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Ask the Dentist: Root Canals and Dental Phobes

We recently heard from a reader with major concerns about impending treatment. He sent the following note:
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We recently heard from a reader with major concerns about impending treatment. He sent the following note:

“I’ve got a dilemma and do not really trust the advice I’ve been given. I’m a 55-year-old man, and my mouth is in pretty good condition. To date, I’m only missing one rear tooth. My dentist retired, and the young doctor who took over suggests a root canal to get rid of some persistent and recurring pain in a rear tooth. I have an aversion to dental pain. As far as I can see, there is no guarantee with a root canal and perhaps major pain. What would you recommend I do?”

He underplayed his aversion to dental pain, and that needed to be addressed. Pain that comes and goes is certainly not to be ignored. It sounds like the tooth may be salvageable now, if root canal therapy is done. This is rarely as uncomfortable as dental myths say, and often patients feel no discomfort. It’s not an exaggeration to state that the two words ‘root canal’ cause more trepidation for some than a CRA audit! I’ve been known to call it a ‘big filling’.

That isn’t far from the truth. The dentist will remove the infected interior of the tooth, and replace it with a special plastic material from a Malaysian tree called Gutta Percha. Often the tooth will require a crown to complete it, and the repaired tooth will look and behave like a natural tooth. The patient will have no space between teeth which may allow for teeth to shift or migrate. A shifting bite is unstable and can cause additional problems not easily remedied. If the tooth is more extensively damaged than thought, an extraction may be suggested. If the patient doesn’t care to treat a tooth with poor chances, this will be spelled out in advance so the appropriate decision can be made. One option may be to replace it with an implant tooth which is a manmade titanium root to replace the diseased molar with a crown affixed to it. They have an expected life span of natural teeth, and zero tooth movement.

This patient didn’t actually mention it, but ‘Dentalphobia’, or fear of dentists, is a concern that affects about one-third of the population. There is one underlying truth. The patient comes into our offices with pain, and we as dentists are tasked to fix it. The pain is from a ‘bad tooth’ situation which had nothing to do with the dental office. We saw a new patient recently who was in great discomfort. There were several options for him, and unfortunately, our Solea ‘needleless’ dentistry wasn’t an option for him.

In his case, he chose treatment in a G.A. Suite (general anesthesia). In this case, the patient is sedated and unconscious for the entire treatment. They go to sleep, all treatment is completed, and they wake up with their dental problem gone. Yes, it does magnify the cost of treatment, because it involves a surgical suite or a hospital operating room. In his case, it added $6,000 to his cost of treatment but his response was he didn’t care! The reality is that any hospital stay for accidents or operations would result in a terrible fear of physicians, but they operate on patients who are unconscious and we treat 99 per cent of cases on conscious patients.

Dentalphobia usually begins from an early childhood experience. In reality, there was ‘poor treatment’ in some cases, but what is more common is the myth of discomfort. Every dentist would tell you how hovering helicopter parents in an operatory create a nightmarish situation by repeating to a child that a) it won’t hurt too much; b) hold Mommy’s hand and squeeze if it hurts too much; or c) Mommy won’t let the dentist hurt you. For some, any slight pain or discomfort is excessive. The Solea laser option solves this for about 80% of cases, and thank goodness for that! We have a 100% record for Solea patients insisting on laser therapy for future treatment as well.

Your dentists have options for ‘pain control’ that didn’t exist even 20 years ago. Be candid with your dentist about aversion of discomfort, and let them demonstrate their treatment options. To be clear – your dentist is the Dental Fireman – fixing problems that you, the patient, brought into the office. Ignoring a problem will only lead to a hole in your mouth where teeth once thrived!

Dr. Michael Dolynchuk is a General Dentist practicing in Caroline and Red Deer.