A Root Canal is Not Something to Fear

You may find it hard to believe, but a “root canal” (short for the therapy to clean out an infected tooth root) has a bad rap in popular culture. “I’d rather have a root canal” is a common refrain that implies it is considered one of the most painful experiences possible. The irony is that with advances in root canal procedures and anesthesia, the treatment is actually virtually pain-free.

A tooth has three layers, the outer surface being the hard enamel and underneath is the dentin, which protects the pulp at the center, which consists of soft connective tissue, nerves, and blood. An injury, such as in sports, might crack the tooth and expose the pulp to infection. Tooth decay can also contaminate it. Once infected, it will become increasingly painful, especially if you chew or put pressure on the tooth. It may become sensitive to hot or cold beverages or food, the tooth may become dark, or the gums in the area can swell and turn red. A root canal may also be necessary if for any reason the root’s nerve has died.

There are many options to prevent pain and anxiety before the therapy starts. If you want to relax first, we offer nitrous oxide (aka laughing gas) to inhale. The area to be treated will be swabbed with a topical numbing solution before a local anesthetic is injected. Oral sedation in mild or strong pill form is available, but not necessary for most patients, who usually experience just some discomfort in the process. Afterwards, you will receive a prescription for the appropriate pain medication to take for a few days and instructions about using cold packs (or frozen vegetables or fruits or a cloth with ice) and gauze for a few hours to prevent bleeding.

The treatment starts with your dentist using a special endodontic microscope and special tiny instruments to go inside the canal and clean out the infected pulp. The canal is then packed with a special material to prevent future problems and it is resealed. Later, a dental crown will usually be put on top to protect the tooth against fracture.

Root canal therapy is one of the most successful procedures in dentistry, with a 90% successful rate the first time. Once in a while, a tooth will need retreatment. If you are feeling severe oral pain, make an appointment right away to have it diagnosed.