Root Canal Therapy- The Procedure To Relieve Your Pain
Many people flinch when their dentists tell them they need root canal therapy. While dentists are sympathetic to fears of pain, they also want patients to know that root canal procedure has three purposes:
- Stop the root canal symptoms of a toothache;
- Prevent bacteria and pain from spreading into the jaw; and
- Maintain the original tooth instead of replacing it with a denture or bridge.
Root canals are actually channels that run from the root of the tooth, which connects to the bone, up to the top surface of the tooth. The canal contains blood vessels, nerves and the complex cells that make up the living tissue inside the tooth. This lifeline inside the tooth is called the pulp.
When a tooth is decayed or cracked, bacteria can get to the pulp. The acid from the bacteria irritates the pulp and it becomes inflamed; it's the same process you watch when other parts of your body become infected. When the pulp tissue becomes inflamed, it's harder for blood to flow to the tissue, and the resulting pressure creates the pain symptoms inside your tooth.
There are two ways to get relief from root canal pain: perform the root canal procedure, or pull the tooth, clean the gum below, and replace the tooth with a denture or bridge. Dentists advise pulling teeth as a last resort because they know that your natural teeth are the ones best suited for your mouth.
It's important to have the root canal procedure done quickly. The bacteria will travel down the canal to the root and into the jawbone. If this happens, the pain of your toothache will spread to your jaw. Even more important, the infection can cause your jawbone to deteriorate and weaken the structure that holds your teeth.
The best way to avoid root canal therapy is to take good daily care of your teeth to prevent the growth and spread of bacteria. Brushing and flossing are important.
Just as important are regular trips to the dentist, to check for the first sign of decay or cracks that could eventually lead to an abscessed tooth. In this case, an ounce of prevention really is worth a pound of cure!
By Brian J. Gray, DDS, MAGD, FICO
Will I Be Comfortable During My Root Canal Treatment?
The answer should be an emphatic "YES!" Fortunately, dentistry has developed new techniques for delivering local anesthetics painlessly. These techniques also assure that the anesthetics act more rapidly and produce a more "profound" level of anesthesia. Additionally, modern dental procedures utilize better technologies that are generally much less traumatic and invasive than those of the past. The result of these advancements is that patients should have minimal or no discomfort during the tooth numbing and/or treatment procedures. Root canal treatment should not cause pain, but rather relieve it and keep it from reoccurring. Unfortunately, dental pain may also have a psychological component, possibly stemming from a negative past experience, a story in the media, or even fear of the unknown. Sometimes these situations can prove challenging for the patient and the endodontist to control. Examples include:
- Patients who associate tooth pain with a past root canal procedure when, in fact, the pain they remember was experienced prior to their emergency visit. Oftentimes, this pain develops over a period of several hours to a few days and is allowed to build and worsen before seeking treatment. Once the patient seeks emergency care from a root canal dentist, the endodontics treatment should not be uncomfortable and should provide quick and certain relief from any painful symptoms stemming from root canal disease.
- Patients may become very anxious when being examined or treated dentally because the mouth is such an important part of the body and psyche. Some patients may feel anxious and vulnerable during a root canal procedure because of their positioning in the dental chair with members of the dental team working above them in such close and intimate proximity.
These and other distresses are real to the patient. Much of the time, however, the distress can be reduced or eliminated if the patient discusses it with the endodontist and gets understanding and reassurance. The doctor and the patient must work together in these situations to make certain that the patient feels as comfortable, trusting, and informed as possible in the dental environment. Most individuals can do this satisfactorily. If patients continue to feel significant distress, even after having these discussions with the dentists, they should be aware that there are therapeutic methods that can be used and for which they might be candidates. These may include:
- Oral sedation dentistry involves ingesting a sedative pill or liquid before the appointment. This can help anxious patients a great deal and make the treatment experience much less stressful.
- Nitrous oxide analgesia, known as "laughing gas," can be inhaled along with oxygen to make patients feel less anxious and more comfortable.
- Intravenous sedation can be administered in a dental facility by a specially trained and certified dental team or by a specially trained dental anesthesiologist. With intravenous sedation, patients are not asleep and they can still respond, but they will not feel or remember anything. This technique works very well in creating a pleasant experience for many anxious patients and is a good anesthetic method for more lengthy dental procedures.
- Hospital dentistry is conducted in an environment where a variety of anesthetic methods are available and can be used under the safest medical conditions. General anesthetic and intravenous sedation can both be utilized in the hospital setting.
These sedative techniques and medicines may also be helpful if particularly lengthy root canal treatment procedures are necessary in specific situations.
With all of the advancements in pharmaceuticals and in their delivery, there should be no need for any patient to delay endodontics treatment because of fear that the treatment will be painful.
By Clifford J. Ruddle, DDS, in collaboration with Philip M. Smith, DDS
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