Do I really need Root Canal?

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Do you live in South Jersey and researching Root Canal in South Jersey?

Then, you should check this Article!  Based on the questions we received from our patients for past 5 years, we wrote this article to provide information regarding root canal treatment.

Call us at 856-829-8668 if you have any question. Please feel free to share this article.


What is Root Canal Treatment?


As you can see from the picture, there is an empty space inside the tooth. That space is filled with blood vessels and nerves. We call them “pulp tissue.” Your tooth is actually alive! The pulp tissue should stay alive and free from disease or dental decay.


If the decay gets inside the pulp tissue or you traumatize the tooth for whatever reasons, the pulp tissue gets inflamed and eventually dies. When that happens, inflammation creates toothache. Also, dead pulp tissue creates infection, which creates pressure inside the tooth. Then you have a really bad toothache. Sometimes, the infection finds a way out from the tip of the root, that’s when you see swelling.

If that happens, you need root canal treatment. We need to clean out the pulp tissue and fill it with filling material.






How is Root Canal Treatment Done?





First, we need to make an opening from the top of tooth to get in to the pulp tissue. Then, we have to measure how long your root is inside the tooth. There is a machine that tells us where the tooth ends. We use cleaning instrument such as “files” by hand or handpiece.



We clean it, shape it, make it little bit wider, so we can clean better. Then we thoroughly rinse with cleaning solution and dry it. After we complete cleaning, we fill it with sealing material called “gutta percha.” We confirm with x ray before we finish.



Why does dentist recommend root canal? It doesn’t even hurt!




Sometimes, patients come in with a large hole in the tooth and they just want to “fill” it especially when it’s not hurting. Some patients are very against the root canal procedure probably because either they had bad experience in the past or heard bad things from a few friends. Or maybe they heard that it’s expensive and dentists just want to make money out of it.





When there is a toothache, patient can easily accept that there’s a problem. There is not much to argue in this case. When there is a medium-large size dental decay that is close to the pulp tissue, it does not hurt at all sometimes. However, there’s a good chance of exposing the pulp tissue if dentist remove all decayed tooth structure because dentist should not leave decayed tooth underneath new filling. Whether the pulp issue is exposed or not depends on the size of decay patients have, not on dentist’s skill. It is very hard to expose the pulp tissue by mistake.


Patients can also have sensitivity after routine filling if the size of decay was large. The sensitivity can go away after a few days or may get worse over time. It if gets worse over time, it means that the pulp tissue had been traumatized slowly by the decay and dentist accelerated the progress of disease by doing dental work near it. Patients were going to need root canal treatment anyway.



My dentist told me that I need root canal but other dentist told me I don’t.

Who’s right???


There can be difference of opinions when diagnosis can be both. Some dentists want to try to put a filling on large decay and see how it goes. Some dentists do not want to take chance of having severe toothache for patients and recommend root canal treatment from the start.


Also, there can be “prophylactic” root canal treatment. When we do major restorative work such as bridge crowns or crowns, we do not want the tooth to have problems right after we finish all the work. When you come in for examination, Dr. Huh can discuss options with you during treatment plan visit regarding doing the root canal treatment first to prevent that from happening.



Why is root canal so expensive?



It is simply because it is time consuming and technique sensitive. We have to clean where we cannot see relying on tactile sensation and guidance of equipment. And there is lots of variations on shape of root canal spaces. We cannot rush it, otherwise we may end up having broken instruments inside the tooth or blocking the way toward the bottom of the root.







Also, the materials used to clean root canal space are expensive. Some dentists re-use cleaning instruments after sterilizing them to reduce the cost. It is OK to do so, but it increases chance of instrument’s breaking inside the tooth. We only use single use instruments here at Rapha Dental.




Does root canal work?


Some article says that success rate is 86%, some article says that the success rate is 97%. There are many published papers out there.

However, there are a lot of factors that can be variable such as the skill set of dentists who performs root canal, patient compliance, materials and so on.


Dentistry is not an exact science, especially root canal. Unlike filling, crowns, extractions when dentists can actually see everything, the root canal treatment is done where it is not visible. And the shape of root canal space inside the root is not cylinder shape, it varies. Even perfectly done root canal space does not get cleaned 100%, it’s much less than that.


That does not mean that we should not do the root canal treatment. Root Canal Treatments have been done for years in dentistry and is a great way to save the tooth.

We just need to make sure that we follow proper protocols.



Does root canal hurt?




No, it should not. It “releases” the pain. We do not want to hurt you, we want to help you with pain. However, patients can have hard time getting numb when there’s active infection around the tooth. This is probably why a lot of people heard that root canal treatment hurts.





If there’s infection and we are trying to do root canal treatment on you, you can experience discomfort. Sometimes, we recommend patients to take antibiotic first to control the infection before we do the procedure.





Should I just get an Implant instead of Root Canal?


We do not recommend it.  Your natural tooth is always better than artificial titanium implant. After the root canal, you still have your own tooth. There is ligament tissue called “periodontal ligament” that holds the tooth in your bone. That’s how you feel chewing sensation when you eat food. If you do the root canal, you will still feel the chewing sensation. You do not have that with implant.


Also, Implant is not perfect, either and they fail just like root canal. Success for the implant is high and it is also commonly done procedure but nothing is perfect. When Implant fails, it gets complicated because you ran out of other options. You have to remove the implant and pack bone, wait 6 months, then place implant again. It also takes more time to get a tooth on the implant, because you have to wait 4~6 months until implant becomes part of your body before we place a tooth on it. We recommend dental Implant over Root Canal treatment as a last resort when it is absolutely necessary.



Should I just take the tooth out instead of Root Canal?






If you cannot afford root canal and crown treatment and need to be out of pain, that would be a last option. However, we do not recommend it. After removing a tooth, other teeth around that area will move toward the missing tooth and eventually ruin your entire bite. As a result, you will have problem with the entire mouth and it will cost more to repair everything.


Why some dentists do root canal and others don’t?


There are specialist dentists who specialized in doing root canal treatment only. They are called “Endodontist.” General or Family dentists are allowed to perform root canal treatment as well. Root Canal treatment is technique sensitive procedure, some general dentists decided that it would be better to refer patients to specialists rather than trying to master the skills themselves. Some general dentists decided to learn and perform the procedure, it is based on dentist’s preference and treatment philosophy.


Dr. Huh believes that performing root canal treatment is necessary to help patients in pain and treat patient as a whole. So, he learned the root canal treatment in depth to master the skills. However, there are cases that even Dr. Huh needs to refer patients to specialists.



Why do I need to go to specialist?


Dr. Huh had completed more than a thousand root canal treatment. However, there are cases that require more advanced training and different instruments. Here are some examples.




Also, Dr. Huh does not re-do Root Canal Treatment that was done by other dentists.

There must be a reason why the root canal treatment was failed on first place, so he believes that it would be best for patients to see specialist.





We found out that some people looking for Root Canal in South Jersey, do not want to go to the Specialist. When we refer patients to Endodontists, patients try to go to other general dentists sometimes.


They hope to find somebody who’s willing to do the root canal treatment without seeing specialist to save the cost. Then we end up seeing failed or poorly done root canal on patients or patients eventually end up being referred to specialist.






If you need the root canal that someone like Dr. Huh cannot perform, you really need to go to specialist. Even going to the specialist that comes to general dentist office occasionally is not good enough. You need to go to the specialist office where proper equipment and instrument are in place such as endodontic dental microscope (It is not a magnifying lenses on glasses, its on the photo above) that can actually see inside the root canal space. Otherwise, you might as well consider other options like extraction and dental implant.




Do I really have to get a crown after the root canal?


Yes, root canal space needs to be sealed after the treatment. Otherwise, it will start leaking over time and will get contaminated again. Then, you will have to go to specialist to re do the root canal treatment.


Also, tooth becomes very fragile after removing all the decay and making a large hole to do the root canal treatment. Without crown, the tooth may fracture.

There are some occasions that the teeth do not need the crowns. It is for the front tooth where patients did not have much decay. Dr. Huh will tell you after the examination.



Do you need Root Canal in South Jersey?


We recommend you to make an appointment at Rapha Dental to have consultation with Dr. Huh. We are located in Cinnaminson, conveniently located on Route 130. Call us today at 856-829-8668 if you have any question. We look forward to meeting with you.