Root canals are the subject of one of dentistry’s most persistent myths: that they are an excruciating procedure to be dreaded. This reputation appears to have developed at some point in the early to mid 20th century and has never quite caught up with modern techniques and anesthesia. The reality is that most people who have had root canals report they were about as uncomfortable as getting a filling.
Why root canals are needed
The inside of a tooth contains the nerve, blood supply, and connective tissue. When bacteria reach the pulp via deep decay, a crack, or repeated trauma they cause infection. An infected pulp produces the throbbing temperature-sensitive spontaneous pain that is classic for needing a root canal. If left untreated the infection spreads to the bone around the root tip forming an abscess. A root canal removes the infected pulp, cleans and shapes the canals, and seals them to prevent re-infection.
What the procedure actually involves
The area is thoroughly numbed with local anesthesia. A rubber dam isolates the tooth keeping it clean and dry. The dentist creates an access opening through the top of the tooth to reach the pulp chamber. The pulp is removed and the canals are cleaned and shaped using fine files. The canals are irrigated with sodium hypochlorite solution to disinfect them. Once clean they are filled with gutta-percha and sealed. A crown is typically recommended afterward to protect the now non-vital tooth from fracture.
After the procedure
Some soreness for a few days after a root canal is normal. OTC ibuprofen and acetaminophen alternate effectively. Avoid chewing on the treated tooth until the final restoration is in place. Get the crown placed promptly. Root canal-treated teeth without crowns fracture at very high rates and often end up needing extraction anyway.
The only alternative
The only alternative to a root canal for a tooth with irreversible pulpitis or pulpal necrosis is extraction. For most teeth in functional positions root canal and crown is the better long-term choice. For a tooth with severely compromised prognosis extraction may be more appropriate and an implant can replace it.
Educational content. If you have been told you need a root canal and are uncertain getting an evaluation from an endodontist is a reasonable step.
