Endodontists debunk misconceptions about root canals

The term root canal often evokes a shudder, as many people misinterpret the procedure as painful.

President Barack Obama even said that the bank bailout, which was hated by Democrats and Republicans, was 'as popular as a root canal” in his 2010 State of the Union address.

But because of modern technology, the pain associated with the procedure may simply be a myth.

'In 2016, people still fear root canals,” said Dr. Fabricio Teixeira, head of the Department of Endodontics at the University of Iowa College of Dentistry. 'We can pretty much, today, perform the entire treatment with no pain.

'Once in awhile, you have challenging situations, but we have way better techniques, better understandings, and we can pretty much reduce discomfort to almost none.”

Many times the pain caused by infection in a root canal can make it uncomfortable for patients to chew or even sleep. Root canal therapy, commonly called 'a root canal,” is a procedure where infectious material in a tooth's root canal is removed, the canal is reshaped and cleaned, then filled to eliminate pain or decay.

'Endodontists are specialists in saving teeth because once the root canal gets infected, you have only two options; one is extracting the tooth, pulling the tooth, and the other is doing the root canal,” Teixeira said.

While many dentists perform root canals, according to the Journal of Endodontics, patients are more likely to have a successful procedure with an endodontist, which is likely because of their specialized education and technologies in their offices, Teixeira said.

Dr. Derek Peek of Eastern Iowa Endodontics said that everything from the chairs and lights, to the microscopes and 3-D X-rays, help him put his patients at ease.

Peek, who was a seventh-grade teacher before going to dentistry school, also believes it is important to tell the patient what he is seeing in the diagnostic stage so the patient can be involved in the decision to have a procedure. He often uses a whiteboard in his explanation.

'There's a science and education that goes into it,” Peek said. 'You have to take something that's very specific and detailed and explain it to people of various backgrounds and knowledge.”

Peek shows the patients the pictures he takes from his microscopic examinations and sometimes uses a Cone Beam Computed Technology machine that gives a detailed, 3D-image of the tooth.

The machine is often used for confirmation purposes rather than for finding the problem. In fact, the American Association of Endodontics recommends using CBCT machines only when necessary to limit patients' exposure to radiation.

'The mark of a good endodontist is that they can figure it out, without X-rays, just by listening to the patient,” Peek said.

However, sometimes the tools allow endodontists to see a problem they wouldn't otherwise know about.

Teixeira and Peek have had cases where an X-ray wouldn't have shown an infection, but the CBCT machine enabled them to identify the issue.

Endodontists also use advanced anesthetic techniques and instruments designed for efficiency to make the patient comfortable, Teixeira said.

'The biggest reward is when they start snoring,” Peek said.

The roots of root canals

In the early 1900s, pulling the tooth was more common than root canal therapy because the common misconception of the time was that a dead nerve or infection around the roots affected every organ in the body, said Dr. James Gutmann, president of the American Academy of the History of Dentistry. In the early days of endodontics, materials such as gold foil, hickory sticks or pieces of metal were use to fill the tooth, without regard to the biological impact - but that changed in the mid-to-late 1900s, he said.

'We didn't have near the intruments we do today,” Gutmann said.