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Will I Be Comfortable During My Root Canal Treatment?

The answer should be an emphatic "YES!" Fortunately, dentistry has developed new techniques for delivering local anesthetics painlessly. These techniques also assure that the anesthetics act more rapidly and produce a more "profound" level of anesthesia. Additionally, modern dental procedures utilize better technologies that are generally much less traumatic and invasive than those of the past. The result of these advancements is that patients should have minimal or no discomfort during the tooth numbing and/or treatment procedures. Root canal treatment should not cause pain, but rather relieve it when present and keep it from reoccurring. Unfortunately, dental pain may also have a psychological component, possibly stemming from a negative past experience, a story in the media, or even the fear of the unknown. Sometimes these situations can prove challenging for the patient and the dentist to control. Examples include:

• Some patients associate tooth pain with past root canal treatment when, in fact, the pain they remember was experienced prior to their emergency visit. Oftentimes, this pain develops over a period of several hours to a few days and is allowed to build and worsen before seeking treatment. Once the patient seeks emergency care, endodontic treatment should not be uncomfortable and should provide quick and certain relief from any painful symptoms stemming from root canal disease.
• Patients may become very anxious when being examined or treated dentally because the mouth is such an important part of the body and psyche. Some patients may feel anxious and vulnerable because of their positioning in the dental chair with members of the dental team working above them in such close and intimate proximity.

These and other distresses are real to the patient. Much of the time, however, the distress can be reduced or eliminated if the patient discusses it with the dentist and gets understanding and reassurance. The doctor and the patient must work together in these situations to make certain that the patient feels as comfortable, trusting, and informed as possible in the dental environment. Most individuals can do this satisfactorily. If patients continue to feel significant distress, even after having these discussions with the dentists, they should be aware that there are supplementary modalities for which they might be candidates. These modalities include:

• Oral sedation involves ingesting a sedative pill or liquid before the appointment. This can help anxious patients a great deal and make the treatment experience much less psychologically stressful.
• Nitrous oxide analgesia, known as "laughing gas," can be inhaled along with oxygen to make patients feel less anxious and more comfortable.
• Intravenous sedation can be administered in a dental facility by a specially trained and certified dental team or by a specially trained dental anesthesiologist. With intravenous sedation, patients are not asleep and they can still respond, but they will not feel or remember anything. This technique works very well in creating a pleasant experience for many anxious patients and is a good anesthetic modality for more lengthy dental procedures.
• Hospital dentistry is conducted in an environment where a variety of anesthetic modalities are available and can be used under the safest medical conditions. General anesthetic and intravenous sedation can both be utilized in the hospital setting.

These sedative techniques and medicines may also be helpful if particularly lengthy treatment procedures are necessary in specific situations.

With all of the advancements in pharmaceuticals and in their delivery, there should be no need for any patient to delay root canal treatment because of fear that the treatment will be painful.

By Clifford J. Ruddle, DDS, in collaboration with Philip M. Smith, DDS

Dental Care: Frequently Asked Questions

Q. How does one care for primary teeth?

A. As soon as the first tooth erupts, primary teeth may be cleaned with a clean, wet wash cloth or wet gauze. The gums should also be gently wiped. If a toothbrush is used, it should be an appropriate size.

Q. Where does decay on the primary teeth occur most often?

A. With inappropriate or prolonged use of the baby bottle, decay may occur on the upper front teeth (incisors). The second most-often occurring site are the upper primary molars, which are found furthest back in the mouth. If there is no spacing between the primary teeth, there is a much greater chance of decay between the primary molars. These teeth should be flossed as soon as they come in.

Q. Why are dental sealants beneficial for children?

A. Dental sealants are protective coatings for the chewing surface of permanent molars. They protect the teeth from decay. Read on for more information.

Q. What is a dental implant?

A. A dental implant is a permanent artificial tooth replacement after a tooth loss.

Q. What is the procedure for receiving dental implants?

A. Dental implats are inserted surgically in two steps. The first step is to insert a "post" into or onto the jawbone. This post will then become the "anchor" for the artificial tooth that will be placed over the "post."

Q. How long is the procedure for dental implants?

A. Getting a dental implant is a two step process. Once te "post" is inserted into the jawbone, the patient will have between three and six months with a temporary restoration. During this period, the bone and gum area around the post will heal to create a strong and healthy bond. Once this bond is complete, an additional set of smaller posts is attached to the original post and then the artificial tooth is secured to the posts. The entire procedure could take anywhere from three to ten months.

Q. Can I eat regularly while the implants are bonding?

A. While th "post" is bonding with your jaw and gums, your dentist will place a temporary artificial tooth on the post. During the bonding period, you will need to eat soft foods.

Q. Do implants require special care?

A. Yes and No. Dental implants need to be brushed, flossed and checked regularly ba dentist, just as you would do with your regular teeth. But dental implants don't need special brushes or pastes.

Q. Can you eat and chew normally with dental implants?

A. Yes. Consider that natural teeth can absorb up to approximately 540 lbs. per square inch of biting pressure and properly placed dental implants can withstand up to approximately 450 lbs. per square inch of the same pressure.

Q. How long should a dental implant last?

A. With proper placement, excellent home care, regular dental visits, and good overall health, dental implants should be permanent.

Q. What are wisdom teeth?

A. Wisdom teeth are the third molars.

Q. Why is it necessary to remove wisdom teeth?

A. It is necessary to remove wisdom teeth to avoid problems, such as an impacted tooth destroying the second molar.

Q. Why do wisdom teeth cause problems?

A. Wisdom teeth generate problems because the shape of the modern human mouth is too small to accommodate these teeth, and they become impacted or unable to come in or move into their proper place.

Q. What problems occur from impacted third molars?

A. Partially erupted wisdom teeth are breeding grounds for bacteria and germs that may cause infection. Cysts and tumors may grow on trapped wisdom teeth.

Q. How is a wisdom tooth removed?

A. Wisdom teeth are remove by surgery. The gum tissue over the tooth is removed, the connective tissue is stripped gently away from the tooth and bone, the tooth is removed, and the gum sutured.

Q. When are lasers used in dentistry?

A. Lasers are used in oral surgery, gum surgery, tooth whitening, cancer sore treatment, and the treatment of gums that have been diseased.

+Jim Du Molin is a leading Internet search expert helping individuals and families connect with the right dentist in their area. Visit his author page.