Question:
I'm trying to decide whether or not to get a root canal or just
have my tooth pulled. Is a root canal as painful as they let on on tv?
What kind of pain is it? Is it painful at all or just annoying?
Also, is there any other alternative? This is the second dentist I
have ever been to in my life. I did not like my first dentist and did
not seek another for three years....I know that was a mistake. But now
I have to deal with it.
Answer:
And . . . .do not let anyone work on this tooth if it is already sore.
Try antibiotics and wait it out. If you have the tooth anesthetised
you will not feel what is going down.
As for pain, there is less (or none) if there are no bacteria pushed
through the apical foramen (hole in the tip of the root).
Some root canal treatments hurt like crazy! Most are totally painless. The
ones that are allowed to "fester" for too long before they get treated
always have some pain.
Remember human tendency is to shout bad news and whisper good news. If you
have a negative experience, you go back and tell 15-20 people about it. If
you have an excellent experience you often just go home and smile. The same
applies to dental/medical work. For every negative comment you hear about
Root Canal treatment and wisdom tooth extraction, there are many others out
there who happily sit and smile.
Root canal treatment is painful (usually only the first visit) when there is
enough "infection" near the root tip to acidify the anesthetic and render it
neutral. These are the cases that either need to bear with the pain for
about ten seconds or bear with the pre-treatment symptoms (usually pain
also) while antibiotics help reduce the intensity of the infection. Normal
"numbing" like you would have for a routine filling is more than enough to
make the remaining root canal treatments easy.
By the time you need a root canal treatment, the only other alternative is
an extraction.
I'll disagree with Dr. Joel and suggest you not wait for the symptoms to get
better before seeking treatment. At the worst, ten seconds of pain is much
better than 4-5 days of pain waiting for antibiotics to help, (not to
mention all the possible side effects of taking antibiotics). Any
competent dentist can perform a fully adequate root canal treatment
(provided he/she received the training and like to do them). some dentist
who graduated a LONG time ago, did not receive this training in dental
school. Others, simply don't like doing them.
I believe that many years ago root canals were done without anesthesia.
That would be painful. The bad jokes and wives tales continue to this day.
We have come a long way since then with much better techniques, materials
and anesthesia. A root canal can be understood as simply a filling which is
placed within the root/s of the tooth. If adequate anesthesia is achieved
you should not feel any discomfort. If there is a large abscess, the area
becomes acidic which can interfere with the anesthetic. This makes complete
anesthesia difficult. In this case it is best to reduce the infection first
with antibiotics. High anxiety can also make anesthesia difficult. In
those cases I recommend Nitrous Oxide (laughing gas) to help the patient
relax. Many general dentists are well qualified to perform root canal
therapy. Some prefer not to do root canals if they have an endodontist
nearby. I practice in the mountains of Colorado so I have done many of
them. If I feel one is beyond my ability I refer the patient to our
endodontist in Denver. If your general dentist refers you to an endodontist
you should follow his advice. BTW, the alternative to having a root canal
is to have the tooth extracted. It is always better to try to save your
tooth if possible. Leaving a tooth missing can lead to problems in the bite
and replacing it is usually more expensive and involved than saving it. If
it was my tooth and I could save it, I would.
