It sounds a lot worse than it is
One of the more unnerving things a dentist can say to a patient is “you need a root canal.”
It sounds painful. Those long vowels being stopped short by the voiceless velar stop of the hard c. There’s something abrupt to it. You’re sailing along on the “oo” and you slam into a wall. It’s a little car wreck of a term.
It might also partly be because a lot of of us have no idea what a root canal is, how it’s done, and why.
It doesn’t help that knowledge of the procedure is usually handed down by an elder who underwent a process that’s much more primitive than the sort a modern endodontist (a root-canal and dental pain specialist) provides nowadays.
This declaration was uttered to me recently, with my only knowledge of what to expect being unsettling stories from a newsroom co-worker in the ’90s. Before my root-canal diagnosis, I’d had only three cavities in my life, the repair of which went smoothly (I wore braces, too, but that’s an ortho story, not an endo story, with its own myths and legends to sort through).
According to the American Association of Endodontists, treatment is necessary when the soft tissue inside a tooth’s root canal becomes inflamed or infected. The inflammation or infection can have all sorts of causes such as deep decay, repeated dental procedures on the tooth, or a crack or chip in the tooth.
We’re not advocating self-diagnosis here, but you might be in the market for an endodontist if you feel sensitivity or pain while chewing or biting, an unsettling awareness of hot and cold, swollen and tender gums, or darkening of the gums. Go see your regular dentist first. They’ll tell you what you need to do.
It’s not a procedure that lends itself to being put off for any length of time. Treatment involves removing the inflamed or infected pulp, a careful cleaning and shaping of the inside of the root canal, followed by filling and sealing the space. After that the patient returns to a general-practice dentist, who places a crown or other restoration on the tooth to restore it to full function.
Evidence of root canals goes back to the third century BC, when Romans used primitive forms of dental crowns and dentures—they might not have known much about bacteria, but they knew that whatever was inside a painful tooth needed to be released. A similar procedure to a modern root canal was first performed in 1838, when Washington, D.C., dentist Edwin Maynard used watch-repair tools to open a tooth and release the bacteria inside it.
The main difference now: Anesthetics. Good ones.
Remember when you were a kid and needed to have a cavity filled? The dentist injected Novocaine into your inner cheek or gum. It hurt.
Now they use lidocaine, which works better and longer, preceded by a superfast-acting numbing gel, so you don’t feel the needle like you did back then. With a root canal, the endodontist still might have to drill and scrape and chip away at the troublesome innards of the tooth—the whir of drills is just as unnerving as ever—but if all goes according to plan, you won’t feel a thing. It wears off relatively quickly, and doesn’t produce the drooling and slurred speech that can accompany the use of Novocaine.
My ultra-modern endodontist’s office looks like a miniature intergalactic space vehicle, with gleaming technology and instruments that make a regular dentist’s office look like a farrier’s stable. My endodontist even has a TV mounted in the ceiling, so a nearly prone patient can watch soothing images of sheep roaming in mountain meadows; it’s much more distracting than, say, a TV blasting Fox News from a corner in the room where it can’t be seen.
He wore an immaculate white coat over a stylish dress shirt and tie. He exhibited the ability to conduct a one-sided conversation, complete with humor, and checked regularly to make sure I was doing OK (I was). He explained just enough about what he was doing to keep me engaged without scaring the hell out of me.
And then, when about 90 minutes later I was released into a reception area with handsomely spare contemporary furniture, and intriguing modern art, I was informed by his office receptionist that my bill was … hefty.
“What about my insurance?” I asked as I shakily inserted a credit card into a payment processor. “We will submit your claim to your insurance company, and they will reimburse you,” she said with a hint of a Teutonic accent that suited her perfectly coiffed hair and elegantly office-appropriate dress.
It all went well, although I’m not anxious to have to undergo the procedure again. At least the payment processor didn’t present me with options for leaving a tip.