The mere sound of the term “root canal” has been long associated with a long, drawn out painful procedure. It has been the butt of many jokes as well. There are plenty of euphemisms which say that something is more painful than a root canal or I'd rather have a root canal than do “x.”

I would like to take a few minutes to debunk the myth of the painful root canal and show how technology has made this procedure one that is simple, easy and predictable.

Let's start with why a tooth may need root canal therapy. The tooth is a living piece of body tissue that is made up of several layers as well as fibers which hold it in the bone. Every tooth has a hollow space or canal in the center. This hollow space is filled with a tissue called the pulp. This pulp is made up mainly of three components: the artery, the vein and the nerve. These three things exit the bottom of the root of the tooth and enter the bone.

A tooth needs root canal therapy when this pulp tissue dies off and the hollow canal becomes infected with bacteria. The source of the bacteria comes from several sources. Be aware that the middle layer of the tooth or the dentin contains many microscopic holes in it where in a healthy tooth projections of the pulp tissue extend. The most common reason for a tooth needing root canal therapy is that bacteria gets in to the hollow center of the tooth through these holes in the dentin. These bacteria are the same bacteria that cause tooth decay.

Once it gets into the pulp tissue and kills the pulp off there is now no more blood supply to that canal space. These same bacteria can then leak out the end of the tooth into the bone. At this point the only way to get rid of these bacteria in the tooth is either root canal therapy or tooth extraction.

If you followed that short lesson in dental anatomy and biology you may be wondering where the pain comes from. I mentioned just above that the bacteria kills off the pulp of the tooth which contains the nerve. When the bacteria leaks out the end of the tooth it puts pressure on the tissue that holds the tooth in the bone which is loaded with nerve receptors.

So what are the differences between root canal therapy of years gone by and today's treatments?

For those of you who have had this procedure done, you will notice that the whole thing is usually done in one visit. It used to be that the treatment would take three or four visits and that is without the final restoration. It was a common problem for the tooth to get reinfected during the interim time between visits thus causing pain.

It is also commonplace for the dentist to use some sort of magnification to make sure all of the tiny tunnels or canals are located and treated. I prefer to use a surgical microscope.

You might think I'm nuts so feel free to ask either Kathleen or Beth, my two dental assistants, but root canal therapy is a procedure that is most likely for patients to fall asleep during. The painful aspect can be attended to with new modern anesthetics and also new techniques for administering these anesthetics right into the bone. The filling materials are also greatly improved so that the risk of failure is extremely low. Rather than little points of silver that were cemented in place, new modern cements and bonded fillings are the norm to insure that no bacteria can remain or repopulate the canal spaces.

Hopefully if your dentist informs you that it would be best to have root canal therapy performed on a tooth you can now be assured that the process will be simple and easy on you the patient.

Dr. Michael K. Keating, DDS, is a dentist in Auburn and can be reached at 252-7278 or e-mail him at DrMike@FingerLakesSmiles.com