If you’re experiencing serious pain in your teeth, you may wonder if you need a root canal. But that is not always the case.
In a root canal, a dentist removes the dental nerve, known as the pulp, and fills it with an inert material called gutta percha. After doing this, the dentist must restore it with a post and a crown. The restoration strengthens the tooth and prevent cracks and fractures later.
Root canals can be helpful in treating a painful or dead tooth and in avoiding extraction. But it’s important to be aware that a tooth with constant or severe pain doesn’t necessarily need a root canal. Other conditions such as sinus infections, myofascial pain, neurovascular disorders, neuralgias, neuritis, neuropathy and neuromas can also simulate tooth pain. Even a heart attack can cause pain in the teeth of the lower jaw.
Root canals also come with risk you must consider with your dentist. A tooth is an “open” biological system that interacts with the body. Anything that is placed in the tooth, including the materials used in a root canal, may eventually find its way into the body and may interact with a susceptible cell or organ. Beyond this, the seal at the apex, or tip, of the tooth isn’t a true hermetic seal. If your resistance is low, a root canal may provide passage for bacteria and bacterial toxins.
Your dentist will need to do a proper diagnosis before recommending root canal or other treatment. In evaluating whether a root canal is necessary, your dentist will consider a couple of key questions:
- Is it possible to restore the tooth at all?
- Can you achieve good results with a root canal treated tooth?
At that point, the dentist has two main options to recommend: perform a root canal or extract the tooth. If a patient is not sure, the dentists can remove the nerve (in a procedure known as a pulpectomy) to reduce pain and give the patient more time to decide.
If a root canal is not the right option for you, your dentist will likely recommend surgical and tooth replacement options. Surgical options include tooth extraction and bone grafting to improve bone loss and prevent bone healing.
If you decide to go ahead with a tooth extraction, it is possible to do a bridge, where your dentist joins together three or more crowns together to “bridge” a missing space; use implants made of titanium or zirconium; or use removable dentures.
After an extraction, many patients do well with zirconium implants, also known as ceramic zirconia implants, which are surgically placed in the jawbone. Benefits include a natural appearance, comfortable chewing and ease of maintenance; durability and the ability to use them without the involvement of adjacent teeth.
There are some downsides, however. Implants are invasive due to implantation into the bone. There is a higher failure rate among patients who have high dental stress, including people who clench or grind their teeth. Smokers, diabetics, people with autoimmune diseases and those with sinuses and nerves close to surgical sites may have contraindications. Beyond this, a removable appliance must be used until the implant restoration is complete. But every patient is different, and many patients find dental implants are very successful for them.
Your best bet: Make time to talk with your dentist. Every patient is an individual, and treatment has to be customized to your situation.