Chicagoans are a tough breed – we endure long, hard winters (polar vortex anyone?) and years of losing teams (Cubs?), but two simple words bring fear even to the toughest Chicagoan… root canal.
Unfortunately the words “root canal” brings fear to even the strongest person, and TV and movies have portrayed a root canal as a very painful and uncomfortable procedure. In this week’s blog we will cover: what is a root canal, why you would need a root canal, what do the tests involve, what are the signs and symptoms, how can I prevent a root canal and are root canals painful?
What is a root canal?
To understand what is a root canal, one must first understand what a tooth consists of. In the picture above there is a cross section of two teeth. The outer white area of the tooth is called enamel. Enamel is the strongest material in the body. When decay (the brown substance) gets through the enamel, it reaches a substance called dentin. Dentin has the same density as bone and is not as resistant to decay as enamel. If the decay continues it can reach the root canal system. The “root canal” is like a tunnel in a tooth, it carries your nerve and blood vessel tissue thought the tooth. Like a highway tunnel with cars, when this system has an accident (decay), it becomes busy (inflamed).
A simple root canal is where the dentist or endodontist (a root canal specialist) access the nerve canal (think tunnel) from the decayed part of the tooth, or a small hole made in the top of the tooth, and cleans out the dead tissue. No part of the root is actually removed.
During the root canal procedure the dentist should (it is the standard of care) use a rubber dam to isolate the tooth from oral bacteria. The rubber dam also protects you as a patient from sharp instruments entering your mouth. After the rubber dam is placed, the dentist will make a small access point in top of the tooth to reach the root canal system using a dental drill. He/she will then gently clean and shape the inside of the root using little files. Once completed, he/she will use an antimicrobial agent to kill most of the bacteria, and then seal it using a filling material.
After the root canal is completed, the dentist will complete treatment by sealing off the environment with a post and core and crown. We will cover these two items in a future blog topic.
Why would I need a root canal?
You may need a root canal for many reasons. As always, it’s most important to see your dentist right away if you are experiencing any discomfort or think you may need such a procedure. When you go to the dentist, he/she will perform a few tests to determine if the tooth may need a root canal.
Common reasons people need a root canal are: decay, cracked tooth and or accident (bike fall, car accident, etc.).
What do the tests involve?
In order to properly diagnose if you need a root canal, your dentist will perform a few tests.
Percussion test: This is where the dentist taps on the tooth in question to see if there is pain associated with the tooth. A percussion test applies slight pressure to the tooth system, and if an infection is indeed present, will elicit a small discomfort letting us know there could be a potential infection below the tooth that needs to be drained.
Palpation test: Like the percussion test, this test “feels” for an infection below the tooth. This is done using a gloved finger to feel around the problem tooth for a possible infection.
Cold test: The cold test checks the vitality of the tooth to see if it is indeed alive or if the pulpal tissue is dead.
EPT test: This is another test that send a little pulse into the tooth to check the vitality of the pulpal tissue.
Based on these tests, along with a proper X-ray, a diagnosis will be made. If it is determined that a root canal is needed, your dentist will go over the proper procedure to follow up and remedy the issue, which could include a root canal procedure.
What are the signs and symptoms of a root canal?
Is the tooth pain waking you up at night? Does OTC pain medication not fix the pain? Is there swelling or bruising? If you have any of these symptoms call your dentist ASAP, as you may need a root canal procedure.
How can I prevent a root canal?
At Chicago Style Smiles we practice life long prevention, and this prevention hinges on a good relationship between the patient and the doctor. In most cases, we see a patient twice a year. As the patient, you are lucky enough to spend 365 days a year with… you! Prevention starts with you. Regular checkup also are very important to catch decay and cracks early to try to prevent the need for a root canal. We aren’t all perfect and life happens, so decay sometimes can go unchecked and lead to the pulpal system, and ultimately a possible root canal.
Are root canals painful?
The million-dollar question! You always hear on TV – “it’s not as bad as a root canal”. Root canal procedures are now done under some great anesthetic. Pending on your particular diagnosis, a root canal can be completed with little to no discomfort! As always, it is important to let your dentist know if you are experiencing any discomfort with the procedure so they can administer more anesthetic if needed.
In Summary: What is a root canal?
At Chicago Style Smiles we do our best to keep you smiling. We understand that Chicago is a busy city and things happen, so we are always here for you, if needed. A root canal doesn’t have to be a scary thing, a little understanding of the tooth goes a long way to understanding why this procedure may be needed and what can be done to help prevent it. If you think you have any of these symptoms, give us a call at 312-372-4845 and we will work to get you in ASAP. If you would like to learn more the ADA.org has good information on root canals that can be found here.
As always, keep smiling Chicago.
Kevin Dow DDS