The Truth About Root Canals (From Yahoo CN)

Behind the expression of “rather having a root canal” is the truth about the operation. here is actual first-hand testimony of one such ordeal…

Editor’s Note:  This was originally an article I wrote in Yahoo Contributor Network, back when it was still called “Associated Press” (2008).  I recently received a message that said they were shutting down Yahoo CN, and removing all the posts I made there.  This was the only post with active readers, so I thought I’d bring the article here.   I’m hoping it’ll have as many readers as my article on Globe Tattoo; or at least some readers.

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There is a common expression people use when faced with the choice of doing something they strongly are opposed to: “I’d sooner have a root canal”. This is similar to “having teeth pulled out”, but the root canal has gained more psychological potency to the point that it has become more terrifying than the pulling of teeth.

To those that have never had a root canal, there have been various contentions–some say that it is as nightmarish as people might imagine, and that the expression does speak for the truth of it. Others will argue that the root canal cannot possibly be painful, as anesthetics injected into the nerves would kill any sensation from them.

It was in my fortune to have experienced a root canal. There were many explanations to how the need for it emerged-steady decay of the tooth, consequences of an impacted tooth, and simple biting too hard on food-nevertheless, the reality of the need for it existed. I will thus impart what I do know to dissipate the speculations, though I will explain in as simple a term as possible, as I do not have knowledge of the technical words.

Day 1

The people are divided on two camps of thought-the ones that say root canals are painfully terrifying, and those that say there is no pain, since the nerves would be deadened byanesthetics. The root canal begins with the application of the anesthetic. Local anesthesia is first applied to the part where the general anesthetic would be applied. After a few minutes, the anesthetic is injected.

The tooth is then drilled in dead center. The anesthetic would have done its job well, so little to no pain would be felt while the drilling is done. It will be cleaned by a few sprays. Having opened the tooth for the cleaning to begin, the anesthetic begins to lose its appeal.

I’d have to explain, at this point: the anesthetic does not completely deaden the nerve, but merely weakens the pain receptors. At moments of intensity, the point is not that the pain will be absent, but that thepain can be endured, or willed off. In the case of root canals, the actual cleaning is painful because the operation focuses on the nerve-that is, the killing of it.

The pain starts out as endurable, and that only anticipation will magnify. The level of pain, however, rises as the cleaning goes deeper and deeper into the tooth. When it reaches that point of its highest pain, it really does unsettle and would inspire uncontrolled outbursts. However, the logic of this highest pain is this: it is the same pain as having a tooth pulled out. It is not less painful, not more painful, but just the same.

This cleaning continues in earnest, with varying, elevating levels of pain, and in my experience the dentist would take X-rays of the tooth to see its progress. Afterwards, when the cleaning has been largely done, the dentist will apply several chunks of paste-like substance to fill in the emptiness that was left in the tooth following the operation. The hole in the tooth is then temporarily taped over… but it is applied in such a way as it would not easily be taken out.

Day 2-3

Adding to the psychological effect of the pain itself is the number of sessions that would be taken up for the root canal. This would entail repeated days of pain, even if, as described, they are only comparably to tooth being pulled off.

In truth, this is only true as far as the second day. While the first day was indeed harrowing with its scales of pain, as the days progress the nerves are really deadened as to leave little to no sensation of pain. Insofar as the number of sessions is concerned, the operations can be intervals of every other day, and by the fourth day every next week.

On the second day, the anesthetic was still needed. The level of pain, while still occasionally shooting up to near that high point of pain, will never reach that extreme point again and have practically stabilized to where it is not felt.

The second day begins where the first day left off; a few drills and a few scrapings will do away with the “pulp” that was left to fill the emptiness in the tooth. Further cleaning begins. Afterwards, it is sprayed and cleaned, and new pulps returned. The operations last little to 10-15 minutes.

On Day 3, the general anesthetic is not even applied. There are still pinching points of pain, but it is endurable and almost not felt. The dentist I went to used the strategy of placing a television in the operating room, to help the patient get distracted from the pain. This lasts 5-10 minutes. When the cleaning is done, pulp is re-administered and the patient is asked to return for the medicine for Day 4.

Day 4

The scraping of the tooth for the affected nerve veins from Day 1-3 comprises only Phase 1 of the root canal. Phase 2 officially begins on Day 4, where the dentist, having fully killed the tooth’s senses (or if not, then a few more scrapes would clean it off), will begin to clean the tooth of its pus and plaque. Let me emphasize the near painlessness of the operation by pointing out one simple fact: I did not need the application of anesthetic.

The pulp will be taken out. The drilling begins; you would be soon wondering why this particular drilling leaves moist or damp particles flying about. You begin to choke on your own spit. The dentist assures you that there is little to no pain because of the liquid; what liquid?-it is then that you’d have a chance to gargle with a nearby glass of water.

Gargling and washing would explain a lot. As you expel the water from your mouth, you would see that it is soon filled with blood. Blood that has probably been spilling out in droves as the drill probes further into your gums and teeth for the pus and plaque. There are moments of pain, though remember this is without anesthetic. This is a durable pain that is inherent in all minor dental operations. Most of the scare that is in Day 4 is the fear of the blood rather than any feeling of pain.

Gargling (while closing my eyes), eventually the teeth would be fully cleaned. That is the time when the doctor would clear for the second part of Phase 2: this is the application of the medicine. It is a green thing, which the dentist assures would give amount of pain on application. It is applied repeatedly, on the various internal parts of the tooth.

During the operation the dentist would get to stick your teeth into a paste-like mass which is the dental equivalent of sculpting clay. Both for the upper and lower jaw would be stuck to the two masses, which would soon shape into the contours of your mouth. This would help the dentist prepare to shape the temporary crown for the root-canaled tooth.

When all of this is done the tooth will then be sealed with pulp and prepared for the crowning. There is one week of observation, so technically the next day is actually the next week.

Day 5-6

Day 5 doesn’t last too long. The dentist clears the pulp; and cleans what’s left inside the tooth (if there still is). Then begins the tedious process of “dental sculpting”. From what the dentist has seen with the “teeth clay”, a preliminary crown is made and assessed for the root canal tooth. The essence of crowning follows the consequences of a root canal: in any severely decayed tooth, there are possibly two options: pull it out, or have a root canal. The root canal would clean the tooth of the pus, but leave it intact. The operation also leaves a critical problem: the tooth becomes structurally unsound and weaker, what with the nerves and the vessels providing calcium to its shell no longer there. Crowning, therefore, would shelter the weakened tooth.

A lot of fitting, grinding and biting are made to assess the competence of the new crown. When this has been done, the dentist will have made the proper adjustments for the temporary crown, and would ask you to come back for the next day for the fitting. It is on the next day that the crown will be applied; the tooth is crammed by a form of dental clamp. This is especially discomforting if your teeth are notoriously crammed into each other that so much that the bits that get between them and to the gums are difficult to extract and become “base of operations” for plaque.

The cramming is not painful. The temporary crown applied is not painful. And, after a few more adjustments, the crown is placed to replace an ordinary tooth, and left for another week for evaluation.

Day 7-Conclusion

The permanent, lifetime crown is ready. The clamp is done again, and a few last-minute adjustments. Bite and grind. Afterwards the dentist explains that for some days the tooth would feel “off”. It does and you know it’s not the same. The tooth initially feels crammed and as if an intruder exists within your company of teeth. Afterwards you get to adjust to it but you no longer have the capability of biting that hard into that part of your teeth.

That, then, is the summary of a root canal. It lasts multiple sessions, but only the nerve-killing is the painful part, and equal to the pulling of tooth. The rest of the sessions are painless and only psychologically intimidating. There is pain, but not the terrifying pain that is described by those who have not had it. It is exhausting an effort, but not altogether excruciatingly tortuous as it would be popularly attributed to.

Extractions on impacted, wisdom teeth, on the other hand, are a whole different ball game. And I have had the tragic misfortune of also needing two of these. To these I will next turn.

Editor’s Note:  I didn’t get that wisdom tooth pulled out.  Or teeth.  It’s 2014, and I wrote this back in 2008.   The wisdom teeth operation terrified me that I backed out at the last minute.  Life gets complicated as 1, I still need to have at least one pulled out; 2, the structure of my teeth is so pushed out; and 3, the wisdom tooth also rendered the tooth beside it in need of a root canal.  So, if I ever decide to get my wisdom tooth removed, I’ll write the ordeal here.  

Another Editor’s Note:  So apparently the pain is only visible if the tooth was rotting from within in the first place.  If otherwise the tooth just needs a “normal” root canal, there’s no pain