I’ve just come back from my root canal treatment and wanted to blog my thoughts on it and to perhaps encourage anyone with any reservations with it to give it a go. I’ve taken the conscious decision not to include any images on this blog as, for me, the images are always the worst (and most unnecessary) part.
I am using Animated Teeth to get the step-by-step breakdown involved in the procedure (I don’t know about anyone else, but I was much calmer by knowing everything including the ‘science’!). NHS Choices also have some good resources on the subject
So here we go… no images, no scare tactics, simply my experience.
Lets start at the very beginning (a very good place to start, so said Julie Andrews).
I have had a fear of dentists for many a year. My first recollection of a negative experience with dental issues was when, on my eighth birthday, I ate a chewy lolly and ripped a filling out of my mouth. As an eight year old, that was terrifying! My mother was rather scared of the dentist too I think, and so negativity towards dentistry has been with me pretty much all my life. I also have hypo-plastic teeth, which makes them weaker than most other peoples and more susceptible to problems. Common sense dictates that I really can’t afford to be scared of the dentist!
Apart from a short-lived stint a few years ago, I have always been to a dentist only in times of emergency, so it is no surprise that fear has been able to manifest throughout my young-adult life.
When I was fifteen, one morning a large slice of one of my molars simply fell out (about a quarter of the visible tooth). Of course, I have had a temporary filling on it over this time, however I have never had it properly looked at.
Getting my root canal done today was the culmination of an process that started nearly 9 years ago, and has been causing me a whole manner of problems ever since. I don’t think many people, myself included yet, realise how much of an ‘event’ this is for me.
So, enough background, now for the experience. I have taken excerpts of explanation from ‘Animated Teeth’ and then blogged my experience of it underneath. I hope that this is of use to some people, as it REALLY IS NOWHERE NEAR AS BAD AS IT’S PORTRAYED! (lots of people trying to show bravado and drum it all up in my opinion!)
DAY ONE (yesterday)
1. Numbing Up
If the tooth is dead, your dentist may not numb you. Mine was still very much alive and kicking (n.b. I now feel guilty for killing it!) and so they numbed me up. I would say that this was the worst bit of all of Day 1 as they are injecting right into the nerves around the tooth, but really just a minor niggle.
2. Gaining access to the nerve area of the tooth.
As a starting point for the process of performing your root canal treatment your dentist must first gain access to that area inside the tooth where the nerve tissue resides. This is accomplished by using a dental drill and making an access hole that extends down to the pulp chamber of the tooth. On posterior teeth this hole is made on the chewing surface of the tooth. On front teeth the access hole is made on the tooth’s backside.
In my case, this involved removing the old temporary filling, and tidying up the existing cavity. In theory, this is no worse than getting a filling, and with the anaesthetic, I didn’t feel anything really. The drill doesn’t hurt, there’s not really any pressure on the tooth, and personally I found it quite relaxing. We all fear the drill, right? Do you still fear it when you’re lying in the chair and you’re completely fine and not freaking out?
3. Cleaning the tooth out.
The next step of the root canal treatment process is for your dentist to clean out the interior of your tooth (the pulp chamber and all root canals). As we discussed previously, this cleaning process removes any bacteria, toxins, nerve tissue, and related debris that are harbored inside your tooth.
For the most part the cleaning process is accomplished by way of using “root canal files” and copious irrigation. Root canal files look like straight pins but on closer inspection you would find that their surface is rough, not smooth. These instruments literally are files and are used as such. Your dentist will work a series of root canal files, each of increasing diameter, up and down in your tooth while simultaneously using a twisting motion. This action will scrape and scrub the sides of the tooth’s root canal(s), thus cleaning it out.
As an additional part of the cleaning process, your dentist will wash your tooth out periodically (“irrigate” the tooth) so to help flush away any debris that is present. Traditionally, a number of different solutions have been used for this purpose. Now day’s, sodium hypochlorite (bleach, Clorox) is commonly used. An added benefit of bleach is that it is a disinfectant.
The goal is for your dentist to clean the entire length of the tooth’s root canal(s), but not beyond. As a means of determining the length of a canal your dentist may place a root canal file in your tooth and then take an x-ray. Once developed the x-ray picture will reveal if the file extends the full length of the canal or not. Alternatively, your dentist may have an electronic device that can make this same determination when it is touched to a file that has been positioned in a canal.
Traditionally the filing action of root canal files has been created by way of the dentist manipulating them with their fingers. There are, however, special dental drills (dental drills are called “handpieces”) which can hold and twist these files, and your dentist may choose to use one. As a variation on this same theme, there is yet another type of dental handpiece that produces a cleaning motion by way of holding a root canal file and vibrating it vigorously.
Granted, this bit sounds gross, and in a way, it is kinda, but again, definitely not as bad as it sounds!
YES, you will ‘feel’ some friction inside your mouth, YES, it does feel a little weird, though I wouldn’t go as far as to say unpleasant, however IT DOES NOT HURT! It does seem a little repetitive, about 15 minutes of my 30 minute appointment was spent doing at this. It is important, however, for the area to be clean. If not, the root canal will most certainly fail due to the presence of bacteria, and you will have just spent a whole lot of money and time on nothing. 15 minutes of dental grinning and bearing it is worth it if it means avoiding extraction…right?
At this point, my thirty minutes was up. My dentist X-ray-ed progress and put a temporary filling onto the tooth and told me to make another thirty minute appointment. Mine had to be made for the next day as my dentist is on vacation next week, however a dentist will typically ask you to return in a week to ensure that the area has remained bacteria free.
Day Two (this afternoon; about 90 minutes ago).
I went back today and there was not really any kerfuffle, straight in to the surgery, the usual how do you dos and nervous jokes / checks for surgery staff sobriety, and then right into the dental surgery.
This time, there was no numbing up (which, at the time, scared me witless!). Having done everything now, and looking back, it really wasn’t necessary and it is remarkable how much a tooth can take without feeling pain (plus the fact that your tooth is now dead…of course!).
Removing the temporary filling was a bit ‘yuk’ and I was still rather scared at this point. Personally, this stemmed from my experiences as a child with the extraction of some rather stubborn hypo-plastic teeth, and in theory was no worse than when they removed my old temporary filling the prior day. The difference was that she tried to pull this one out as opposed to drilling it out as she had done the day previously (presumably so as not to undo the previous days hard work!).
4) Placing the root canal filling material.
Once the tooth has been thoroughly cleaned your dentist can fill in and seal up its interior by way of placing root canal filling material. Sometimes a dentist will want to place the filling material the same day that they have cleaned the tooth out. Other times a dentist might feel that it is best to wait about a week before completing the root canal process. In the latter case your dentist will place a temporary filling in your tooth so to keep contaminates out during the time period between your appointments.
What root canal filling material is used?
The most common root canal filling material being used by dentists now days is a rubber compound called gutta percha. Guttapercha comes in preformed cones that are sized to match the files which have been used to clean out the inside of the tooth.
A root canal sealer (a paste) is usually used in conjunction with gutta percha cones. It is either applied to the cone’s surface before the cone is placed into the tooth’s root canal, or else applied inside the root canal itself before the gutta percha cone is positioned. Sometimes several cones of gutta percha need to be placed before the interior of the tooth has been filled adequately.
At times a dentist will warm the gutta percha cones (either before or after they are placed into the tooth) so they become softened. This allows the gutta percha to more closely adapt to the precise shape of the interior of the tooth.
As an alternative to the use of preformed cones, sometimes a dentist will place the gutta percha via the use of a gutta percha “gun.” This apparatus is somewhat similar to a hot glue gun. It warms a tube of gutta percha so the material is very soft. The gutta percha is then squeezed out into the tooth.
After your dentist has finished the filling and sealing aspect of the root canal process they will place a filling in the access hole they created at the beginning of your treatment. The individual steps of performing the root canal treatment have now been completed.
My dentist used the ‘gun’ to fill the root canal with the gutta percha which wasn’t particularly unpleasant and I didn’t really feel anything.
I am also due to have a crown placed over my tooth (which is fairly common I believe) due to the fact that my tooth is now rather brittle following treatment (as effectively, you have killed off the tooth and the supply of nutrients to it).
Placing a dental crown on a tooth that has had root canal treatment.
Crowns are dental restorations that cup over the portion of a tooth that lies above the gum line. People sometimes refer to dental crowns as “caps.” Dental crowns can either be gold or else have a porcelain surface so they look white like a tooth’s neighboring teeth.
A dentist will use a dental crown as a means of improving the appearance of a tooth, restoring a broken tooth to its original shape, and/or strengthening a tooth. Additionally, and very importantly, dental crowns create an excellent seal over a tooth. By this we mean that a crown cemented in place provides a barrier that is helpful in preventing bacteria and contaminates from seeping back into those inner aspects of a tooth where the root canal treatment has been performed. After a tooth has had its root canal treatment completed, any or all of these qualities which a crown can provide may be needed.
What steps are needed to make a dental crown?
Before a dental crown can be placed the tooth must first be trimmed so it is tapered in shape. This tapered aspect of the tooth will extend up into the dental crown’s center and is a very important factor in the crown’s stability. After the needed shape has been achieved your dentist will take an impression of the tooth, which in turn is sent to a dental laboratory which will create the crown. Once the dental lab has completed your crown your dentist will cement it in place.
Being completely honest, the worst part of day two was the awful cast that they put in your mouth in order to take an imprint of the area. It is like biting into a really sticky treacle toffee pudding and then, after a minute or so, being asked to try and open your mouth! Due to the sweet incident that I mentioned at the start of this post, I really really was worried! Perhaps this won’t rub others up the way it rubbed me up; I think my experience was mainly based on the prior incident and the hyperbolic fear that I’ve had of sticky foods since! That, and the fact that I have not eaten on that side of my mouth for nigh on nine years! Needless to say, I shouldn’t have been worried and it was all fine in the end (though typically I had to do it twice… UGH!).
So, that’s me.
I felt no pain throughout the process, have not had any adverse effects to treatment and despite being a huge scaredy cat, I am very very proud of myself. I feel that I have broken through several of my personal barriers and now have a positive image of dentistry as a whole.
I’m due back in two weeks to get my crown (and I pray that it’s not going to be made by Elizabeth Duke [who do Argos jewellery] heh!), and I’m sure that it’ll all go well. It’s only a twenty minute appointment, and it’s custom made, so should fit nicely. I’ve gone for a gold one as it’s right at the back of my mouth; plus it’s more sturdy than a ceramic white one, which would be unsuitable for a molar.
I hope that this helps anyone who needs root canal and is worried about it. Believe me, I’ve been there and thought all sorts for the last nine years, however with a little bit of research (well, I am very geeky!) and skirting a little too closely to a near-life-threatening dental infection, I have come to learn that there are far worse things in life to fear than root canal treatment.
Of course, there will always be people who have bad experiences of root canal treatment. It’s a fact of life and obviously dependant on a whole host of variables. However, in the same vein, I worry that if I go to the supermarket that I may slip on a wet floor… does that stop me from going? At absolute worst case scenario, if something goes wrong, you’re already in good hands with the one person in the world who is able to help you; your dentist! (or maybe his/her friendly dental friend if (s)he’s the problem! :P)
Happy to answer any questions on my experience that anyone has via the comments section too – though bear in mind I’m a 23 year old lad who works in accounting… so go easy on me! 😛 If you have a dentist, you may also wish to try and see if they can sit down with you and talk you through it first before commencing treatment.