The truth about root canals By Dr. Eric Gustavsen, Published in the Walla Walla Union Bulletin 4/6/12 In a recent State of the Union Address President Obama said something that made any drowsy dentist watching lurch out of their Lazyboy. He referred to the bank bailout as being “as popular as a root canal.” It may be an attention getting line but is this comparison fair? Confusion abounds regarding root canals. What are they? Why would someone need one? Why would they even want one? To begin with, what exactly is a root canal? The process usually begins when a tooth has had some kind of injury. Most commonly from bacteria invading the nerve from a deep cavity or from some kind of trauma. For example, wrestling with your brother (my experience) or a blow while playing sports. These insults cause the nerve to swell resulting in pain. Sometimes that pain goes away and the tooth gets better for a while. Sometimes it just gets worse. That’s a time when you are happy to visit a dentist. When your dentist evaluates the tooth he/she will take an x-ray to see if there is any infection at the end of the root of the tooth. They will also ask you questions such as: does it hurt when you bite things? Is it sensitive to hot or cold drinks? Does it wake you up at night? If your dentist determines that the nerve is too sick to get better or has died and is causing an infection he/she will give you the option of fixing the tooth or removing it. In most cases the best option is to fix the tooth with endodontic therapy, aka root canal. Inside the root of every healthy tooth is a small channel containing the nerve and blood vessels, which supply moisture and nutrients to the tooth. When the nerve is traumatized pressure builds inside the rigid casing of the root of the tooth. This can be very painful as any one who has experienced this will be eager to tell you. To help a person feel better, their dentist will first completely anesthetize the tooth. They will then put a covering over top of the tooth to keep the area clean. The pressure inside the tooth is relieved by cleaning and sterilizing the hollow tube in the roots where the blood vessels used to be. After your dentist is satisfied he/she has thoroughly disinfected the tooth, a comfortable rubber filling will be placed in the root and sealed to keep bacteria out. Contrary to a common misunderstanding, endodontic therapy doesn’t remove the roots of the teeth. It cleans and disinfects the inside of the root and makes the tooth comfortable again. Why would someone want a root canal? In most cases, for relief of significant discomfort and pain. The alternative to endodontic therapy is removing the offending tooth and leaving a gap. This can seriously alter ones social life depending on the location of the missing tooth. Replacing a missing tooth usually involves a lot more time, effort and
money than saving the tooth that’s already there. So where did root canals’ bad reputation come from? Perhaps things were different 30 or 40 years ago. With todays very effective anesthetics and modern techniques the pain a person experiences is before the treatment from a dying nerve or infection. Only very rarely during or after the appointment and these can be managed very effectively. Treating the tooth takes care of the problem! It is perfectly normal to be apprehensive before dental treatment. If you are anxious, discussing this with your dentist prior to treatment will help him/her plan additional ways to make you feel more relaxed. Most offices offer some form of light sedation such as laughing gas or a “walking” sedative like valium. Your dentist will probably ask you to give him/her a predetermined signal, such as a raised hand, should you need more anesthetic. If you are very apprehensive or your dentist determines your tooth will be more challenging to treat, she/he will probably suggest you see our local root canal specialists, Advanced Endodontics. They are excellent! Endodontists, or root canal specialists, have years of additional education and can deal with challenging situations or complex cases more precisely and quickly than those without this specialized training. Endodontists also have advanced equipment such as microscopes and 3 dimensional x-rays to help them find hidden or extra roots. This results in a better long-term outcome for teeth that can hold surprises, such as upper molars. Maybe root canals will never be as popular as the president, but things change, and with todays’ improved anesthetic techniques and technology it’s not something to avoid. People are usually surprised at how easy the treatment is. In fact it’s often so monotonous that many patients fall asleep during the procedure! Now that’s change you can believe in.