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Toothache: Root canals don’t really hurt

Toothache: Root canals don’t really hurt

  • November 2, 2021

Do you know what’s going on in your teeth? I had never thought about it until April when one of my molars began to revolt and my teeth became the only thing I could think of. As anyone who has been in this position knows the strange discomfort that the word brings Toothache does not imply the incredible misery that toothache can cause; Sometimes the pain was so bad that I found it difficult to use my laptop.

After a week of inconclusive x-rays, a futile round of antibiotics, and a handful of an Internet-recommended ibuprofen-acetaminophen cocktail, I finally went to see an endodontist – a specialist who treats toothache – to face my tormentor. I broke a tooth that the endodontist was finally able to locate with a CT scan. Moments later I was shot up with novocaine, and after a few minutes of drilling, the endodontist asked me if I wanted to see the source of all my agony. “Yes,” I said, mostly through my nose. He held up his tweezers, and at the end dangled what looked like a tiny, leafless tree, bathed in the bright red of fresh blood. It looked too perfect, its edges too discreet, like something made for a movie rather than an ordinary blob of human entrails.

None of this went as I expected. When a tooth cracks, the often recommended treatment is one of the most feared procedures in modern medicine: a root canal so known to be terrible that its name has long been a popular metaphor for a long tour of the agony itself. That was what I was sitting in the chair that day – drilling out my tooth and scooping out its nerves and blood vessels. After the CT scan, I pleaded with the specialist to take root immediately, feeling the courage of utter despair instead of letting me come back the next day. That’s when it got strange. The procedure was quick, and it was painless enough that at the sight of the newly removed piece of my face I gave a startled approval. When the endodontist told me we were all done, I thought he might be kidding – for years pop culture had hardened me for an experience that apparently didn’t exist anymore. A few hours later, when the local anesthesia wore off, I ate dinner as if nothing had happened.

My story is not an unusual one from the past year and a half. A combination of intense stress, new medication, and a previously mild predisposition to grind teeth while sleeping made me feel like many other Americans in what appeared to be an a Pandemic Toothcracker Bonanza. According to a February poll from the American Dental Association, nearly two-thirds of dentists reported seeing more cracked teeth in their offices than before during the pandemic, and 71 percent reported higher rates of bruxism, the involuntary grinding of teeth that can lead to cracking. This is what my endodontist said: The root canal business was booming.

Asgeir Sigurdsson, the chairman of the NYU Department of Endodontics, told me that this is still the case six months after my procedure. Not only are people stressed, but many people whose problems would have been noticed during a routine visit in 2020 have skipped their checkups for financial reasons or for fear of COVID-19 infection. Then, as Americans started vaccinating, dentists’ schedules filled quickly, which may have helped to further deter some patients from getting a cleaning on the calendar.

Checkups are easy to postpone – even the simplest dental care is expensive and at best physically uncomfortable, and about a third of American adults don’t have insurance to cover some of them. Chances are that if you undergo a cleaning, you will be told that you will need an expensive, painful procedure, and there are some unscrupulous doctors who take advantage of patients’ inability to assess their own oral health.

People who need a root canal usually know they need it or know they need it some. Cracks, infections and severe rot are clearly noticeable. Teeth are extremely sensitive; Each tooth has 1,500 to 2,000 nerve fibers in its core, according to Sigurdsson, and most of them are some kind of receptor that only feels pain. (If you’ve never considered the total absence of dental pleasure in your life, then it’s fine.) It may come as no surprise that at some point in the not-too-distant past you’ve got all of these nerve fibers drawn from your tooth hurts very much– enough to create an understanding of the root canal that endures well beyond its own accuracy. Thank God for advances in medicine and technology.

Aside from the fact that there hasn’t been a lot of significant advances in root canals. Sigurdsson has been doing the procedure on a regular basis for 30 years, and it’s basically the same as it was when he first learned it in dental school. “What I think maybe has changed more is the way we teach our students to deal with it,” he said. “In order to have more empathy for your patient, wait until the anesthesia has really set in and then give additional anesthetics if necessary.” If you had a root canal treatment a few decades ago and the pain has marked you for a lifetime, it probably didn’t have to be – your dentist or endodontist might just be an old school guy who rubs some dirt on it doesn’t really care if it was.

None of this means that treating every single patient is now pain-free, even if everything is done correctly. The novocaine injections are quite uncomfortable in themselves and can be terrifying for patients who fear needles. Some patients with additional complications like severe nerve inflammation do not fully respond to the available anesthetics, noted Sigurdsson. And some evidence suggests that people with intense fear of their procedure are more difficult to numb, perhaps because their fight-or-flight response or some other neurochemical reaction is inhibiting the effectiveness of the anesthetic. But, Sigurdsson promised me, the majority of his patients would be “pleasantly surprised”.

If for decades dental students have been taught to completely anesthetize their root canal patients rather than diving directly into their pulp, why does the procedure’s reputation persist? It could be because, fortunately, for most people, root canals are rare. Many people who need more than one over the course of their lives put decades between procedures, not knowing that their next one won’t be that bad. People who have never had a root canal may remember that their parents complained about a particularly bad canal.

Or millions of people have just been misled because they grew up in the 1990s. Corresponding Google ngramTracking the popularity of words in books and newspapers over time, the phrase was particularly ubiquitous in the media this decade. Joking about root canals goes well with the comedy of the time about airplane food; a result of His field even reveals the ghost of Jerry’s future root canal and the seriousness of the procedure as the reason he struggles with Elaine. But as more educated dentists enter the field and more people have uncomfortable but uneventful root canals, the same Google data shows that the procedure’s ability to at least metaphorically instill fear in our hearts may deteriorate. 2020s comedians have to find another way to tell you how excruciating it is to go to the DMV.


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