My name is Dr. Nick Leon-Guerrero. I grew up in Modesto, California and attended college at the University of the Pacific. I continued at the University of the Pacific in San Francisco, CA for my dental school training and finished my degree in 2014. After that, I completed a one year General Practice Residency at Kings County Hospital in Brooklyn, NY. After one year in private practice, I decided to further my training with a two-year endodontics residency program at Columbia University in New York, NY. After graduation, I started private practice with Limited to Endodontics in Boston, MA. Currently I live and work in Arlington, Virginia with several outstanding colleagues at Dominion Endodontics. We have additional office in both Falls Church and Alexandria, Virginia. I love working here and taking care of my wonderful patients, but I am always excited for new opportunities. I love the power endodontics has to save teeth. Our specialty is taking great strides in patient care by embracing fundamental ideas of the past and incorporating new innovative methods to provide the best care possible. I enjoy practicing at the cutting edge with regenerative, minimally invasive, and surgical techniques to reach patient-centered outcomes. My priority is always to provide successful treatment and gently alleviate pain for my patients.
Education and Training
Columbia University Certificate in Endodontics 2018
University of the Pacific DDS 2014
Kings county Hospital General practice Residency Certificate 2015
Nicholas Leon-Guerrero's Expert Contributions
It is possible to place an implant many years after a tooth has been extracted, however there are several factors that can affect the success of these treatments. The first is that over time, the adjacent teeth may drift into a space and prohibit placement or restoration of an implant. The second factors is that over time, bone in the site may resorb (shrink) and prohibit placement of an implant due to insufficient bone. Sometime grafting can be done to overcome this, but it is not always successful. Not every patient or space is a candidate for implant placement. It is best for one to communicate with their doctor one's plans to replace the tooth in the future, so that space and bone may be maintained and allow for successful placement of an implant in the future. READ MORE
Root canals, when done properly, generally have a success rate between 85-95%. Failure is rare, but does happen from time to time. If a root canal does not relieve the symptoms within a few weeks to months after the procedure, then it could be considered a failure. Many times, an X-ray will be required to evaluate changes in the bone. These changes may take months or even years to occur, but are an important indicator for success or failure of root canal treated teeth. Either way, the success or failure of a root canal is best determined through consultation and examination with a root canal specialist called an endodontist. READ MORE
It is important to follow your dentists specific instructions after a root canal regarding post-operative care. Generally it is advised that one not each any hard or sticky foods while to the tooth has a temporary filling. The tooth may be pressure sensitive or uncomfortable, so one can take pain medication as advised by their doctor after the procedure READ MORE
Tender gums may be normal after a root canal but typically resolve within 2 weeks. If one has persistent pain after a root canal procedure, one should communicate with their doctor to determine the need for follow up or additional treatment. READ MORE
After an extraction, one should eat softer foods and avoid anything particularly hot or spicy. Most importantly, it is important to keep the area clean as advised by one's doctor after the procedure. READ MORE
The typical side effects after a wisdom tooth extraction include pain, swelling, bruising, and difficulty opening the mouth. Some more serious side effects can include persistent bleeding or nerve paresthesia. One should personally speak with his or her own dentist to review any and all possible complications for any dental procedure. READ MORE
Gums may be sore after a root canal procedure due to several causes. First the injection site may have some soreness due to the insertion of the needle. Additionally, the gums near the tooth may be traumatized by the instruments used in a root canal procedure. Any inflammation caused by the procedure typically resolves within 7-10 days. Follow any instructions as given by your doctor after the procedure to help reduce the chance of complications. READ MORE
Ideally, a tooth that has had a root canal should be crowned as soon as the postoperative pain has resolved, which is usually between 1-2 weeks. If the tooth has a temporary filling, it may be more vulnerable to fracture or reinfection. Best not to wait longer than 2 months to get the crown after the root canal to avoid these possible complications. READ MORE
After a dental extraction, there may be a hole in the gum where the tooth was previously located. Gum tissue will cover the hole typically within 2-3 weeks and underneath new bone will fill in the space within 3-6 months. It is important during the healing phase that one keep the wound clean and follow the post-operative instructions given to them by their doctor to avoid complications. READ MORE
A root canal is completed within the tooth and therefore will not directly affect ones gums, which are outside the tooth. If the infection indirectly caused inflammation or abscess that presents in a patients gums or soft tissue, this should heal within weeks after a successful root canal. READ MORE
Generally receiving root canal treatment is more comfortable than a dental extraction, because the feeling of pressure that comes with a tooth extraction can not be fully diminished with local anesthesia. Both may be a comfortable experience as long has sufficient anesthesia has been achieved. READ MORE
After a root canal, one must be careful to not bite on anything hard that could fracture the tooth or anything sticky that could pop a temporary filling off. Otherwise the tooth is typically brushed and flossed like normal. It is important to follow all the instructions given to you by your dentist after the procedure. READ MORE
Yes, a crown procedure can be done without a root canal if it has been determined that the pulp and periapical tissues on the tooth are free of disease. Be aware however, the crown procedure itself may cause inflammation that may necessitate a root canal after the crown has already been placed. READ MORE
In a 16-year study conducted by Dr. P. Simonis, the cumulative 16-year survival rate of the dental implants studied was 82.94%. Dental implants generally have a high success rate, although they are not without their own complications over time. Clin Oral Implants Res. 2010 Jul;21(7):772-7 READ MORE
Postoperative pain after a root canal procedure generally worsens the first 2-3 days after the procedure and then improves during the following 7-10 days. It is important to follow all of the post-operative instructions given to one by their dentist to avoid complications in healing after the procedure. READ MORE
No antibiotics are not always indicated after a root canal, but may be depending on one's overall health history and current condition. It is important to speak to ones dentist to fully determine if antibiotics will be necessary in addition to treatment. READ MORE
The time a root canal takes depends on the difficulty of the tooth and the skill of the provider. The average time is somewhere between 45 minutes to 1 hour, however some difficult root canals may take several appointments, each longer than and hour. READ MORE
If one has too pain, it possible but not certain a root canal may be necessary. Anyone with dental pain should seek evaluation by a dentist to fully determine what treatment options may be available. READ MORE
If one is experiencing postoperative pain after a root canal procedure, It is recommended to follow up with one's dentist to see if any additional treatment is needed. The provider who completed the procedure or a specialist called an endodontist will best be able to help you resolve this condition. READ MORE
The evidence in the scientific literature suggests a success rate of between 85%-95% for root canal treatment, however each individual tooth may have several factors that raise or lower the lifespan of the tooth. A well done root canal in patient with good oral hygiene habits may last a lifetime. READ MORE
While any dentist may be licensed to perform a root canal procedure, dental specialists known as endodontists exist to exclusively do root canals. Root canals are known to be a difficult procedure for many general dentists, whereas an endodontist may have special equipment to complete the root canal procedure. READ MORE
Antibiotics like amoxicillin start to work as soon as you begin taking them. Most patients report a noticeable difference in symptoms after 2-3 days. If one has issues with their antibiotics, it is important so speak with ones doctor to see if the type or dosage needs to be changed. READ MORE
There is no limit to the amount of dental fillings that you can get at one time. However doing a full mouth of dental appointments can be a long appointment and lead to discomfort afterwards. Most dentists choose to do either 1/4 or 1/2 of the mouth at one time and space the work into 2-4 appointments. READ MORE
For most gaps, the least invasive way to treat this is to get orthodontic treatment (braces). Some options including fillings, crowns, and veneers may be able to close gaps between teeth as well. If the space is very large or caused by a missing tooth, the space may need to be replaced by an implant, bridge or removable prosthesis. Each case is different and a dentist will need to do a full evaluation to determine which treatment is best. READ MORE
No a root canal itself will not cause movement of the nearby teeth. Movement of nearby teeth is more likely to occur after an extraction (removal) of the tooth. READ MORE
A root canal may or may not be necessary before a bridge and depends on several factors. If tooth preparation need to be shortened or angulated to fix the bridge, or if there is deep decay, then a root canal may be necessary. A root canal may also be necessary if symptoms or infection develops after the bridge. For some teeth, a root canal will not be necessary for the bridge to seat and therefore can be avoided. I would advised one speak with their dentist regarding their possible need for root canal treatment prior to any bridge preparation. READ MORE
The misconception that root canals are painful stems from a time when effective dental anesthesia was not available. Today, most root canal procedures can be done painlessly, although there is typically some mild post-operative discomfort afterwards. READ MORE
No, tooth pain does not necessarily mean you need a root canal, although often it does. Some conditions may heal on their own or require different kinds of treatment such as a filling, cleaning, or extraction. Every case is different, so when one has tooth pain, it is important to see a dentist for evaluation before it gets worse. READ MORE
The anesthesia typically used for a root canal procedure is the same local anesthesia that would be used when doing a simple filling. The most common local anesthesias used in dentistry include lidocaine, mepivicaine, and articaine among others. These local anesthesia may include a vasoconstrictor such as epinephrine to increase their effectiveness. It is important before any dental procedure to review your medical history with your doctor to determine if these kinds of anesthesia may be safe for you. READ MORE
A root canal procedure is done within the center of a tooth and its filling materials should not be left open to the mouth after completion. Because it is sealed within the tooth, yes it should be perfectly fine to drink cola after the procedure. READ MORE
A root canal alone will not change your face shape. The root canal is done internally in a tooth within your mouth, and therefore will not affect your facial structure or bite. However, complications before or after a root canal may lead to temporary swelling which cause your face or jaw to appear different. This however is temporary and should resolve after the swelling heals. READ MORE
Gum recession depends on several factors including genetics and quality of oral hygiene. There is no set age that gums will start to recede, and some people may see recession early in life or reach old age with no visible gum recession. Overall, seeing the dentist for regular cleanings and making a habit of proper brushing and flossing can prevent gum recession. If one does have recession, it is important to speak to a dentist about periodontal disease and the different treatment options regarding this condition. READ MORE
Enamel erosion can be caused by several factors including bruxism (teeth grinding), acid reflux, consuming acidic foods and drinks, and using abrasive tooth pastes. It is important for one facing enamel erosion to visit their dentist and identify which specific factors are causing the erosion in order to prevent and treat this condition. READ MORE
It is typical to have mild or moderate post operative discomfort after a root canal procedure. This typically presents as a pain to pressure or a mild aching feeling. A small percentage of patients will have severe pain or swelling afterwards that may require additional care. It is important to remain in contact with one's dentist after a root canal procedure to ensure proper healing of an endodontically treated tooth. READ MORE
The time it takes for the gums to heal after an implant surgery is relative to the amount of trauma to the area that occurred during the procedure. Typically, the gums around any oral surgery with heal within 2-4 weeks. However, I do want to clarify that the bone below the gum may take several months to properly heal. Implants work by "integrating" with the bone, with typically takes 3-4 months in the mandible (Lower jaw) or 5-6 months in the maxilla (upper jaw). READ MORE
Each time a dental filling is replaced, more tooth structure must be removed and the filling depth will move closer to the pulp, which are the inner nerves and blood vessels inside the tooth. There is no set limit of times a filling can be replaced on a tooth. However if the amount of remaining tooth structure is reduced enough, replacing the filling may no longer be an option and instead a root canal and/or crown may be necessary instead. READ MORE
After a root canal, it is recommended to avoid any hard foods on the tooth. Things like ice or hard nuts could possibly crack the tooth while it is in temporary state. After a root canal tooth is restored with a crown, one can typically resume eating normally. READ MORE
The answer is both yes and no. A loose tooth may tighten up and reduce its mobility if the underlying infection has been controlled. However, If too much bone has been lost, there may not be enough bone regeneration to properly stabilize the tooth. It its important to speak with one's dentist regarding their specific case to see what options may be available. READ MORE
If left untreated, a decaying tooth will continue to decay. As the decay progresses deep enough, the tooth may become infected or even be "nonrestorable" This process may take weeks or months. It is important to see a dentist to repair tooth decay soon after it is noted to prevent extension of the decay. READ MORE
Yes, some but not all root cavities may be filled. Deeper cavities m ay require a root canal prior to being restored or even require an extraction. It is important to have a dentist evaluate one's specific case to determine what treatment options may be available. READ MORE
During the covid-19 pandemic, many dentists are still providing emergency services. Each state has different orders regarding this and one would need to call their dentist's office to determine if their root canal is deemed an emergency and the appointment can be kept. READ MORE
Depending on the difficulty of the extraction and the clinical skill of a provider, a dental extraction could take from seconds to over an hour for some. If one is concerned about a dental extraction, they may consider seeing a specialist such as an oral surgeon for their treatment. READ MORE
A root canal procedure is when the nerve tissue and infection are removed from inside the root of the tooth. Afterwards, the space is sealed with a rubber material called gutta percha. Teeth with root canals may be weakened and may require a permanent filling or crown to increase their resistance to fracture. Symptoms after the root canal typically resolve within weeks and healing in the bone may occur over the next year. READ MORE
Yes typically implants can be done to replace a tooth with a failing root canal. It is important to speak to one's dentist about their specific cases, as each case may require different kinds of treatment READ MORE
Depending on the size of infection, the time frames ranges from several weeks to several months after the root canal before one can get braces. It is important to speak with one's doctors regarding their specific case to determine how long after a root canal one may begin orthodontic treatment. READ MORE
In most cases, no antibiotics are not needed after a root canal. According to the AAE and ADA Guidelines, antibiotics are typically recommended only for patients who are immunocompromised or for a spreading/systemic infection. READ MORE
For most cases, gentle brushing and flossing as normal can resume right after a root canal procedure. As each case is different however, one must ask their dentist after the root canal if any changes to their oral hygiene routine may be necessary. READ MORE
In general, dental abscess are unlikely to spread as they are typically a localized infection. If an infection does spread, one would likely have systemic symptoms such as fever, increased swelling, malaise or shortness of breath. If one has a dental abscess, it is important to see a dentist as soon as possible for an evaluation. A systemic infection can lead to sepsis and may require a trip to the emergency room READ MORE
Areas of expertise and specialization
Faculty Titles & Positions
- Faculty University of the Pacific 2015 - 2016
- American Dental Association
- American Association of Endodontists
Charities and Philanthropic Endeavors
- Northern Virginia Dental Clinic
- AAE Foundation
Nicholas Leon-Guerrero's Practice location
Arlington, VA 22203Get Direction
Falls Church, VA 22043Get Direction
Alexandria, VA 22314Get Direction
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