Endodontist Greg Dearing points out that dentists perform 15 million root canals a year in the United States, yet mere mention of the word makes most people wince. “The root canal is still stigmatized,” he says, “but that is slowly changing.” The procedure has improved so much over the past 30 years, there’s no need to fear any discomfort at all. “At this point,” says endodontist Robert C. Director, “the typical root canal is a minor nuisance.”
Root canals become necessary when bacteria enters the tooth through a cavity or crack and infects the inner pulp. The procedure entails removing the pulp and nerves, smoothing the inner walls of the tooth and root, packing the area with a synthetic resin to keep bacteria out, then crowning or otherwise sealing the tooth.
The procedure has been performed “since caveman times,” Director says, but became commonplace after World War II. Old root canals may have been painful for the patient, but they worked, Director says. He sees teeth where root canals have held up well for 30 years and more, which may have justified the discomfort—most dentists prefer to save a tooth, whenever possible, instead of removing or replacing one.
Today the worst pain a patient may feel is the minor, momentary discomfort of anesthetic shots. Endodontists can now inject anesthetic into the ligament between the tooth and bone with very fine needles. New anesthetics themselves are more powerful than old ones. The design of surgical instruments is better. And knowledge has improved; Dearing says endodontists have learned a great deal about the number and location of nerves in the mouth. Director praises the operating microscope. Better magnification and lighting increase efficiency. “I use it start to finish,” Director says. “It allows us to look at the internal anatomy, to find canals we couldn’t find before. It has revolutionized endodontics. All that has made the experience better for the patient,” Dearing says.
Which means there’s no need for fear, but better yet, take good care of your mouth, dentists say. It’s the best way to avoid the need for any procedure.