Interview: Relax, it's a root canal

By CHRISTINE DELL'AMORE, UPI Consumer Health Correspondent  |  Oct. 26, 2006 at 4:53 PM
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WASHINGTON, Oct. 26 (UPI) -- Spinal tap, anyone? Many people would rather get that notoriously painful procedure than a root canal, according to a new survey by the American Association of Endodontists. The group represents the nation's root canal specialists, arguably one of dental science's most underappreciated specialties.

But here's something to chew on: Root canals aren't that bad. New advances in endodontics have made root canals a relatively painless, if not exactly a pleasurable, experience. United Press International talked to endodontist Marc Balson, the immediate past president of AAE, to get to the root of these unpopular surgeries.

Q. What is a root canal?

A. When a nerve in the tooth is diseased, we remove contents of the canal and clean and sterilize the canal system to free it of bacteria and other toxins. A root canal fills in the (canal) space where the nerve used to be. One tooth has a single root, and the canal houses a nerve, blood vessels and connective tissue. (After the surgery), we refer patients back to their general (dentist), and they put a permanent restoration on the tooth, like a crown.

Q. Why is it done?

A. Most things are bacterial-driven -- if someone has decay caused by bacteria, the decay breaks through enamel and dentin (a substance beneath the enamel), and that can insult the pulp or nerve. That's when the nerve becomes diseased, and when people (feel) symptoms, such as (sensitivity to) hot and cold, troubling chewing and earaches.

Q. Nearly half of people in a recent survey thought root canals were "excruciatingly painful." Where did this idea come from?

A. Unfortunately, much of that goes back to 30 to 40 years ago. Back then, I wouldn't have wanted to get a root canal either. The art and science of endodontics wasn't at its highest level. Modern endodontic therapy is painless -- just ask anyone whose been to a competent endodontist. We don't deserve the reputation we get. Every endodontist has heard the saying: 'That's about as much fun as getting a root canal,' about 100 times. Modern root canals are remarkably painless, and require one or two rapid visits.

Q. Is it true saving the tooth is always the best idea?

A. A good analogy is no one wants to have their knees replaced or hips replaced if they don't have to. If you can salvage if it, and it functions properly, why have it removed?

Q. Are people usually able to keep their tooth?

A. The success rate of implants and root canal therapy (are more than) 95 percent. If you were a patient sitting in chair, (and you hear) both (procedures) have a success rate of (more than 95) percent, and the dentist said, 'I could save your tooth,' why would you want to have your tooth extracted?

Q. I've heard root canals are painful for the pocketbook.

A. When you go to a specialist you expect something special -- you're paying for their education and expertise and ability to do this very complex procedure. Most implants in conjunction with crowns are probably anywhere from $750 to over $2,000 -- that's more expensive than a root canal, depending on the tooth involved and the location. The farther back you go (in the mouth), the more expensive the root canal gets. The same (can be) said about implants. If you look at the cost basis for an implant versus a root canal, the national average for an implant is (estimated by some organizations as) $2,500. A root canal costs many hundreds of dollars less.

Q. What's the best way to avoid root canals to begin with?

A. To avoid coming to see an endodontist, maintain good oral health, which is so important for general health. The mouth is the window to the rest of your body. If you don't take good care of teeth, and you don't eat your food properly, it could lead to infections and pain. If you can't chew your food properly, you'll eat softer foods that aren't as healthy for you. (You should) go to the regular dentist twice a year to have your teeth cleaned, and maintain good oral home care.

Q. Do you have any stories of particularly dentist-shy patients?

A. It's amazing how many fearful people come into my office on a weekly basis. A few years ago, (a woman came in who was) so deathly afraid she had her husband and daughter with her. She said, 'Doc, I heard you are nice, but I want you to know I hate dentists.' I diagnosed the case, and I said to her husband and daughter, stay in the room and keep an eye on me. When it was over, she said, 'I feel like a complete fool.' As endodontists, we turn people around all the time, and show them there are better and more painless root canals.

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