Root Canals: A Bum Rap

How many times have you heard someone joke, "I'd rather have a root canal!” The media portray and many people believe root canal treatment to be painful and something to be avoided at all costs. In actuality, most people are quite surprised when they learn the truth that root canal treatment is rarely painful. However, there are times when it can be uncomfortable if certain procedures are not followed.

Root canal treatment or endodontics is required when the nerve of the tooth begins to die or becomes infected after it dies. In the first case the tooth aches, throbs, and is very sensitive to cold. In the later case, the tissue around the tooth will swell and/or the tooth will be sensitive to pressure. This can be caused by a deep cavity, crack in the tooth, trauma or even from repeated dental treatment over the years.

The procedure involves numbing the patient using a local anesthetic. Usually the more the tooth has been aching, the more difficult it is to numb. In the past, sometimes patients weren't adequately anesthetized, giving root canals a bad reputation. Now, with improved anesthesia techniques, this is rarely the case. After the tooth is numb, a hole is made in the tooth. The nerve tissue is removed from inside the roots using files much like you would snake a pipe. Front teeth usually have one large straight root and the back teeth usually have 3 or 4 narrow curved roots. After the canals are shaped and disinfected, a filling material is placed in the tooth. The roots remain completely intact. Root canal treatment usually requires a one visit but more infected teeth require two appointments

Success rates of root canal treatment vary. The treatment success of newly infected teeth is usually 95%. Treatment of teeth with abscesses that have been present for some time and can be seen on an xray have a 75% success rate. The greatest influence on success rate is sealing the tooth form the oral environment to prevent contamination. The faster and the better the seal the greater the success. This is done by placing a core & crown or an adequate filling.