Frequently Asked Questions

Endodontic Specialists, Timothy S. Kim, DDS

What is a Root Canal?
Is a Root Canal for You?
What is Involved in a Root Canal Procedure?
Is the Root Canal Procedure Painful?
Will I Feel Anything After Root Canal Treatment?
What are the Benefits of Root Canal Therapy versus Extraction?
Are Root Canals Making me Sick?

What is a Root Canal?

ROOT CANAL is a "lay persons" term for endodontic therapy or root canal therapy. Root canal therapy is necessary when the nerve inside the tooth becomes irreversibly damaged or infected. This is usually due to the entry of bacteria into the center most part of the tooth called the dental pulp ("nerve"). Root canal therapy involves the removal of the entire nerve system, as well as cleaning, shaping and filling 3-dimensionally the canal system with gutta-percha and a dental sealer.

Is a Root Canal for you?

Do you have any of the following symptoms?

Sensitivity to hot or cold that lingers
Discomfort when chewing or biting
Dull ache
Discomfort that wakes you up at night
Your dentist has diagnosed the need for endodontic treatment either by clinical exam or x-ray

If you answered yes to any of the above, you might very well need a root canal.
Please call and schedule for an evaluation.

Be aware not all teeth that ARE in need of root canal therapy will cause pain. It is possible to be pain-free and still need a root canal.

What is Involved in a Root Canal Procedure?

The endodontist examines the x-ray and the tooth, then administers a local anesthetic. After the tooth is numbed, a Small protective sheet, called a dental-dam is placed to isolate the tooth, A Small opening will be made in the crown of the tooth and Small instruments will be used to clean the canals and to shape the canal spaces for filling. Once the canals have been adequately cleaned and shaped, the canals will then be filled with a rubber-like material called "gutta-percha" and sealer. A temporary filling is then placed to close the opening. Your dentist will remove the temporary filling before the tooth is restored.

Is the Root Canal Procedure Painful?

With modern techniques and anesthetics the procedure is much faster and with less discomfort than there has ever been. A similar anesthetic as the one used by your dentist will be used for the root canal. For the first few days after treatment, your tooth may feel sensitive to the bite. This discomfort can be relieved with over-the-counter or prescription medications in order to control normal post-treatment discomfort.

Will I Feel Anything After Root Canal Treatment?

In most cases the quantity and quality of discomfort will subside dramatically within the first 24-48 hours. Any sensitivity to cold, hot or even breathing air "in" will be gone after your visit. Nevertheless, you may experience mild discomfort that will last for several days after treatment. Taking over-the-counter medications such as aspirin, Advil, Motrin, or Aleve usually relieves this discomfort. Tylenol has been proven not to be as effective as aspirin, etc., because it does not have the anti-inflammatory component as these other medications. The most common complaint is tenderness to touch, bite, tapping or chewing on the tooth. It is recommended to refrain from any of the above until your dentist permanently restores your tooth.

What are the Benefits of Root Canal Therapy Versus Extraction?

The single most important benefit of root canal therapy is that you keep your tooth. Extraction may lead to other dental problems. For instance, drifting of teeth, bite problems, TMJ discomfort, and the need to treat adjacent teeth that do not otherwise need dental treatment in order to restore the missing tooth. No matter how effective modern tooth replacements are - and they can be very effective - nothing is a good as your natural tooth.

Are Root Canals Making me Sick?

THE BOOK
In 1993, Dr. George Meinig published a book alleging that root-filled teeth contribute to the incidence of systemic illness and "degenerative" diseases. The book, Root Canal Cover-up Exposed! Many Illnesses Result, based upon the focal infection research of Dr. Weston Price (c. 1910-1930), states that bacteria trapped in dentin tubules during root canal treatments can cause almost any type of "degenerative" disease, including rheumatic fever, heart disease, kidney disease, arthritis, bladder disease, mental illness and pregnancy complications, to name just a few. With this decades-old research as his justification, Dr. Meinig recommends that concerned patients consider extracting root-filled teeth. Dr. Meinig also alleges that Dr. Price's research and his discovery of bacteria in the dentinal tubules have been "buried" by self-interested dentists. Dr. Meinig is a founding member of the American Association of Endodontists.

THE TRUTH
Attempts to replicate research indicating that root-filled teeth act as foci of infection that contribute to systemic illness have been unsuccessful. Researchers now believe the early correlations might be attributed to the crude sanitation techniques and imprecise research protocols often practiced on cultures in early bacteriology labs.¹

Population studies performed in the 1930s and 1940s failed to correlate the presence of illness to the presence of root-filled teeth. Instead, researchers found that people with root fillings were no more likely to be ill than people without them.^1,2

Microbiologists have long been aware of the presence of bacteria in the dentinal tubules. Certain strains of bacteria are present in the mouth and teeth at all times, even in teeth that have never had a cavity or other trauma. The mere presence of these bacteria does not constitute "infection" and is not a threat to a person's health.³

Dr. Price and the many other researchers who explored the focal infection theory convinced us all of the need to emphasize the importance of good oral health in maintaining the overall health of our bodies. Their research brought up many valid questions about how bacteria in our bodies affect our health, inspiring further research on bacteria, the immune system and the safety and efficacy of root canal treatment.^1-19 These studies support the truth we report today -- that properly root-filled teeth do not cause systemic illness.

The members of the American Association of Endodontists share Dr. Meinig's concern for the well being of endodontically treated patients. Because we share that concern, however, we cannot condone the recommendation to extract root-filled teeth for the purpose of treating or preventing systemic illness. Saving the patient's natural teeth, if at all possible, is always preferable to extraction.¹³ If artificial teeth make a patient's bite feel unnatural the patient may avoid certain foods. Maintaining the natural dentition is important so that the patient can continue to enjoy the wide variety of foods necessary to maintain the proper nutrient balance in his or her diet.

For most patients, the natural tooth is preferable to a replacement and should be maintained whenever possible. Endodontic treatment, along with restoration, is a cost effective way to treat pulpally involved teeth and is usually less expensive than extraction and placement of a bridge or implant.¹³ Endodontic treatment has a very high success rate (over 90%), translating into countless millions of healthy endodontically treated teeth serving patients all over the world. Those healthy teeth are helping patients chew and bite efficiently, maintain the natural appearance of their smile and enhance their enjoyment of life. Through endodontic treatment, endodontists and dentists worldwide enable patients to keep their natural teeth for a lifetime.

¹Easlick K. An evaluation of the effect of dental foci of infection on health. JADA 1984;42:615-686, 694 -697.
²Grossman L. Pulpless teeth and focal infection. J Endodon 1982;8:S18-S24.
³Schonfeld SE. Oral microbial ecology. In: Slots J, Taubman M, eds. Contemporary oral microbiology and immunology St. Louis: Mosby Year Book, 1992:267-274.
⁴Grossnman L. Root canal therapy. 4th ed. Philadelphia: Lea & Febiger, 1955:15-40.
⁵Grossman L. Focal infection: Are oral foci of infection related to systemic disease? Dent Clin N Amer 1960:749-63
⁶Bender IB, Seltzer S, Yermish M. The incidence of bacteremia in endodontic manipulation. Oral Surg 1960;13(3):353-60
⁷Goldman M, Pearson A. A preliminary investigation of the "hollow-tube theory" in endodontics: Studies with neo-tetrazolium. J Oral Therapeutics and Pharm 1965; 1 (6):618-26.
⁸Torneck C. Reaction of rat connective tissue to polyethylene tube implants. Part I. Oral Surg 1966;21 (3):379-87
⁹Torneck C. Reaction of rat connective tissue to polyethylene tube implants. Part. II. Oral Surg 1967;24(5):674-83
¹⁰Phillips J. Rat connective tissue response to hollow polyethylene tube implants. J Canad Dent Assoc 1967;33(2):59-64
¹¹Davis M, Joseph S, Bucher J. Periapical and intracanal healing following incomplete root canal fillings in dogs. Oral Surg 1971;31(5):662-675.
¹²Baumgarmer J, Heggers J, Harrison J. The incidence of bacteremias related to endodontic procedures I. Nonsurgical endodontics. J Endodon 1976;2(5):135-40.
¹³Ehrmann E. Focal infection: The endodontic point of view. Oral Surg 1977;44:628-34.
¹⁴Wenger J, Tsaknis P, delRio C, Ayer W. The effects of partially filled polyethylene tube intraosseous implants in rats. Oral Surg 1978;46:88-100.
¹⁵Delivanis P, Snowden R, Doyle R. Localization of blood-borne bacteria in instrumented unfilled root canals. Oral Surg 1981;52(4):430-32.
¹⁶Torabinejad M, Theofilopoulos A, Ketering J, Bakland L. Quantitation of circulating immune complexes, immunoglobulins G and M, and C3 complement component in patients with large periapical lesions. Oral Surg 1983;55(2): 186-90
¹⁷Delivanis P, Fan V. The localization of blood-borne bacteria in instrumented unfilled and overinstrumented canals. J Endodon 1984;10(11):521-24.
¹⁸Benatti O, Valdrighi L, Biral R, Pupo J. A histological study of the effect of diameter enlargement of the apical portion of the root canal, J Endodon 1985;11(10):428-34.
¹⁹Wu M, Moorer W, Wesselink P. Capacity of anaerobic bacteria enclosed in a simulated root canal to induce inflammation Internat Endodon J 22:269-77, Nov./Dec. 1989.

©Copyright 2003- Dental WebSmith, Inc. and Timothy S. Kim, DDS, PS. All rights reserved. Disclaimer: The information provided within is intended to help you better understand dental conditions and procedures. It is not meant to serve as delivery of medical or dental care. If you have specific questions or concerns, contact your health care provider.