The Truth About Root Canals

There are few phrases that strike fear in our hearts the way “root canal” does. No doubt, this dental procedure has a bad reputation-but how much of what we’ve heard is true?

“Whenever I tell someone they need a root canal, their jaw hits the floor, because there are a lot of misconceptions about them,” says Dr. Chris Lee, director of the Emergency Recall Clinic at Dalhousie University’s Dentistry Faculty Practice. With his help, we’ve separated the facts from the knee-buckling fiction.

What is a Root Canal?

Also known as “endodontic treatment,” a root canal procedure involves freezing with a local anaesthetic, followed by the removal of infected, injured or dead tissue (the tooth’s nerve and blood vessels). Your dentist or endodontist fills the space with a soft rubbery substance, then seals the tooth with a filling. A root canal takes one or two appointments (one to two hours each), depending on the complexity of the problem.

Why Do I Need a Root Canal?

A root canal can prevent the loss of the tooth. It also gets rid of infection-symptoms include pain and swelling, and if it isn’t treated, it can cause further problems. The most common cause of infection is bacteria that creeps into your tooth through deep cavities; it can also get in through cracks or under fillings.

Other reasons to get a root canal include a large cavity that reaches the tooth’s nerve, or a broken tooth that exposes the nerve. “We also do root canals for teeth that don’t have enough structure to put on a cap or crown,” says Dr. Lee.

Who is Most Likely to Need a Root Canal?

People who have a lot of cavities. Over time, a cavity can grow, and each new filling must be larger to replace damaged enamel. If enough tooth is lost to reach the nerve, “that’s when you need a root canal,” says Dr. Lee.

How Can I Avoid Root Canals?

Prevent cavities by brushing and flossing daily, and get regular dental checkups. Your dentist can take X-rays to check the depth of cavities.

Why Do Root Canals Hurt?

Actually, most of them hurt no more than getting a regular filling. “Ninety-five percent have no pain involved, after the needle,” says Dr. Lee. “The discomfort is really minimal. A lot of people go right from [our clinic] to work.”

Sometimes, the freezing doesn’t work as well as it should-infection or swelling in the face, for example, may reduce the anaesthetic’s effectiveness. In those cases, the dentist may inject an antibiotic inside the tooth, and the patient returns to complete the procedure another day.

Overall, though, most people are surprised at how easy the procedure turns out to be, says Dr. Lee. “It’s really not as bad as the stories you hear.”

Can Root Canals Fail?

The success rate of root canals is “upwards of 90 to 95 percent,” says Dr. Lee.

A root canal might fail if there is bacteria in your jawbone, which dentists can’t reach, and your immune system can’t deal with it. “Sometimes, that can get infected and you need to redo the root canal. It doesn’t happen often,” says Dr. Lee.

The most common reason for needing another root canal is tooth decay around a filling or crown, which can let bacteria into the root canal filling-all the more reason to brush, floss and get dental checkups.