Q&A Topic: Root Canals
Dr. Barry Musikant, DMD
Q: Why do you think many patients are afraid of getting a root canal?
A: I’ll start off by rightfully recognizing the fear a patient might have when they are informed that they will need a root canal. Too many cynical jokes have been made about the experience comparing it to other procedures we would clearly not like to undergo such as a tax audit without anesthesia. The reality is that while it will never be a procedure one enthusiastically looks forward to, it is a procedure that can be done painlessly, predictably and efficiently. Now those sound like fine words, but can you trust them?
Q: What can patients expect when getting a root canal, is it truly painful?
A: If the root canal procedure is to be done on me, this is what I would want to know, even though I have been a root canal specialist for over 45 years. The dentist is best able to make the correct diagnosis and treatment plan after evaluating X-rays, the patient’s symptoms and some objective testing. Most root canal treatment requires the use of a local anesthesia to numb the tooth to be treated. This can be a source of fear in and of itself. However, prior to injection, a topical is applied that eliminates the initial application of the needle. Slowly injecting the anesthetic under low pressure eliminates most, if not all, of the pain. Certainly, if the anesthetic does not produce complete absence of pain, more anesthetic is given with the added plus that subsequent injections are even less likely to be uncomfortable.
Q: What is the actual procedure of a root canal?
A: With effective anesthesia, the tooth is isolated with a clamp placed over the tooth and a rubber dam then placed over the clamp isolating the tooth from the rest of the mouth, preventing anything from being swallowed and giving the dentist excellent access to the tooth being treated. In no way does the placement of the rubber dam prevent the patient from breathing comfortably and easily swallowing. The dentist now gains access to the infected tissue residing inside the body of the tooth, finds the extensions of the infected tissue that are centered within each of the roots, cleans them out, irrigates the spaces that are being cleansed and shapes them to a size that can be effectively filled with an antibacterial filling that permanently seals the tooth against future reinfection.
Q: Is the old tooth still functional after a root canal?
A: By eliminating the infected tissue and then sealing the canals against future infection, the tooth is saved rather than extracted and can then be restored to full function. Depending upon the complexity of the root anatomy and the initial degree of infection, this procedure can take anywhere from 1-3 visits with two visits being the most common. While no one will write testimonials on how much they enjoyed the procedure, no aspect of root canal therapy need cause pain. For those patients who are first presenting in pain, root canal therapy has great potential in removing that pain after the first visit.
Patients should have full confidence that their comfort is the major consideration in their treatment at Touro Dental Health. Being true to this goal followed by the mechanics of proper root canal therapy produces successful results that leads to trust between the patient and their provider. As Director of the Endodontics Program at Touro College of Dental Medicine, this is the intended purpose of the professional education that I deliver to our dentists in training.
Dr. Barry Musikant, DMD
Touro College of Dental Medicine
New York Medical College
19 Skyline Drive
Hawthrone, NY 10532