Dentist: “After looking at your tooth, you have two options; extract the tooth or have a root canal.”
Patient: “Doc, extract the tooth! Everyone I talk to tells me that when they had a root canal it hurt and I just would rather have the tooth out!”
I too often hear this response when I discuss the options of treatment with a patient. The first thing that comes to my mind, does a friend ever say, “Hey, I just had a root canal and it felt great!” People always tend to tell the horror stories about medical procedures, from difficult births to painful root canals. This is the reason why many patients are afraid to seek treatment, especially dental treatment.
What is a root canal? Many patients are confused by this procedure and what is actually performed. Some people believe that the dentist is removing the roots of the tooth. The basic concept behind a root canal procedure is to get rid of the bugs (bacteria) that are causing the problem. A dentist will enter the tooth and clean, shape and seal each canal. The procedure is usually has minimal discomfort; however soreness can occur after treatment. When a patient is very swollen, it makes it more difficult to calm the tooth and these patients tend to feel a little more discomfort.
What are the advantages of a root canal? I would first like to state the obvious, and that is you keep your tooth. As a dentist who tries to preserve his patient’s dentition, this is obviously the best choice in most circumstances. When a tooth is extracted, it is gone! You only get one set of permanent teeth and to restore that area the choices range from removable appliances to implants.
Why am I being sent to a specialist? When we look at the radiograph of the tooth we want to make sure that there will be no complications in completing the root canal. Sometimes, where the tooth is positions, the anatomy, if it has a crown, if it had a previous root canal, or if the dentist just feels uncomfortable treating that tooth a patient may be referred to an Endodontist for treatment.
Now I need a crown? Well this depends on what is left after the root canal is performed. A patient does not always need a crown, but I would say that many times they do. After the root canal is completed the tooth is weaker. A crown will protect the remaining tooth structure.
In summary, a root canal is a viable option to save a tooth that is infected. Rushing to extract a tooth is not always the answer, even though it sometimes seems like the quickest way to get out of discomfort. I firmly believe in patient education and explaining what we as dentist are doing. If you are unsure about treatment options make sure you talk with your dentist.
