Root canals might not sound too exciting, but can be really beneficial. After all, they’re not as bad as many think. We polled the industry and here are six replies from those in the know on when a root canal should be considered.
Ronald Goldstein, DDS
Dr. Ronald E. Goldstein is commonly referred to as the “father of modern cosmetic dentistry”. He is one of the managing partners of Goldstein, Garber and Salama (GG&S).
A root canal should be considered when a patient is having a throbbing pain localized to a specific tooth especially if the x-ray shows an abscess at the end of the or one of the roots. There also should be sufficient bone to continue supporting the tooth. However, if the crown of the tooth is severely damage and there is too little bone to continue supporting the tooth then extraction and replacement with an implant or a fixed bridge should be considered.
Some of the other reasons for having a root canal are as follows:
- If a patient has had a full crown placed on the tooth that fractures at the gum line even if no pain (the pulp canal could have been receded into the root) then a root canal treatment followed by a post buildup of the underlying tooth structure can result in saving the patient’s tooth…and at times I have found it possible to even use the patient’s own previous crown that broke off, removing the remaining tooth structure inside the crown and retrofitting it with glass ionomer cement in order to save the patient’s tooth. This also holds true if the tooth itself has fractured and not enough tooth structure to build it up…then performing a root canal and post can also save the tooth after placing a crown on top of the post.
- Acute tooth wear….sometimes the teeth have suffered so much from advanced wear (bruxism) to the extent they are worn down to the gum line and again, a root canal followed by post buildup (either direct or indirect) and then a full crown can build back the arch especially when multiple teeth are involved.
- Traumatic injury….could be from an auto accident or even a fight where a person was severely injured in the fight with teeth knocked out…if the person or friend can find the knocked out teeth and get the person to a dentist within the hour it is possible to replace the teeth into the socket and bond them to each other as an interim procedure…later if the teeth require it then root canal therapy can be done. The safest place to keep the tooth until getting the patient to the dentist is in the actual patient’s mouth.
- Patients who have medical problems and the physician will not allow surgery (required to place the implant)…then root canal therapy is the best option. Just did this last year with good results.
- Economics: Sometimes it is less expensive to save the actual tooth with a root canal rather than extraction and implant followed by a full crown.