Wednesday, July 7, 2010

Can Something Small Hurt So Big?

Having a Root Canal (the proper term is Endodontic Therapy) is no fun.  I've heard it all...Having a root canal hurt worse than having a baby; and I've had 6 children.  I'd rather have hemorrhoids than have a root canal.  I'd rather run a marathon than have a root canal.  Finally...just pull it.  My friend had a root canal and said it was worse than boot camp.   

     We dentists don't find sadistic pleasure in  doing root canals.  I promise (The best and most successful root canal is the one I never have to do....said an endodontist).  We try to prevent the need for a root canal with many methods: bases, liners, sedative fillings, adjusting the bite, and our all time favorite...let's just give the tooth some time.  

And unfortunately there is too much mystery surrounding the "need" for a root canal.  Is it because the miniature x-ray the dentist is holding up to the light has some nondescript dark spot at the end of the root? Is it because my tooth throbs ever since the crown was done?  Is it because ice-cream makes my tooth scream?  Is it because I feel a pulsing in my tooth at night?  Is it because the dentist slipped with his drill when he hiccupped?  And how come he can never tell me if I need a root canal until after the drilling has begun (ohh Mrs. Smith, looks like you will need a root canal again).  

I do assure you there is a science supporting endodontics and specific indications for root canal therapy.  The diagnosis is made with a mixture of radiographs, patient symptoms, objective signs, and findings during excavation of decay.  Why can a tooth that needs a root canal hurt so much you might ask?  

      This tissue hanging off the side of a 30 mm Ni-Ti file is the extirpated vital nerve of a central incisor.  So if you were to slice and dice this tissue, slap it on a slide, and put it under a microscope- what would you see?  Axons, dendrites, and all the other things I have forgotten that make up nervous tissue.  

The core of endodontic treatment is getting this nerve out of your tooth to prevent it from sending nasty painful nerve stimuli to your brain.  So yes!  If you have ever received a root canal you know; something this small can hurt so big.  Has anyone had a good experience having a root canal? 


Megan said...

I've had 2 crowns and 1 root canal. I much much prefer a root canal to a crown. Crown are the most painful!

Anonymous said...

I've had 1 crown and that was no fun! Lately we feel like going to the dentist is like taking your car into the mechanic.... Jason went to one dentist and they said he needed repairs costing over $2000 and then to another for a second opinion they said everything was just fine?!?

Anonymous said...

Come see us at Kijabe Dental. I can guarantee I have absolutely no financial incentive to do more crowns.


Jen said...

Found you guys via the guest post at SCL. I've had dental anxiety for as long as I remember (had to go to a pediatric specialist dentist, because I wouldn't open my mouth for the regular dentist, until I was 12 and he kicked me out...I'd still go to him today if he let me even though I'm now 26 he's 2 hours away). Anyway, I've only ever had one cavity and that tooth wound up needing a root canal when I was 16. I had no pain, but the tooth was abcessing and the nerves were almost dead, so root canal it was. I was terrified that I wouldn't be able to deal with the procedure, but honestly, it was one of the more pleasant dental procedures I've ever had done. Almost as good as when I had my wisdom teeth out (my oral surgeon gave me the good drugs...whatever those are. Knocked me right out.) Ironically, that tooth hurts on occasion now, thanks to phantom pain. Funny that it only hurt after the fact. :)

Ed McGoldrick said...

For my part, I would say that having a root canal finally stopped the recurrent toothache I once had before. After back-to-back nights cringing in pain, my dentist (Colorado Springs, CO is where his office is) told me that I'd been overdue for a root canal. True enough, I bade goodbye to jaw-splitting pains.