So I was informed by one of my professional journals that this past week was “Root Canal Awareness Week,” which explains why I had noticed scores of people running fearfully down the streets of Manhattan while screaming in pain. (I’m only joking; not the part about root canal awareness but about the people running around the city in abject terror.) But the fact is that root canal treatment, also known as endodontic therapy, is THE MOST FEARED dental procedure.
Mention root canal to a person who has never had the experience, and images from the movie Marathon Man come to mind; you know the scene when Lawrence Olivier drills into Dustin Hoffman’s tooth sans Novocain, interrogating him, “Is it safe?” (Makes water boarding seem almost benign.) So ingrained in our culture is the torment of root canal that the idiom, “I’d rather have a root canal” has become synonymous with an absolute worst case scenario: that a situation is so bad that one would rather “be subjected” to a root canal is based on the almost universal misconception that root canal is horribly horrifying.
Much of this perception stems from early treatment methods used many decades ago to perform the procedure. Due to these now antiquated techniques and less effective anesthetics available at the time, the misery associated with root canal therapy has been indelibly imprinted upon our collective memories.
The Truth About Root Canal
While a toothache due to an inflamed nerve or abscess can be excruciating, root canal therapy is most often completely painless. Modern dentistry, with all of its advances, has essentially made painful root canal treatment, a thing of the past. In my experience, the patients most fearful of root canal are those who never had it before and believe me, when I tell you the apprehension felt is as intense as it is visceral. Calm reassurance and a gentle caring approach work wonders to lessen the anxiety; but it isn’t until that first visit is over that the patient looks up and says almost incredulously, “That’s it?” In fact, I have found that many “first timers” doze off at some point. (I said root canal is painless, I didn’t say it wasn’t boring.)
What Happens During Root Canal Treatment?
First and foremost, the patient’s mouth is made very numb. Typically an opening is made in the center of the tooth to gain entry into the dental pulp, which contains the nerve. This access opening is made with the dentist’s drill and the sensation is akin to having a cavity treated. Aside from the usual water spray and dental noise (my patients find that headphones and a good selection of music are very helpful), this initial step is usually accomplished very quickly and is the only “drilling” performed during root canal therapy.
Once the pulp is uncovered, special instruments are used to remove this tissue from the inside of the tooth including the root(s). Let me clarify; the roots themselves are not removed, only the pulp inside of them is taken away. When everything is cleaned out and thoroughly disinfected, the area once occupied by the pulp (the root canal system) is hermetically sealed with an inert filler called gutta percha. The entire procedure can be accomplished in a single visit, but often an additional visit or two is required.
Of course, what I just described is a thumbnail sketch of a typical root canal treatment. There can be variations to this theme, such as when there is the presence of an infection or abscess. But the objectives of therapy remain the same: make the patient comfortable, remove the pulp, shape and disinfect the canals, and seal them to prevent future infections. After the endodontic therapy is complete, the tooth must be properly restored to protect it from fracturing.
A Point Worth Emphasizing About Root Canal Treatment
While root canal treatment success is close to 98%, the most common reason for an endodontically treated tooth to fail (i.e., to require extraction) is because it was not properly restored. Most teeth with root canal require a crown or an onlay to ensure longevity.
One last point: while the prospect of having root canal therapy can elicit fear and dismay, the actual treatment is most frequently painless and uneventful. If you are apprehensive about a pending root canal, take heart, you are not alone. But please realize that much of your angst is based on myth and don’t be afraid to discuss your concerns with your dentist. In 2013, there are many approaches available to ensure your mental and physical comfort.
Here are more of my thoughts demystifying dental procedures:
- 7 Things To Consider When Having Cosmetic Dentistry
- Dental Crowns – 9 Reasons You May Need One
- Dental Exams: Not Just For Your Teeth
Dr. Michael Sinkin is a NYC dentist that has been in practice for over two decades. He truly cares about the experience his patients have and takes great pride in making them feel relaxed and comfortable during every visit. Come in for an appointment and experience a different kind of dental practice. To find out more about Dr. Sinkin, please click here.