This well-written article was published in 2010 by
“© Brit (DFC Administrator)” for which I extremely grateful.
I hope you benefit from their experience.
“What does root canal treatment feel like?”
There are lots of technical descriptions of root canal treatment on the internet, but what does it actually feel like from a patient’s perspective?
Since so many people seem to recoil in horror when they hear some friend or other is having (or has had) a root canal treatment on their tooth, I thought I’d share my own root canal experiences.
I had cold sensitivity develop in a molar tooth which had previously been filled twice by different dentists, in the 1970s and in the 2000s. X-rays, cold air-spray, the probe and tooth sleuth (a plastic thing you bite down on each cusp individually to see if the tooth is cracked) all proved inconclusive.
So I was sent away but told to return immediately, if/when it got worse. Well, it took a few days but eventually, I realised the weird pressure build-up sensations and spontaneous twinges in my tooth probably fell into the category of ‘getting worse’.
My dentist agreed that we needed to now take action. He explained that the nerve was in the process of dying and the best thing to do would be a root canal treatment to save my tooth.
The first appointment
The first appointment involved opening the tooth up, taking out the nerve to stop the toothache, cleaning out, finding and disinfecting all the canals; and placing a medicated temporary dressing.
I gave my verbal consent and my dentist imperceptibly and very slowly numbed me up. After a couple of minutes, I felt outstandingly numb – this was reassuring to me. I was charmed into lying back once again by his kind comment that there was not going to be any pain involved whatsoever.
After waiting a while longer, he then tested gently with the explorer and asked if anything felt sharp. My answer was no, so all good to go.
The next step was putting on the ‘rubber dam’ which was new to me. It can be a bit fiddly but you are already numb by this point. If appropriate they may quickly clean the tooth in question before gently anchoring a special clamp with a frame around your tooth and then stretching a piece of rubber over the frame which they then adjust, usually so that only the tooth to be treated is visible in the dentist’s work area.
Using the rubber dam provides essential isolation from saliva for the tooth being treated. It also had the benefit for me whilst lying there that I could ‘swallow’ easily when I needed to and that I was in no danger of accidentally gulping down the treatment debris including old filling material and the bleach later used to disinfect the canals. It also protected me in the unlikely event of there being any dropped instruments/files.
An unexpected further benefit of the rubber dam was that it made me feel it was not ‘me personally’ being worked on but rather ‘just my tooth.’
You may also be given the option of using a ‘soft bite block’ if you find it comfortable and easier on your jaw joint but it is not compulsory. I was offered a soft bite block but it didn’t fit well so I shook my head and he immediately removed it. I did just fine without.
At least 20 minutes had now passed.
Next up was probably the most nerve-wracking moment for a modern RCT virgin… but I already trusted this guy from previous treatment, so I generously gave the benefit of the doubt, when he informed me that he was now going to open up the tooth (by drilling into it with the handpiece in case you were still wondering!).
Before doing so, he reiterated that it was not supposed to hurt at all and if I felt anything untoward, I must signal at once by raising my arm. He further reassured me that it was not a problem to top-up the anaesthetic at any point.
So then came the noise and some vibration….after a couple of seconds, he stopped to check that I was indeed totally pain-free, I confirmed and he gently continued.
The level of vibration/pressure sensations is similar to that for a regular filling (especially when the tooth is initially being opened up and the old filling material is removed). Unwelcome to some but tolerable to me, so long as nothing hurts.
For the next 90 minutes, he stayed totally calm and apparently happily absorbed in intricately working on my tooth. Some anxious patients might prefer more of a ‘running commentary’ (just ask if you do) but I was happy to let him give most attention to the tooth.
Because I was wearing safety goggles with quite a thick rim and because I was tipped back, I couldn’t really see very much at all of what was going on, unless I made a real effort to watch. This means if you don’t want to see, you can just relax and close your eyes, or as per my preference, alternate between staring at the boring ceiling and peeking at the proceedings. However, at one point, I was so relaxed that I found myself beginning to nod off.
Some of the time, it was noisy with the canals being explored using longish L-shaped pointed attachments to the handpiece.
But most of the time, it was quiet with the assistant handing various tiny files to the dentist (he kept asking for particular numbers) which he then either attached to the root canal system handpiece or more often than not used by hand to carefully navigate the canals, gently rotating them to feel his way to the apex. Occasionally I was asked to adjust my head position slightly… just like at the hairdressers. There was quiet music playing in the background.
Some people (and I now agree despite having initially been sceptical) have reported that it is a more relaxing experience than a conventional filling, despite taking longer. The difference is I think, the extensive above-mentioned periods of quiet concentrated work.
At various stages (probably no more than 3 times per appointment) a digital x-ray was taken to confirm progress.
At frequent intervals, I glimpsed a syringe-like nozzle (no needle) which was simply used to squirt the bleach down the canals. The liquid was then suctioned back out.
This alternating process of exploration/shaping and disinfection was repeated endlessly it seems until suddenly the rubber dam was removed and I was all done!
The time had passed surprisingly quickly and I felt a bit euphoric, knowing that the toothache had finally been banished. My jaw felt a bit stiff understandably and the local lasted ages longer before it wore off which was fine by me. The tooth sported a temporary sedative filling and looked slightly open still.
I went away having been assured that the second appointment would be very similar with more shaping and a substance called gutta-percha being placed as the final filling material, topped off with composite and that it would eventually be wise to get the tooth crowned, once we were sure the treatment had been a success.
Between appointments (2 weeks) I had minimal discomfort, just slight soreness occasionally, almost as if the tooth/gum were bruised.
The second appointment
At the second appointment, despite the nerve having already been removed, I was automatically numbed up. It really was – as had been suggested – painstaking work with no stress for me, except for having to keep my mouth open for so long.
The main difference was that the ‘plugger’ was used a lot more since this was the stage where the gutta-percha cones (pieces) were gently pushed down to the bottom of the canals – the goal was to have no gaps.
Towards the end, I could sense some heat coming off something inserted in my tooth – I think this was probably serving to melt the gutta percha?
The last stage was doing the composite filling. This was done very thinly in lots of separate layers and the usual curing light was used multiple times.
My bite was then checked on a strip of paper.
I was advised to take Nurofen for the jaw-joint as soon as I got home and I did so but I felt no need to take a second dose.
This root canal treatment proved to be successful and I later had the tooth crowned. Teeth that have had root canal treatment are more brittle and a crown provides extra support and strength to the tooth, especially if it is a back tooth.
My endodontist experience
I subsequently had an old root canal (done in the early 1990s by a general dentist) retreated at an endodontist. He also did a great job – again over 2 long appointments. The only real difference between him and my dentist was the use of the endodontic microscope at the first appointment and a general air of confidence as to likely success. I was quoted 85% success rate which apparently is high for a re-treatment.
I was told the only real downside of treatment were if a file broke off in the lower portion of a tooth root, it might be hard or impossible to retrieve. However, this was quickly followed up by an assurance that it had been years since he had had such an incident so I probably shouldn’t lose any sleep over this remote possibility.