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7163 Yonge St Unit 265
THORNHILL, ON L3T 0C6
416 855 0302
Hermetic Endo
Dr. Farzad Salehipour
What is Endodontics?
Myths About Root Canals and Root Canal Pain

There are many misconceptions surrounding root canal (endodontic) treatment and whether patients experience root canal pain. As always, when considering any medical procedure, you should get as much information as you can about all of your options. Your dentist or endodontist can answer many of your questions, and if you still have concerns, it is often wise to seek a second opinion.

 

Myth #1—Root canal treatment is painful.

 

Truth—Root canal treatment doesn't cause pain, it relieves it.

 

The perception of root canals being painful began decades ago but with modern technologies and anesthetics, root canal treatment today is no more uncomfortable than having a filling placed. In fact, a recent survey showed that patients who have experienced root canal treatment are six times more likely to describe it as "painless" than patients who have not had root canal treatment.

 

Most patients see their dentist or endodontist when they have a severe toothache. The toothache can be caused by damaged tissues in the tooth. Root Canal treatment removes this damaged tissue from the tooth, thereby relieving the pain you feel.

 

Myth #2—Root canal treatment causes illness. 

 

The myth: Patients searching the Internet for information on root canals may find sites claiming that teeth receiving root canal (endodontic) treatment contribute to the occurrence of illness and disease in the body. This false claim is based on long-debunked and poorly designed research performed nearly a century ago by Dr. Weston A. Price, at a time before medicine understood the causes of many diseases. 

 

In the 1920s, Dr. Price advocated tooth extraction—the most traumatic dental procedure—over endodontic treatment. This resulted in a frightening era of tooth extraction both for treatment of systemic disease and as a prophylactic measure against future illness. 

 

The truth: There is no valid, scientific evidence linking root canal-treated teeth and disease elsewhere in the body. A root canal is a safe and effective procedure. When a severe infection in a tooth requires endodontic treatment, that treatment is designed to eliminate bacteria from the infected root canal, prevent reinfection of the tooth and save the natural tooth. 

  • The presence of bacteria in teeth and the mouth has been an accepted fact for many years. But the presence of bacteria does not constitute "infection" and is not necessarily a threat to a person's health. Bacteria are present in the mouth and teeth at all times, even in teeth that have never had a cavity or other trauma. Research shows that the healthy immune system takes care of bacteria in a matter of minutes.
  • Tooth extraction is a traumatic procedure and is known to cause a significantly higher incidence of bacteria entering the bloodstream; endodontic treatment confined to the root canal system produces much less trauma and a much lower incidence and magnitude of bacteria entering the blood stream.
  • There is no adequate replacement for the natural tooth - it should be saved whenever possible. Root canal Treatment, along with appropriate restoration, is a cost effective way to treat infected teeth because it is usually less expensive than extraction and placement of an implant. In most cases, endodontic treatment allows patients to keep their natural teeth for a lifetime.

 

But what about Dr. Price? This is a good example of how the Internet can give new life to long-dispelled theories. Believe it or not, the misinformation about roots canals that is found on the Internet is still based on Dr. Price’s century-old, discredited research. Dr. Price’s research techniques were criticized at the time they were published, and by the early 1930s, a number of well-designed studies using more modern research techniques discredited his findings. In 1951, the Journal of the American Dental Association took the extraordinary step of publishing a special edition reviewing the scientific literature and shifted the standard of practice back to endodontic treatment for teeth with non-vital pulp in instances where the tooth could be saved. The JADA reviewed Dr. Price’s research techniques from the 1920s and noted that they lacked many aspects of modern scientific research, including absence of proper control groups and induction of excessive doses of bacteria.

 

As recently as 2013, research published in JAMA Otolaryngology—Head & Neck Surgery, found that patients with multiple endodontic treatments had a 45 percent reduced risk of cancer.

 

Myth #3—A good alternative to root canal treatment is extraction (pulling the tooth).

 

Truth—Saving your natural teeth, if possible, is the very best option.

 

Nothing can completely replace your natural tooth. An artificial tooth can sometimes cause you to avoid certain foods. Keeping your own teeth is important so that you can continue to enjoy the wide variety of foods necessary to maintain the proper nutrient balance in your diet. If your dentist recommends extraction, ask whether root canal treatment is an option.

 

Endodontic treatment, along with appropriate restoration, is a cost-effective way to treat teeth with damaged pulp and is usually less expensive than extraction and placement of a bridge or an implant.

 

Endodontic treatment also has a very high success rate. Many root canal-treated teeth last a lifetime.

 

Placement of a bridge or an implant will require significantly more time in treatment and may result in further procedures to adjacent teeth and supporting tissues.

 

Millions of healthy endodontically treated teeth serve patients all over the world, years and years after treatment. Those healthy teeth are helping patients chew efficiently, maintain the natural appearance of their smiles and enhance their enjoyment of life. Through endodontic treatment, endodontists and dentists worldwide enable patients to keep their natural teeth for a lifetime.

 

What is an Endodontist and what do they do?

Endodontists are dentists who specialize in maintaining teeth through endodontic therapy -- procedures, involving the soft inner tissue of the teeth, called the pulp.  The word "endodontic" comes from "endo" meaning inside and "odont" meaning tooth.  Like many medical terms, it's Greek.  All dentists are trained in diagnosis and endodontic therapy, however, some teeth can be especially difficult to diagnose and treat.  That’s why you may have been referred to an endodontic specialist.

In addition to dental school, endodontists receive two or more years of advanced education in this kind of treatment. They study root canal techniques and procedures in greater depth, for diagnosis and treatment of more difficult cases. For this reason, many dentists choose to refer their patients to endodontists.

What Happens During Endodontic Treatment? or What is a Root Canal?

A local anesthetic will be given.  A sheet of latex called the "rubber dam" (we've got nonlatex ones too) will be placed around the tooth to isolate it, hence keeping it clean and dry during treatment.  The treatment consists of three or four basic steps, but the number of visits will depend on your particular case.  Some treatments take 2 visits but many are just a single visit.  Occasionally 3 appointments are needed.

In any case, it depends on the degree of infection/inflammation and degree of treatment difficulty.  To me, it's more important to do it the very best we can then to meet a specific time criteria.  Let's look at the basic steps for nonsurgical endodontic therapy.

There are, of course, no guarantees.  Root canal or endodontic therapy has a very high degree of success, up to 90%.  Teeth which can be treated near ideal have a success rate up to ninety percent!  We will discuss with you the chances of success before any endodontic procedure to help you make an informed decision.  If a root canal or endodontic therapy is unsuccessful or fails you still have options.

Diagnoses and Treats Pain
Oral pain such as toothaches or cracked / fractured teeth can often be difficult to pinpoint.  Because of the vast network of nerves in the mouth, the pain of a damaged or diseased tooth often is felt in another tooth and/or in the head, neck, or ear. An endodontist is a specialist in diagnosing and treating this type of pain.
Treats Traumatic Injuries
Pulp damage is sometimes caused by a blow to the mouth, and the endodontist specializes in treating these traumatic injuries. For example, a blow to a child's permanent tooth that is not fully developed can cause the root to stop growing. A procedure called apexification stimulates bone to be deposited at the end of the root which makes it possible to then save the tooth through a root canal procedure. An endodontist is specially trained in procedures for replanting teeth that have been knocked out of their sockets.
Will I need to return to your office for Additional Visits?
Once endodontic therapy is completed your tooth should be examined periodically, usually every 6 - 12 months.  This allows us to make sure the tooth has healed or is healing properly.  You will be sent a notice in the mail when we feel it is appropriate to reevaluate the area.  Since an abscess may take 2 years to heal, our office will reevaluate the tooth for at least 2 years.
Retreatment

Occasionally a tooth that has undergone endodontic, treatment fails to heal or pain continues despite therapy. Although rare, sometimes a tooth initially responds to root canal therapy but becomes painful or diseased months or years later. When either of these situations occur, the tooth often can be maintained with a second endodontic treatment.