Root Canals: What Exactly Are They, And Why Do I Need One?

The words root canal might possibly be the two most feared words in dentistry by patients. Root canals have had a negative connotation in patient’s minds for years, and the way they were done in the past, we aren’t surprised at all. In any movie or television show you see, if the words root canal are uttered, there is always a reference to how painful they are, or what a nuisance they are to have done. And any time you talk to someone that has had one done, they never have a positive story to tell about the experience.

It is true, root canals in the past haven’t been a pleasant experience for patients to go through. First, if you need a root canal, you are most likely in pain before the root canal is even performed. Secondly, root canals are a very meticulous procedure for a dentist to perform, so sometimes it can be a pretty lengthy procedure.

The good news in all this talk of root canals, is that most of the time, root canals can be totally avoided. Most of the time, a root canal is needed when a tooth has decay present, and that decay has been present for so long that the decay has eaten away at the enamel and dentin of the tooth and has reached the pulp chamber, or nerve, of the tooth. When decay reaches the pulp chamber it starts to infect the pulp, when that happens, an abscess starts to form under the tooth and creates a lot of pressure pushing on the tooth. That pressure equates to pain in the tooth, and can become very uncomfortable.

If the decay is caught before it reaches the nerve, a simple filling can be done. Resulting in a lot less sensitivity, a lot less cost, and the procedure itself is a lot less invasive, and a root canal can be avoided altogether. There are factors, other than decay reaching the neve, that lead to root canals as well. The most common being trauma.

If a tooth is traumatized (i.e. hit with a ball playing a sport, as the result of a car accident, etc.) the nerve inside the tooth could die, and the tooth might start to turn gray. If this happens, the graying can be reversible. What the dentist would need to do in this case, is perform the root canal to remove the necrotic root, and place a bleaching pellet inside the tooth. This pellet will whiten the tooth from the inside out. This tends to take a few visits to complete, with the dentist changing the bleaching pellet each time you come in, and then placing a filling over the access hole once it is done.

Sometimes, patients are apprehensive about getting a root canal done, simply because they don’t know exactly what it is. We wanted to dispel any apprehension by letting all of you know what exactly a root canal entails. A root canal starts out very similar to having a filling done, and you will be extremely numb, so you won’t feel a thing. The doctor will remove the decayed part of the tooth.

They then clean the nerve out of the pulp chamber, effectively relieving the pressure that was built up from the abscess. In the past, dentists used hand files to do this, and that is where most of the apprehension came from with patients. Performing a root canal with hand files takes a long time, and the hand files aren’t the most pleasant to look at. Thankfully, here in our office, we have new technology in the form of the Wave One Reciprocating Endodontic System. What that does is that it automates the file process, and cuts the length of the filing process pretty much in half. It also is a lot more pleasant to deal with than the hand files that we used a few years ago, and that most dentists still use today.

Once the nerve has been removed and the canals have been cleaned, the dentist then fills the canals with a substance called gutta percha. Gutta percha is a rigid natural latex derived from trees. Gutta percha is used to fill the canals because of its biocompatibility, ductility, and malleability, making it the ideal substance for dentists to use. Filling the canals after the root canal is performed is important to prevent them from getting re-infected with bacteria.

The dentist will then fill in the hole that was used to access the canals and build the tooth back up with filling material. This buildup prepares the tooth to be structurally sound enough to place a crown on the tooth. While the tooth is structurally sound with just the buildup done, it is still considered to be in a very fragile state until a crown is placed. The crown provides 360-degree coverage and protection for the very fragile tooth underneath, and is an essential part of the root canal process.

The alternative to having a root canal done, is usually just to have the tooth taken out. While extraction might look like an easier option at the time of treatment. If you choose this route, things get a lot more complicated in the long run. First of all, you will most likely be in more discomfort immediately following an extraction than you will be following a root canal procedure, as there is more trauma to the surrounding jaw and gum tissue during an extraction than a root canal. Then there is always the risk of a dry socket following an extraction, which can be extremely uncomfortable.

Secondly, if you do not replace the tooth that is taken out, you might not be aware of this, but it greatly affects the surrounding teeth and gums. When you chew, the forces of chewing on the teeth that you have stimulates the bone around each tooth, enabling growth and health of the jawbone. When a tooth is missing, there is nothing left to stimulate the bone, so the jawbone begins to break down, or resorb. This lead to issues resorptionsuch as:

  • Changes in your facial profile and distortion of facial features.
  • Surrounding teeth shifting and “tipping” in toward where the tooth is missing – changing your bite and putting extra forces on those teeth and the TMJ, temporomandibular joint.
  • Super-eruption of the opposing teeth – since the opposing tooth has nothing to bite against, it will become loose over time, and eventually will be lost as well.
  • Shifting and misalignment of other teeth – When there is a space created that wasn’t present before, the surrounding teeth will start to shift over time into that space, misaligning all of the other teeth in the mouth, that can normally only be corrected with orthodontics.

Lastly, it is usually more expensive to replace a tooth that has been extracted than it is to get a root canal done. There are a few options to replace a missing tooth, such as an implant, a bridge, and a partial denture, all of which have their own pros and cons associated with them.

So if you have been told that you need a root canal, and are holding off on getting the procedure done because of stories that you have heard from others or the media, give us a call to schedule an appointment so we can bring you in and walk you through the steps so you can see how simple and easy the procedure is. If you have cavities that you have put off getting filled for any reason, call the office and get in before a filling cannot save the tooth anymore. Or if you opted to have a tooth taken out instead of a root canal and have not had the tooth replaced yet, give us a call so we can discuss which option would be best for you.

The whole key, for everyone in general, is to catch issues when they are small and inexpensive. So really, the best way to avoid big expensive procedures is to come in for preventative maintenance as often as possible, and have great home care when you are away from the office, which our hygienists can help you with as well!

Are you afraid of the dentist? There are many ways to overcome that fear.

dental-fear

You would be surprised at the number of people that have some form of fear of coming to the dentist.  It is estimated that approximately 40 million Americans avoid dental care because of fear and anxiety.  This fear can stem from a number of what are called direct and indirect experiences.  The most common reason that people avoid coming to the dentist is that they have had a bad or traumatic experience in the past, and feel that every future visit will be the same.  This is an example of a direct experience.  But others still possess that fear even if they have never had a bad experience, or been to a dentist at all.  Some reasons for this would be that they heard about a traumatic experience from a friend, the negative portrayal of dentists in mass media or cartoons, or a feeling of helplessness and a lack of control.  These are examples of indirect experiences.  All of these factors together lead to people experiencing a “cycle of avoidance,” in which they avoid dental care due to fear until they experience a dental emergency that requires invasive treatment, which can enforce their fear of dentistry.

Dentists today, like Dr. Core, have a breadth of knowledge on how to help patients dental with dental fear.  Dr. Core has attended countless hours of continuing education on this subject alone.  There are a number of ways to deal with dental anxiety that fall into two main categories, behavioral techniques and sedation techniques.

Behavioral Techniques:

Positive Reinforcement – Dr. Core makes positive comments before and during the procedure being done, helping to relax the patient he is treating.

Non-Threatening Language – most dentists speak mostly in clinical terms that no one can understand but them, but Dr. Core uses patient-friendly, non-threatening language with all of his patients, so that they understand what is involved in the treatment that they need.

See-Show-Do Techniques – if you have questions on what any procedure will entail, Dr. Core will first go over it verbally, so that you understand the procedure, and then show you how the procedure is done.  Most anxiety comes from fear of the unknown, and after Dr. Core explains everything, and shows patients what he is going to do, our patients are reassured and the anxiety dissipates.

Distraction Techniques – we have televisions in every room, as well as headphones so that you can listen to music during your appointment, which will take your mind off the dental treatment that is being done.

sedation

Sedation Techniques:

Inhaled Minimal Sedation – You breathe nitrous oxide, commonly known as “laughing gas,” combined with oxygen through a mask that is placed over your nose.  Dr. Core can control the amount of sedation you receive, and the gas tends to wear off quickly.  This is the only form of sedation that you should be able to drive yourself home after the procedure.

Oral Conscious Sedation – Depending on the total dose given, oral conscious sedation can range from minimal to moderate sedation.  With oral conscious sedation, you take a pill, usually Halcion (a member of the Valium family), and it is taken an hour prior to your appointment.  The medication will make you drowsy, and better able to handle any procedure that needs to be done.

IV Sedation – you receive the sedative through an IV, so it will go to work quicker.  This method allows Dr. Core to continually adjust the level of sedation.  This is the preferred method of sedation for our patients that have a lot of fear or anxiety, or need a lot of treatment done at one time.

Deep Sedation and General Anesthesia – you will receive medications that will make you either almost unconscious or totally unconscious (deeply asleep) during the procedure.  This involves having an anesthesiologist come to our office to provide the anesthesia.

Dr. Core truly understands the level of fear that people have about coming to the dentist, and has done everything he can to make an experience at our office the most pleasant it can be.  He is even a sedation certification specialist for the Arizona Board of Dental Examiners who evaluates every other doctor in Phoenix to make sure that they are following policies and procedures.  Call our office today at 602-993-4200 or visit our website to schedule an appointment so that we can get you back on the road to good oral health, and help you to be as comfortable as you can while doing it.