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Will I Be Comfortable During My Root Canal Treatment?

The answer should be an emphatic "YES!" Fortunately, dentistry has developed new techniques for delivering local anesthetics painlessly. These techniques also assure that the anesthetics act more rapidly and produce a more "profound" level of anesthesia. Additionally, modern dental procedures utilize better technologies that are generally much less traumatic and invasive than those of the past. The result of these advancements is that patients should have minimal or no discomfort during the tooth numbing and/or treatment procedures. Root canal treatment should not cause pain, but rather relieve it when present and keep it from reoccurring. Unfortunately, dental pain may also have a psychological component, possibly stemming from a negative past experience, a story in the media, or even the fear of the unknown. Sometimes these situations can prove challenging for the patient and the dentist to control. Examples include:

• Some patients associate tooth pain with past root canal treatment when, in fact, the pain they remember was experienced prior to their emergency visit. Oftentimes, this pain develops over a period of several hours to a few days and is allowed to build and worsen before seeking treatment. Once the patient seeks emergency care, endodontic treatment should not be uncomfortable and should provide quick and certain relief from any painful symptoms stemming from root canal disease.
• Patients may become very anxious when being examined or treated dentally because the mouth is such an important part of the body and psyche. Some patients may feel anxious and vulnerable because of their positioning in the dental chair with members of the dental team working above them in such close and intimate proximity.

These and other distresses are real to the patient. Much of the time, however, the distress can be reduced or eliminated if the patient discusses it with the dentist and gets understanding and reassurance. The doctor and the patient must work together in these situations to make certain that the patient feels as comfortable, trusting, and informed as possible in the dental environment. Most individuals can do this satisfactorily. If patients continue to feel significant distress, even after having these discussions with the dentists, they should be aware that there are supplementary modalities for which they might be candidates. These modalities include:

• Oral sedation involves ingesting a sedative pill or liquid before the appointment. This can help anxious patients a great deal and make the treatment experience much less psychologically stressful.
• Nitrous oxide analgesia, known as "laughing gas," can be inhaled along with oxygen to make patients feel less anxious and more comfortable.
• Intravenous sedation can be administered in a dental facility by a specially trained and certified dental team or by a specially trained dental anesthesiologist. With intravenous sedation, patients are not asleep and they can still respond, but they will not feel or remember anything. This technique works very well in creating a pleasant experience for many anxious patients and is a good anesthetic modality for more lengthy dental procedures.
• Hospital dentistry is conducted in an environment where a variety of anesthetic modalities are available and can be used under the safest medical conditions. General anesthetic and intravenous sedation can both be utilized in the hospital setting.

These sedative techniques and medicines may also be helpful if particularly lengthy treatment procedures are necessary in specific situations.

With all of the advancements in pharmaceuticals and in their delivery, there should be no need for any patient to delay root canal treatment because of fear that the treatment will be painful.

By Clifford J. Ruddle, DDS, in collaboration with Philip M. Smith, DDS

Discover How Your Dentist Can Help You With Mouth Cancer

According to the American Cancer Society, about 30,000 new cases of mouth cancer will be diagnosed this year, and more than 8,000 people will die from it. Mouth cancer ranks as the sixth most common form of cancer that can affect any part of the mouth or lips. When detected early, the chances for successful treatment are enhanced. If left untreated, it can spread, leading to chronic pain, facial and oral disfigurement, loss of function, and even death. As a result, early detection and diagnosis of mouth cancer is vital.

Smoking and chewing tobacco significantly increase your risk. The carcinogens in tobacco, alcohol, and certain foods are leading risk factors. In fact, if both tobacco and alcohol products are used, one is 15 times at greater risk for developing mouth cancer. Exposure to sun also is linked to mouth cancer. Age, gender, and genetics are factors, too. About 95% of all mouth cancers are diagnosed in people 45 years or older. Men are twice as likely to develop mouth cancer as women.

Mouth Cancer Warning Signs

If you notice any of these symptoms, contact your dentist immediately for a thorough screening:

• A persistent sore on your lips, gums, or inside your mouth that doesn't heal within two weeks.
• Repeated bleeding in your mouth without any known cause.
• Swelling, thickening, or lumps in your mouth, neck, lips, or on the tongue, often painless in the early stages.
• Difficulty chewing or swallowing food, or difficulty in speaking or moving your tongue or jaw.
• Numbness or pain in your throat or mouth without any known reason.
• Color changes such as white, scaly patches or red lesions inside your mouth or on your lips.

Preventive Measures

Following good oral hygiene practices, eliminating risk factors such as tobacco and alcohol, and scheduling regular dental exams are important to maintaining good oral health. Research also has demonstrated that eating plenty of fruits and vegetables every day is a positive practice.

Dentists screen for mouth cancer during regular routine check-ups. They feel for lumps, tissue changes in your neck, cheeks, head, and mouth and look closely for sores. Early detection of cancer and prompt treatment is critical. Ask your dentist for more information about preventing mouth cancer.

By Richard Rogers, DDS