. Many patients come in dreading it, expecting the worst. The truth? A root canal is designed to relieve pain—not cause it.
When the soft tissue inside your tooth (called the pulp) becomes infected or severely inflamed, it can cause intense, persistent pain. This can happen due to deep decay, a crack in the tooth or repeated dental procedures on the same tooth. Left untreated, the infection can spread to the surrounding bone and tissue. Root canal therapy removes the damaged pulp, cleans the interior of the tooth and seals it to prevent further infection. The result is a tooth that's free of pain and fully functional.
How we use CBCT imaging for more precise root canal treatment
One of the things that sets West Fort Worth Endodontics apart is our use of cone beam computed tomography (CBCT) imaging. Unlike traditional X-rays, CBCT gives us a three-dimensional view of your tooth and the surrounding structures. This level of detail allows Dr. Nieves and Dr. Fitzhugh to identify the exact location and extent of an infection before treatment begins.
We're also a licensed GentleWave® provider—a cutting-edge root canal technology that uses advanced fluid dynamics and broad-spectrum acoustic energy to clean the root canal system more thoroughly than conventional methods. Patients who choose GentleWave® often experience less post-procedure discomfort and faster healing.
What to expect after a root canal
Most patients are surprised by how quickly they recover. Some mild soreness in the days following the procedure is normal, but it's manageable with over-the-counter pain relievers. You'll want to be mindful of what you eat during recovery and follow up with your general dentist to have the tooth permanently restored with a crown. With proper care, a tooth treated with root canal therapy can last a lifetime.
Dental pain diagnosis: Getting to the root of your toothache
Why diagnosing tooth pain isn't always straightforward
Not every toothache points to an obvious problem. Tooth pain can stem from a wide range of sources, including nerve damage, sinus pressure, TMJ issues or an infection deep within the root. Figuring out the real cause takes experience, the right diagnostic tools and a trained eye.
Our team specializes in diagnosing mystery tooth pain—the kind that's hard to pin down. We use CBCT imaging, pulp vitality testing and other advanced diagnostic methods to determine exactly what's going on before recommending a course of treatment.
When pain signals pulp necrosis
One condition we frequently diagnose is pulp necrosis, which occurs when the pulp tissue inside the tooth dies—often as a result of untreated infection or trauma. It doesn't always cause obvious pain, which means patients sometimes don't realize there's a problem until the infection has already spread. That's why we encourage anyone experiencing unusual tooth pain to come in for an evaluation rather than waiting it out.
Apicoectomy: When a root canal isn't enough
What is an apicoectomy?
Most of the time, root canal therapy fully resolves an infection. But in some cases, a small amount of infection persists at the very tip of the root—an area that's difficult to reach during a standard root canal. When that happens, an apicoectomy may be the right solution.
During an apicoectomy (also known as a root end resection), Dr. Nieves or Dr. Fitzhugh makes a small incision in the gum tissue to access the root tip, removes the infected tissue and seals the end of the root with a biocompatible material. The procedure is performed under local anesthesia and is far less intimidating than it sounds.
Who needs an apicoectomy?
An apicoectomy is typically recommended when a patient has persistent pain or infection after a root canal, or when retreatment of the root canal isn't possible due to a crown, post or other restoration. Recovery from an apicoectomy usually involves a few days of swelling and mild discomfort, but most patients return to their normal routine quickly. It's a highly effective way to save a tooth that might otherwise need to be extracted.
Cracked tooth management: Saving fractured teeth before it's too late
How we diagnose a cracked tooth
Cracked teeth are more common than most people realize. They can result from biting into hard foods, grinding your teeth, dental trauma or simply the natural wear that comes with age. The challenge is that cracks aren't always visible on a standard X-ray. Symptoms like sharp pain when biting, sensitivity to temperature or discomfort that comes and goes can all be signs of a crack.
At West Fort Worth Endodontics, we use specialized magnification, transillumination and CBCT imaging to locate cracks that other practitioners might miss. Catching a crack early is critical—the longer it goes untreated, the deeper it can extend, making it harder to save the tooth.
Treatment options for cracked teeth
The right treatment for a cracked tooth depends on the type and severity of the crack. Some cracks can be managed with a root canal followed by a crown, while others may require more advanced intervention. Our complete guide to cracked tooth repair options breaks down what to expect based on the type of crack. In the most severe cases, where the crack extends below the gumline, extraction may be the only option—but that's a last resort, and we do everything we can to avoid it.
Why choose West Fort Worth Endodontics?
There are general dentists who can perform some of these procedures, but endodontists are specialists. Dr. Nieves and Dr. Fitzhugh completed years of additional training beyond dental school, focusing exclusively on diagnosing and treating conditions that affect the interior of the tooth and the surrounding tissue. That focused expertise makes a real difference in outcomes.
Our Fort Worth practice is built around two things: precision and patient comfort. We understand that dental procedures can feel intimidating, which is why we take the time to explain everything before we start, answer your questions honestly and use the most advanced technology available to make treatment as effective and comfortable as possible.
We serve patients from across the area, including Fort Worth, Benbrook, Crowley, Willow Park, White Settlement, Aledo and Weatherford. Whether you've been referred by your general dentist or you're seeking care on your own because you're experiencing tooth pain, we're here to help.
Don't let tooth pain dictate your life
Tooth pain isn't something you should have to push through. Whether you're dealing with a random toothache, sharp pain when you bite down or swelling around a tooth, these are signs that something's wrong—and the sooner it's addressed, the better your chances of saving the tooth.
At West Fort Worth Endodontics, we're committed to getting you out of pain and keeping your natural smile intact. If you're ready to find out what's causing your tooth pain and get the treatment you need, schedule a consultation with Dr. Nieves or Dr. Fitzhugh today. Relief is closer than you think.
Frequently asked questions about endodontic procedures in Fort Worth
What's the difference between an endodontist and a general dentist?
An endodontist is a dental specialist who has completed two to three years of advanced training beyond dental school, focusing specifically on diagnosing tooth pain and treating conditions that affect the dental pulp and root structures. General dentists can perform some of these procedures, but endodontists handle complex or difficult cases every day, which means more experience and better outcomes for patients.
How do I know if I need a root canal?
Common signs that you may need a root canal include severe or persistent tooth pain, prolonged sensitivity to heat or cold, tooth discoloration, swelling in the gums near the tooth or a pimple-like bump on the gum. The only way to know for sure is to have the tooth evaluated by an endodontist.
Is a root canal painful?
Root canal therapy is performed under local anesthesia, so you shouldn't feel pain during the procedure. Most patients describe the experience as similar to getting a routine dental filling. Some mild soreness for a few days afterward is normal and manageable with over-the-counter pain relief.
How long does a root canal take at West Fort Worth Endodontics?
Most root canal procedures at West Fort Worth Endodontics can be completed in one to two appointments. The exact timeline depends on the complexity of the case and the number of canals in the tooth. Our team will give you a clear picture of what to expect before treatment begins.
What happens if I ignore tooth pain?
Ignoring tooth pain—especially pain caused by infection—can lead to the infection spreading to the jawbone, surrounding teeth or other parts of the body. It can also result in the loss of the tooth entirely. Early treatment is almost always less invasive and more successful than waiting.
Does West Fort Worth Endodontics accept patients without a referral?
Yes. While many patients come to us through a referral from their general dentist, you don't need one to schedule an appointment. If you're experiencing tooth pain in Fort Worth or the surrounding area, you can contact us directly to book a consultation.