Do I really need a root canal?!!

If you have excruciating pain, you’re a lot more likely to think a root canal is a good idea. If you have just some discomfort, or no pain at all, you’re a lot more likely to think a root canal isn’t really necessary. So not true! When you’re in pain, the problem is obvious. It’s usually one of two things. Either the nerve is dying and is not going quietly into that goodnight or, infection has gotten outside the tooth and is causing problems. Since 100% of dead teeth get infected, either way, you need a root canal. The bottom line on root canal treatment is that it controls infection.

If you have little or no pain, you can still have infection that eventually will cause all kinds of issues. Your tooth may have died quietly so you never knew it happened. But, as I said, 100% of dead teeth get infected so your dentist probably saw signs of that infection during an exam and/or on an x-ray. The most common sign is bone loss at the tip of the tooth’s root. That only continues to get worse until not only that tooth but teeth around it get compromised. Not to mention the health risks of having an uncontrolled infection.

Two stories to make my point. The first was someone who had an upper molar die and get infected. Because those teeth are pushing on your sinuses (in some cases they actually hold the sinus up but that’s another post), any infection can move into your sinuses. Because infection had been so long-standing and she frequently had sinus infections anyway, she lost the tooth. Then she lost the implant because the infection kept returning. Then she had sinus surgery. And back and forth it goes. She is now losing another tooth to the same cycle of infection. And, implants are not an option since that cycle continues. And, it all started because she waited several years before treating the initial problem. It wasn’t really painful so it could wait, right?

The second was an 18-year-old who came to our practice with a lower front tooth that hurt. She was actually referred 2 years before but since her pain was minimal, they didn’t pursue the referral. Now, at 18 the pain has gotten significant enough that she came to see us. The x-ray we had from when she was 16 showed some bone loss. As a healthy kid, that bone loss would have healed in no time. In a year or two there would be no sign of it (when we’re older, like all our aches and pains, things take a little longer to heal). Unfortunately, she did not come then. When she finally did, the bone loss was so extensive she was not only going to lose that tooth but the two teeth to either side of it (maybe more). That has to be the worse time I had to deliver such news to a patient. An 18-year-old girl losing all of her lower front teeth.

While those are extreme examples, someone waiting too long to see us because the pain wasn’t too bad happens nearly every week. Then they really don’t need a root canal because the tooth is unrestorable and has to be extracted. So…don’t wait!!

X-rays showing bone loss progression over two years.
Tooth trauma and root canals
athlete

Here is an online dental trauma guide. It’s probably a good idea to know what to do in an emergency, especially if you have kids.

And, while we’re talking about tooth trauma, be sure and wear mouthguards for all sports or other activities where you run the risk of getting hit in the mouth. You’d be surprised how easy this is. One of the more common causes we see is where someone is knocked in the mouth by a baby or dog.

Tooth pain!
toothache
Make it stop!

Here is an article on Dear Doctor about tooth pain. It discusses the different types of pain, possible causes, and treatments.

One thing I’ve learned working in this practice, it doesn’t get better on its own. It only gets worse (and the longer you wait, the more expensive the treatment options become). If you’re having tooth pain, get to your dentist!

Greetings!

Welcome to our new blog on all things endodontic. We will try to find resources for your frequently asked questions, descriptions of the different types of root canal treatments, and current research in the field. If you know of reputable sources, please let us know and we’ll be happy to add them to our site. If you have any questions, just ask. We’ll do our best to answer them ourselves or find an answer for you. And, if there’s anything else you’d like to see on this site, just send us a request.
This blog is provided by the practice of Deb Conner, DDS, MS, an endodontist in Durham, NC.
Our hope is that you will never need a root canal treatment. But, if you do, we then hope these pages will help you learn all you need to know to be prepared for your appointment.

Tricia