Do I need a Root Canal?

The day almost slipped by without my promised weekday entry. Whew.

Having worked on 3 cases of root canal therapy I feel that today we should talk along these lines.

First case was a long standing root canal. This tooth was restored more than 10 years ago. Over time the bacteria that originally caused this problem can slowly grow again. They can hide in accessory canals or have remained from first treatment. It is imperitive for the dentist to CLEAN the canals. It is not just enough to fit a filling material into the tooth, it is PARAMOUNT to clean the inside of the tooth.

The second was a tooth that we had treated and finished today. At times a tooth will be very "HOT" everything will bother it, hot, cold and pressure. This patient had a large cavity but no exposure of the nerve. Over time however

When a patient presents with acute symptoms it is easy to tell that a root canal is needed. However our last case today did not result in a root canal. This patient had pain but no sensitivity to hot or cold (at least nothing out of normal). After viewing his X-ray and finding no infection I proceeded to ask him questions. The tooth did not throb, it did not respond to hot or cold abnormally. It did not hurt when he bit down on a test instrument. It did hurt him in the morning of an appointment to his doctor's office. His concern for that appointment resulted in stress and that caused him to clench his teeth while asleep. A tooth needing root canal will throb and throb with pain. A tooth as this last patient hurt only at times and only when the patient was stressed. This tooth did NOT need a root canal. It needs protection from stress. I suppose going into the weekend should alleviate some stress...from his life and hopefully all of us needing to rest.