Blog

Feb 28

SO, I NEED A ROOT CANAL?

This question itself, with many people, sounds distressing enough.

With my patients I very often will describe and explain the procedure to them without using the term.  I found if I use the term first, they very often don’t focus on the explanation and the reason for the procedure.  I will say at the end of the consult, the lay person term for endodontic treatment is a root canal.  The response is very often,  “it didn’t sound too bad until you said root canal”.

However,  root canal procedural protocol and instruments have changed dramatically within the last several years.

Patients always seem to have the misconception that the root has been removed from the tooth.  The root of the tooth is still there, however,  the soft tissue inside the root has been removed and the void left is sealed up.

Root canal therapy of past years was usually all done by hand  and was very time consuming and tedious both for patient and dentist.

Dr. Dibling performs almost all his root canal therapy using computer driven instruments made of a special nickel titanium alloy.  The computer driven handpiece from Morita allows for efficient, safer and more comfortable cleaning of the canal.  The nickel titanium instruments from SybronEndo are very flexible and very easily go around curves and root shape as it gently scours and cleans the walls of the infected tissue.   The instruments spiral the infected debris up and out through an access opening through the top of the tooth.  It is for this reason patients have less discomfort after the procedure.  Patients will very often remark,  “this root canal seems so much easier than the one I got years ago and the tooth was only a little sore the next day”.

I explained that with the computer driven root canal system, the device has something called an apex locator in it.  This directs the instruments to stop and reverse when reaching the end of the tooth.

This safety feature helps prevent trauma to the sensitive and sometimes inflamed tissue outside of the tooth itself.

It also helps reduce the number of x-rays which is required to evaluate progress.  This is a great plus, too.

With root canals sooner is better than later.  Patients unfortunately procrastinate going until a tooth is very painful or what dentists refer to as a “hot” tooth.  In these instances, Dr. Dibling will take two visits to complete the tooth if the patient presents with such acute symptoms.

Many times a new patient will arrive and state “my old dentist did a deep filling and stated lets see if that will work or you may need a root canal later”.

This anti-dentistry philosophy does no service for the patient or the dentist.  Waiting for the tooth to diagnois the issue is not a good choice.   It only leads to a painful, untimely episode for the patient and decreases the prognosis of saving the tooth long term.

Signs and Symptoms That May Indicate That a Root Canal is Required:

– A tooth that causes spontaneous pain with no provocation from hot, cold or chewing

– A tooth that requires a crown and has had multiple prior fillings “services” and now has recurring decay.

– A tooth that has pain from hot or cold which lasts more than a minute or two and has no treatment done to it recently.

– A tooth on x-ray that shows a black dot on the end of the root.  This area is what the dentists call periapical pathosis.

There are of course other reasons and signs but nothing can compare to a thorough history and physical exam of the tooth and its symptoms.  Dr. Dibling will always give consults at no charge and welcomes patients arriving for second opinions.  You can hear testimonals of Dr. Dibling’s patients on our website.