This phrase evokes fear more than any other word used by a dentist. Many people haven’t had a root canal, and many more haven’t had a negative experience with a root canal, so why do root canals have such a bad reputation?
Root canals are not always performed under the same circumstances and symptoms, and this can makes all the difference in outcomes. Some people don’t find out that they need a root canal until the dentist informs them. Teeth demonstrating no symptoms typically have an easier time with a root canal than those teeth that are experiencing pain. Those who show up in pain almost always have an infection of some sort. When the tooth is in pain, and an infection present, getting someone numb now becomes increasingly difficult. This is because infection cancels out the anesthetic.
So What is a Root Canal?
A root canal is commonly your last option to save a tooth. In the very center of the tooth are all of the nerves, blood vessels, and other tissues called the pulp. This part of the tooth is alive. When there are problems with this part of the tooth, the ability to heal itself is quite poor. For this reason, the dentist “kills” the tooth on purpose to avoid these problems from getting worse. The picture below shows the pulp of a tooth outlined in red.
The tooth is killed by removing the vital part of the tooth found in small thin canals using files. The canals are then widened by using progressively larger files. It is important for the files to clean within 1 mm of the tip of the root but not beyond. The canals are then sterilized with a substance called sodium hypochlorite. Finally, the canals are then plugged with a rubber material called gutta percha. A successfully completed root canal allows people to keep their teeth for decades longer. The following picture shows a completed root canal.
Is a Root Canal Painful?
The procedure itself is typically not painful. There are instances where a person has what dentists call a hot tooth meaning the tooth is in so much pain, inflammation, and infection that trying to do anything to the tooth causes pain. Anesthetic used to numb the tooth can neutralized by the infection, making it ineffective. Usually this pain and inflammation can be controlled with antibiotics, but if there is too much swelling or the patient needs urgent care, then the tooth then needs work immediately. The picture below demonstrates how swelling due to an infection can become quite significant.
What can cause a root canal?
There are many different things that can cause the need for a root canal to be performed. These can include:
- deep cavities
- tooth trauma
- tooth is already dead (called necrosis)
The picture below depicts a large cavity that will lead to a root canal.
It is amazing to think that a small cavity that requires a simple filling can grow and eventually lead to this if left untreated. If the cavity enters the pulp, then it is game over and the tooth needs a root canal. Cavities that get to the pulp imminently can cause infections and start the process of a dead tooth.
Acute trauma to the tooth can also start the process of a dead tooth. This process can be quick or slow, but always leads to the need for a root canal. Blunt force trauma to the tooth can also cause immediate death. When a tooth is dead, it typically is not painful and often is found on x-rays by the dentist. A dead tooth has an infection at the root tip, and if left untreated, will spread and jeopardize the other teeth.
So what happens if I don’t get a root canal?
The only other alternative is to extract the tooth. It is very expensive to replace a missing tooth, rather than treat the existing tooth with a root canal. If you can stand the pain and allow the tooth to die, the pain may eventually subside but the infection will still be present. The question you need to ask yourself: are you willing to gamble all of your other teeth because you don’t want to get a root canal on one tooth?
The process may take a while and cost some money up front, but saving the tooth saves you time and money in the long run. Don’t be afraid of the root canal!