Dra. Teresa Chacur de Miranda
Endodontista | CRO 10225 RJ
Throughout my professional career, I could hear various issues and clients questions. In several of them, I noticed some myths and unknowns that led to fear, distress and, sometimes, the abandonment of treatment. Many do not sleep well the night before going to the dentist to treat the canal. Others delay the most going to the dentist and, in this way, worsen the prognosis of the case.
I describe here the most frequently questions from my clients, as well as their fears and doubts.
Frequently asked questions //
1.
Does root canal treatment hurt?
It does not hurt! With the use of advanced technology and the emergence of more accurate techniques, root canal treatment became painless nowadays.
Does treating the canal weaken the tooth?
If this tooth does not receive an adequate prosthetic restoration after root canal treatment, it can fracture and, depending on the commitment, can be sentenced to extraction. It can also suffer recontamination because it was not well sealed. Therefore, it is essential to return soon to the clinical dentist when the endodontist completes his job. Prevention is the best way to keep the tooth!
Does a tooth, once treated, never hurt again?
A tooth with treated canal loses sensitivity to hot and cold, but the tissues surrounding it are still alive and can come to hurt again if this tooth is submitted to a trauma (excessive force on the teeth), has an advanced periodontal disease (gum and bone) or suffers recontamination (abscess).
4.
Is root canal treatment forever?
Nothing in the human body or in nature is "forever". Many clients seek the specialist to retreat the canals and do not understand the reason for this indication. They complain of pain despite of the canal has already being treated.
A tooth treated canal can suffer recontamination by bacteria due to several factors. The most common causes are the inaccurate shaping, cleaning or sealing of these canals. If all the root canal space is not accessed, decontaminated and well-sealed, the bacteria reorganize and proliferate in this environment, bringing pain and tooth abscess.
Another very common cause leading to the retreatment is not treating all existing canals within each tooth. Whether by poor technique, lack of knowledge, or the anatomical complexity of the case, many canals may not be found (missed canals) and are not treated, keeping the bacteria that gradually multiply in biofilms.
The failure of a first treatment usually leads to the need of retreatment of the same tooth.
Whenever the tooth aches is a canal problem?
Not necessarily. Toothache caused by canal commitment is very specific, with very characteristic signals and symptoms. Generally the pain relates to temperature (hot and cold) or to the use of the tooth (chewing and touch).
It can be spontaneous, triggered or continuous. However, there may be other orofacial pains, not caused by endodontic origin, that radiate through the face, coming from other sources, such as periodontal, neuropathic, myofascial, neuralgic, TMJ pain (temporo-mandibular joint), among the most frequent.
6.
Is root canal treatment time consuming, difficult and painful?
It will depend on the experience and training that the specialist has to solve the case.
A professional, qualified and updated endodontist, with modern equipment, certainly solves all the difficulties with a more secure form, and brings faster and painless solutions.
7.
Can you treat “milk teeth” using root canal?
Yes. When a deciduous tooth (milk tooth) suffers a trauma or has a deep cavity, the dentist will evaluate the possibility to save it through the canal treatment. A "milk tooth" with problems compromises the permanent tooth related to it. Therefore, in case of any accident or pain in the primary dentition, go as quickly as possible to your dentist or pediatric dentist.
9.
What difference does the use of the optical microscope make in root canal treatment?
It makes a lot of difference, particularly in the success rate, which increases significantly. The purpose of the canal therapy is to promote disinfection and eliminate the bacteria that invade the inside of the root canal. The magnification and the quality of the microscope vision allow a better view of the canals and, consequently, cleaning, shaping and filling them much more efficiently.
"You can only clean what you see!"
Not to mention the cases that are only possible to be diagnosed and resolved because the specialist makes use of the microscope (see examples in clinical cases).
10.
The laser is also used in root canal treatment?
The great challenge of canal therapy is the maximum elimination of bacteria from inside the tooth.
A lot of technology has been developed to achieve this goal, and one of them is the application of low-power laser, which operates in disinfection, in tissue repair, analgesia and modulation of inflammation. Laser use is growing fast in dental offices regarding to new researches that promote more scientific basis for its application.
11.
Can the tooth with root canal become dark?
It all depends on the way it was treated. If the canal isn’t well cleaned, or if there are pulp tissue debris, decay or dental material in the internal tooth space, the tooth both the crown and the root can get stained or darkened.
The dentists have to be very careful with the use of sealers. Some of them, such as those containing silver, which are already in disuse for a long time, can stain the tooth definitely giving a grayish color to it.
The use of certain medicines during the canal treatment may also cause color change. It is also good to note that a tooth with pulp necrosis (“dead nerve”) can change color, becoming dark due to tissue degradation. The only way to avoid this is to promote an efficient root canal treatment.
12.
Can the tooth treated with root canal develop cavities?
Yes. Root canal treatment only prevents the pain of decay but not "immunize" the tooth. While there is dentinal structure decay can occur, because the bacteria will accumulate on the tooth surface if brushing does not promote effective cleaning.
Having a tooth treated with root canal requires more rigorous prevention. In fact, due to the absence of pain caused by decay in a root canal treated, this decay may progress, and causes the loss of the tooth if the commitment is extensive
Visiting the dentist frequently prevents better this possibility!
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8.
Should I treat the canal or place an implant?
The implant alternative should be recommended only if there is not a better solution to keep the tooth in the mouth. A well-prepared and equipped professional performs treatments with success rates as high as 95%. Preserving the tooth should always be the first option. Always consult an endodontist before having your tooth extracted. Our specialty is to save your teeth!