Why Root Canals aren’t as Scary as they Seem


San Francisco and Marin CA

Root canals

Root canals are routine dental procedures that can save teeth and spare patients a lot of pain. Usually taking no longer than an hour, they are not lengthy procedures, nor are they painful since the tooth and surrounding area are numbed by anesthesia. Despite this, root canals are often regarded with dread and have several misconceptions about them. What is involved in a root canal? When are they needed, and why are they so feared?

Why are root canals needed?

Every day, the human mouth has varying levels of bacteria in it, including what’s known as Streptococcus mutans. S. mutans produce lactic acid, causing a process known as demineralization of tooth enamel. This demineralization is reversed by the various ions in saliva (which fluoridated water helps bind to the teeth while also neutralizing the acid), so as long as the bacteria are not allowed to become excessive and the acid does not overpower the saliva, teeth remain healthy.

However, if the acid buildup overpowers the saliva, it can wear pits or holes into the enamel. These worn spots of decay are called cavities or caries (from the Latin word caries, which means “decay”). These can be spotted by a dentist, and if the cavities are not severe, they will usually suggest they be treated by a filling: a sort of “plug” for the hole worn by acid.

Extensive decay, however, might have worn through the enamel and the tissue underneath (called dentin), seeping into the innermost part of the tooth known as the pulp. Injury to the tooth may have a similar effect. If the pulp gets infected, it may spread into the roots of the teeth, causing a pocket of decay called an abscess. The infection may even threaten the jawbone underneath.

This requires treatment more extensive than a filling: usually a root canal. Sometimes, this may involve being referred to an endodontist, a dentist who is specialized in treating problems with the insides of the teeth.

What happens in a root canal?

A local anesthetic is administered to make sure the patient feels no discomfort. A latex barrier is placed to keep the tooth clean and dry. The endodontist will then use a tool very much like a tiny drill to create an opening in the tooth. He or she will then rinse the interior using a fluid to kill any infection, and then remove the pulp from the tooth. This should not be cause for alarm: an adult tooth does not actually need the pulp and the nerve within it and will function perfectly without it (assuming the infection is removed and kept from returning). The roots then have a canal where the pulp was, which is cleaned and shaped by another tool.

Once any debris is removed, the created canals are sealed with a non-toxic, mildly antimicrobial rubber-like material called gutta percha. A temporary filling is placed in the hole, which is often also covered with a temporary crown. A permanent crown, made of materials like porcelain or porcelain-over-metal, will almost always be recommended and will be placed (once it is fabricated at a lab) in a follow-up appointment.

Why are root canals feared?

There are a few persistent myths about root canals that have contributed to a general terror about them.

These include:

Root canals are overly complicated; simple extraction is better

An extraction – a tooth that is pulled – results in a tooth that is missing. Simply leaving it missing is never recommended, as it can cause a wide variety of complications, including increased decay, bite shift and grinding, and a change in appearance. A bridge, implant, or partial denture can replace a missing tooth and are excellent options for teeth that are already lost. They are not, however, preferred over a living tooth, which is saved in a successful root canal. Natural teeth are better on the jaw and bite.

Root canals are painful 

In all fairness, this may very well have been the case once upon a time. After all, the first recorded root canal can be dated to 1766. But surgical anesthesia did not come about until 1842. Early anesthetics were not as effective, but modern anesthetic technique renders the operation practically painless; there will likely be some aches right after the procedure, but no worse than a filling. In fact, since tooth-nerve infection can be very painful, many patients will experience less pain after the root canal.

Root canals can lead to illness

This is another holdover from the past. When root canals were first performed, the inside of the tooth was not rinsed to clear out the infection nor sealed with gutta percha. In fact, the tooth was not even filled until the 1820s. The infection that was cleaned out in the procedure could easily return, and this infection could lead to serious health complications.

Things are much different now. A successful root canal is designed to treat infection and prevent its return, and no study performed over the last century shows any other illness caused by a root canal.

Taking the fear out of root canals

A successful root canal will not be painful, and, in many cases, will help the patient hurt less. The procedure, itself, is an all-day affair but is performed quickly under local anesthesia.

Glen Park provides comprehensive dental options to people in the San Francisco area, including routine checkups to help make sure cavities do not form. If a root canal is necessary, Glen Park dentists have extensive experience in endodontistry and can perform root canals from beginning to end. For more information, call (415) 799-3900 or email smile@glenparkdental.com.