I’m often surprised how many people visit their dentist and recount, they were told they need a root canal. why? As in what’s the reason behind the procedure? Most patients say they don’t know. The follow up question is, do I really need one?
First, what’s a root canal? A dental procedure performed by an Endodonist, where the crown of the tooth (the visible white part—enamel) is exposed by use of a high speed hand piece to remove infectious tissue from the pulp chamber of a tooth. When a cavity spreads to the pulp chamber— a live bundle of nerves and blood vessels that keep the tooth healthy—a root canal is usually ordered in an attempt to save the overall tooth structure without resorting to an extraction—removal of a tooth.
Another reason for a root canal can be due to a periapical abscess—a pocket of infectious fluid/ pus that pools at the root tip and below the root spreading within the gums or gingiva. A dentist will expose the crown of the tooth, remove the infectious pulp, clean the canal and fill it or a temporary crown is made if the original crown can not be saved
Are there setbacks to a root canal? It is possible that during the procedure, the tooth cracks. Once the tooth cracks, the procedure becomes an extraction in order to prevent the infection from spreading into the gums or gingiva.
Are root canals typically painful? A patient should be numb before a root canal begins. If the patient can feel the procedure, dental staff usually stop to numb again or to reschedule should the numbing agent fail. A patient may feet discomfort hours after the anesthesia wears off. It’s recommended they follow the directions of their dentist. But if the pain persists after a root canal beyond a week, it’s in the best interest of the patient to go back to the dentist to do an exam and to check if all the infectious fluid has been removed or cleared if the dentist prescribed an antibiotic.
Do I really need a root canal? If your dentist recommends a root canal, it’s necessary. However, your insurance may need a pre-authorization to do a root canal or it may not simply be covered by the patient’s insurance. In this case, some patients opt for an extraction instead of paying for the root canal out of pocket which can be very expensive.
While an extraction is a much cheaper alternative to a root canal, most patients would prefer to save their tooth if it’s possible. Doing an extraction will still allow the dentist to clear any infectious fluid/ tissue but the removal of the tooth will leave a space behind. Some dentists recommend braces to close the space or a bridge—a removal porcelain tooth that is kept in place by neighboring teeth, or implants—porcelain teeth that are anchored to the jaw bone with a tiny screw.
Whatever the patient decides, it’s always best to ask questions. Discuss concerns with your dentist and dental staff if you’d like to know why you may need a specific dental procedure.