
Dr. Nicholas Leon-Guerrero, DDS
Endodontist | Endodontics
4350 Fairfax Dr. Suite 160 Arlington VA, 22203About
My name is Dr. Nick Leon-Guerrero, and I am a Board-Certified Endodontist. 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
Board Certification
American Board of Endodontics
Provider Details

Dr. Nicholas Leon-Guerrero, DDS's Expert Contributions
How is dental calculus removed?
Dental calculus, or tartar, is a hard buildup of minerals and bacterial plaque in the oral cavity. Calculus must be removed manually by dental professionals using metal or ultrasonic instruments. The procedures in which the calculus will be removed are called a prophy (cleaning) or a Scaling and root planing (deep cleaning). READ MORE
What are the symptoms of an infected root canal?
The symptoms of an infected root canal range from severe pain and swelling to no symptoms at all. Symptoms tend to come and go intermittently. Most infections begin with pain to pressure on the tooth or pain when pressing along the gum. More advanced infections with have a painful swelling or a bubble that appears on the gums. READ MORE
What are the symptoms of a bad root canal?
The symptoms of an infected or failing root canal can range from severe pain and swelling to no pain or symptoms at all. If one is concerned about the possibility of a dental infection, I would recommend they see and endodontist for a consultation regarding the issue, READ MORE
How long do teeth hurt after a root canal?
Post operative discomfort is normal for about 5-7 days after a root canal procedure. It is typical for the pain to increase for a period of 2-3 days before it starts to get better. If the pain is severe or you experience swelling after the procedure, it is recommended to contact your dentist as you may be experiencing a "flare up." The incidence of a flare up after a root canal is approximately 5-8% and the treatment is often a course of antibiotics. READ MORE
Is a root canal considered oral surgery?
Typically a root canal is considered a non-surgical procedure. READ MORE
What does tooth erosion feel like?
Tooth Erosion is generally a gradual process where the tooth wears away because of acid or abrasive contact. Most people will not feel any sensation from the erosion itself, but as more tooth structure becomes eroded, the nerves will become less insulated and there will be increased sensitivity to cold, sweets and brushing. READ MORE
How fast do antibiotics work for tooth abscess?
When used as treatment of a tooth abscess, antibiotics will typically need to be in one's system for at least 24-48 hours before the drug begins to take affect. This amount of time is dependent on the dosage, type of drug, and the rate of absorption in a particular person's body. Please take all medications as described by your doctor and alert them of any negative side effects you may experience. Also, please remember that dental treatment in addition to antibiotics may be necessary to eliminate the underlying cause of the infection. READ MORE
Can a decayed tooth be saved?
While new dental materials and dental technology can allow for more and more decayed teeth to restored, there are still limitations to these advances. Generally the less remaining tooth structure above the gum, the less likely the tooth is to be restored with long term predictability. Other factors that can effect the restorability of the tooth include the presence of a crack or fracture, periodontal disease, position in the mouth, the skill of the dentist, and bruxism. It is recommended to seek consultation with a dentist to determine if a tooth is restorable, and if non-restorable discuss what options you may have for replacement of the decayed tooth. READ MORE
Can you fix gum pockets?
"Pocketing" of the gum occurs when the gingiva loses attachment to the tooth due to inflammation or infection from bacteria. In some cases, bone loss may accompany the gum attachment loss. This is termed "periodontal disease." With proper home care and deep cleanings by a dental office, one can typically reduce pocketing that has occurred. Some severe cases however my require surgery or be too far compromised to achieve adequate healing. A consultation with a dentist or specialist called a periodontist is recommended for those with gum pocketing to accurately determine prognosis and what treatments may be available for their specific case. READ MORE
Can you get an implant years after extraction?
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
How do you know if root canal failed?
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
How should you recover from a root canal?
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
Why do my gums feel inflamed after a root canal?
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
What can I eat 3 days after a tooth extraction?
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
What are the side effects of a wisdom tooth extraction?
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
My gums hurt after my root canal?
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
How long after root canal do you get a crown?
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
Is there supposed to be a hole after wisdom tooth extraction?
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
How does a root canal affect your gums?
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
What hurts more tooth extraction or root canal?
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
Areas of expertise and specialization
Faculty Titles & Positions
- Faculty University of the Pacific 2015 - 2016
Professional Memberships
- American Dental Association
- American Association of Endodontists
Charities and Philanthropic Endeavors
- Northern Virginia Dental Clinic
- AAE Foundation
Dr. Nicholas Leon-Guerrero, DDS's Practice location
Dominion Endodontics
4350 Fairfax Dr. Suite 160 -Arlington, VA 22203Get Direction
Dominion Endodontics
1650 King Street 300 -Alexandria, VA 22314Get Direction
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