Do You Need a Dental Root Canal?

Of all den­tal pro­ce­dures, a root canal is prob­a­bly one more dreaded by patients than any other, because prac­ti­cally every­one has heard some night­mare story about them.  Remark­ably, though, with proper diag­no­sis and man­age­ment, the need for root canals can largely be avoided, and in cases where they are needed, they are vir­tu­ally never painful, either dur­ing or after the pro­ce­dure!  There is so much mis­in­for­ma­tion out there, though, that it seems appro­pri­ate to pro­vide some answers to those Fre­quently Asked Ques­tions about Den­tal Toothaches & Root Canals:

What is a Root Canal, and Why Might You Need One?

There are sev­eral pos­si­ble rea­sons you might need a root canal, including:

• A large cav­ity that reaches the nerve, result­ing in pul­pal infection
• Part of the tooth breaks due to trauma
• The tooth cracks due to grind­ing or clench­ing your teeth
• Tooth resorp­tion

Essen­tially, what hap­pens dur­ing a root canal is that we remove the infected, painful nerve tis­sue from inside the tooth, clean the area with sev­eral dis­in­fect­ing solu­tions, which also help remove debris, then seal the inside of the roots with a cement and a spe­cial form of rub­ber called gutta per­cha.  There are sev­eral vari­a­tions on the tech­nique and seal­ers, but they all do the same basic thing.

Does a Root Canal Hurt?

In the large major­ity of cases, once the tooth is numbed, the answer is NO, you should NOT expe­ri­ence pain dur­ing the pro­ce­dure.  If you do, please sig­nal your den­tist that you are still feel­ing the procedure.

Some­times, a tooth is so badly infected that your face may swell up.  In these cases, the infec­tion is severe enough that it will decrease the numbing’s effec­tive­ness, and you may just need a lot more anesthetic.

Shouldn’t  I  Get Antibi­otics for the Infection?

For most patients, if the infec­tion is not bad enough that your face is swelling or you’re expe­ri­enc­ing signs of real ill­ness, such as fever or body aches, antibi­otics are NOT appro­pri­ate.  In fact, the risk of you expe­ri­enc­ing an aller­gic reac­tion to com­mon antibi­otics is greater than the ben­e­fit.  Why aren’t they the right thing?  Because the holes in the tooth roots where the nerve and blood ves­sels enter the tooth are so small, not enough antibi­otics can get into the tooth to make a dif­fer­ence.  If a tooth hurts that badly, an alter­nat­ing reg­i­men of ibupro­fen and Tylenol is just as effec­tive for most peo­ple as nar­cotic pain relievers.

What about After the Root Canal — What Does the Tooth Need?

For most teeth in the back of your mouth (pre­mo­lars and molars), you should get a crown done, or some­thing sim­i­lar that will hold the tooth together.  Because a lot of the inside of the tooth is removed dur­ing the pro­ce­dure, it is much weaker, and a crown will help hold the rest of the tooth together.  For most front teeth, how­ever, crowns are usu­ally avoid­able unless the tooth is badly decayed or bro­ken.  If you do need a crown, please get it done quickly!  If you wait too long, the tooth may break beyond repair, which means all the time and money you spent goes to waste.

How Long Does a Root Canal Take to Do?

If you think about it, doing a root canal is much like micro-surgery, because the roots inside the tooth are so small and skinny.  A front tooth, with a big open nerve, might only take 40–60 min­utes to com­plete prop­erly.  A molar tooth, with long skinny roots and mul­ti­ple canals, may take sev­eral hours.  Basi­cally, they are rarely easy and require time to do well.  It helps a lot if your den­tist or endodon­tist uses a high level of mag­ni­fi­ca­tion and intense light to see well; a den­tal oper­at­ing micro­scope is the best way to see well.

If you are in pain and need an emer­gency den­tal appointment,

call us at 704–364-7069 or Request an Appoint­ment Online.

As an active mem­ber of online pro­fes­sional forums, and through my many years of ongo­ing Con­tin­u­ing Edu­ca­tion, I am for­tu­nate to know many excel­lent den­tists around the United States, and even around the world, to whom I would feel com­fort­able send­ing my own fam­ily for needed den­tal work.  We share this list of col­leagues, so if you are out of town, mov­ing to another city, trav­el­ing, whatever.……if you need a den­tist for emer­gency den­tal treat­ment or need a new den­tist, please see if there is one on this list of my rec­om­mended colleagues:

The Den­tal Refer­ral Network