In my practice, I have noticed that few phrases trigger immediate anxiety quite like the words “root canal.” It is arguably the most misunderstood procedure in modern dentistry. When I tell a patient that this treatment is necessary, I often see a look of hesitation or even fear cross their face. This reaction is usually not based on personal experience, but rather on stories passed down from decades ago or myths circulating on the internet.
As Dr. Justin Raanan, I want to set the record straight today. My goal is to help you understand that modern endodontic therapy is not something to fear. In fact, it is often the hero of the dental world. It is the very treatment that saves your natural smile and gets you out of pain, not into it. With the incredible advancements in technology and anesthetics we have today, the reality of the procedure is vastly different from the scary stories you might have heard.
Let’s take a deep dive into the world of endodontics. I am going to walk you through the most common myths I hear, debunk them with science and facts, and explain exactly what is happening inside your tooth. By the end of this article, I hope you will see a root canal for what it truly is: a safe, effective way to save your tooth.
Understanding the Basics: What is a Root Canal?
Before we tackle the myths, we need to agree on what this procedure actually entails. Inside your tooth, beneath the white enamel and a hard layer called dentin, is soft tissue called the pulp. This pulp contains blood vessels, nerves, and connective tissue. It is responsible for growing the root of your tooth during development.
However, once a tooth is fully developed, it can survive without the pulp because the tooth continues to be nourished by the tissues surrounding it. A root canal becomes necessary when that pulp becomes inflamed or infected. This can happen for several reasons: deep decay, repeated dental procedures on the tooth, faulty crowns, or a crack or chip in the tooth. Sometimes, even trauma to a tooth can cause pulp damage even if the tooth has no visible chips or cracks.
If pulp inflammation or infection is left untreated, it can cause pain or lead to an abscess. During the procedure, I remove the inflamed or infected pulp, carefully clean and shape the inside of the root canal, then fill and seal the space. Afterwards, you will return to your general dentist, who will place a crown or other restoration on the tooth to protect it and restore it to full function. It is essentially a deep cleaning for the inside of your tooth.
Myth #1: The Procedure Is Extremely Painful
This is, without a doubt, the biggest myth I encounter. The reputation of root canals as painful dates back decades, to a time when dental technologies and anesthetics were nowhere near as effective as they are today. The reality is that the procedure is done to relieve pain, not cause it.
When you come in with a severe toothache caused by damaged tissue, you are already in pain. The treatment eliminates that pain. Most of my patients report that they are comfortable during the procedure. With modern local anesthesia and numbing techniques, having a root canal is very similar to getting a routine filling. The only difference is that it might take a little longer.
I always tell my patients: the infection is the problem; the treatment is the solution. Once we numb the area, you shouldn’t feel the procedure. Afterwards, there might be some sensitivity for a few days, but this is easily managed with over-the-counter medication. The intense, throbbing pain caused by the infection is gone the moment we clean out the nerve.
Myth #2: It Is Better to Pull the Tooth
We live in an age of dental implants, which are fantastic, but I firmly believe that nothing can completely replace your natural tooth. There is a misconception that it is easier, faster, or cheaper to simply have the tooth extracted. I want to caution you against this line of thinking.
Saving your natural tooth should always be the first choice whenever possible. Your natural teeth allow for more efficient chewing and normal biting force. They help you maintain your natural smile and, perhaps most importantly, they limit the need for ongoing dental work. When you extract a tooth, it creates a gap. The surrounding teeth can shift into that gap, affecting your bite and jaw alignment.
To replace a pulled tooth, you would need a bridge or an implant. These procedures are often more expensive and time-consuming than a root canal treatment and restoration. An implant requires surgery and months of healing. In contrast, endodontic treatment saves your natural structure.
The Success Rate Reality
Many people believe that the treatment fails often. This is simply not true. According to the American Association of Endodontists, root canal treatment has a very high success rate, with more than 95% of treatments resulting in a saved tooth that can last a lifetime. When you compare this to the timeline and cost of extraction and replacement, saving the tooth is the clear winner for most patients.
Myth #3: Root Canals Cause Illness
This is a dangerous myth that refuses to go away. It stems from poorly designed research conducted nearly 100 years ago by Dr. Weston Price. In the 1920s, he promoted the “focal infection theory,” suggesting that bacteria trapped in dentinal tubules during treatment could leak out and cause systemic diseases like arthritis or heart disease.
I want to be very clear: this research has been debunked for decades. There is no valid scientific evidence linking root canal-treated teeth to disease elsewhere in the body. In fact, people with treated teeth are no more likely to be ill than people without them. The bacteria found in the mouth are found elsewhere in the body, but the immune system handles them. Leaving an infected tooth untreated, however, puts a constant burden on your immune system. By removing the infection through treatment, we are actually improving your overall health.
For more detailed information on safety, I recommend reading this article from the American Association of Endodontists regarding the safety and myths of the procedure.
Myth #4: The Tooth Is “Dead” and Will Turn Black
I often hear patients worry that their tooth will turn black or become brittle and “dead” after treatment. While it is true that we are removing the nerve and blood supply from the inside of the tooth, the tooth is not dead in the traditional sense.
The tooth still sits in your jawbone and is held in place by the periodontal ligament. This ligament is very much alive. It allows you to feel pressure when you bite down. This is why a treated tooth still feels like a part of you, unlike an implant which has no sensation.
Regarding discoloration: in the past, materials used to fill the tooth sometimes caused darkening. Modern materials and techniques have largely eliminated this issue. Furthermore, because most treated teeth (especially back teeth) are covered with a crown, they look perfectly natural. If a front tooth does darken slightly over time, we have internal bleaching techniques that can restore its brightness.
The Step-by-Step Reality of the Procedure
To help alleviate anxiety, I believe in transparency. When you understand the steps, the mystery fades away. Here is what typically happens when you sit in my chair for this treatment:
1. Diagnosis and Imaging
First, we take X-rays or 3D scans. This allows me to see the shape of the root canals and determine if there are any signs of infection in the surrounding bone. We want a roadmap before we begin.
2. Anesthesia
This is the most important step for your comfort. I will use a local anesthetic to numb the tooth and the surrounding area. I will not start the procedure until I am certain you are completely numb. For anxious patients, we can also discuss sedation options.
3. The Access Opening
I place a small protective sheet called a dental dam over the area. This isolates the tooth and keeps it clean and free of saliva during the procedure. Then, I make a small opening in the crown of the tooth to access the pulp chamber.
4. Cleaning and Shaping
Using very small, specialized instruments, I remove the infected or inflamed pulp. I then shape the space to prepare it for the filling. During this stage, I use biocompatible irrigation solutions to flush out debris and kill any remaining bacteria.
5. Filling and Sealing
Once the space is cleaned and shaped, I fill the root canals with a biocompatible material, usually a rubber-like material called gutta-percha. The gutta-percha is placed with an adhesive cement to ensure complete sealing of the root canals. In many cases, I place a temporary filling to close the opening.
Recovery and Aftercare
The recovery period is usually very short. When the anesthesia wears off, your teeth and gums might feel sore. This is normal. The tissue around the tooth has been inflamed, and it takes time to heal. I typically recommend over-the-counter pain relievers like ibuprofen or acetaminophen to handle this sensitivity.
You should try to avoid chewing on the treated tooth until you have it permanently restored by your general dentist. This helps avoid recontamination of the interior of the tooth and prevents the fragile tooth from breaking before the crown is placed.
It is vital to return to your dentist for a final crown or other restoration. This step protects the tooth from future damage. Once the restoration is in place, you simply continue to brush and floss as you normally would.
Why Endodontists are Specialists
While general dentists are trained to perform root canals, there are times when seeing a specialist—an endodontist like myself—is the best path. We have undergone two or more years of specialized training beyond dental school. We focus exclusively on treatments of the dental pulp.
We also utilize advanced technology, such as operating microscopes. These microscopes provide magnification and fiber-optic illumination, allowing us to see tiny details inside the tooth that would otherwise be invisible. This precision is key to finding all the canals and ensuring the infection is thoroughly removed.
Did you know? Endodontists perform an average of 25 root canal treatments a week, while general dentists typically perform less than two. This volume of experience allows us to handle complex cases efficiently and comfortably.
Embracing Modern Dentistry
The field of dentistry has evolved rapidly. We now have digital imaging that exposes you to 90% less radiation than traditional X-rays. We have 3D Cone Beam CT scans that let us view the tooth in three dimensions to plan the procedure perfectly. We have rotary instrumentation that makes the cleaning process quieter and faster.
All of these advancements are designed with one person in mind: you, the patient. My priority is to save your smile while ensuring your absolute comfort. The “horror stories” of the past are just that—history. They do not reflect the modern reality of high-tech, patient-centered care.
Your Smile is Worth Saving
I hope this discussion has helped clear the fog surrounding root canals. It is easy to fear what we do not understand, but the facts paint a very positive picture. We are talking about a procedure that relieves pain, removes infection, and allows you to keep your natural body part. That is a medical success story.
If you have been told you need a root canal, please do not panic. Instead, look at it as an opportunity to save your tooth. Trust in the technology, the science, and the training of your dental professional. Your natural teeth are precious, and they are worth the effort to preserve.
If you have any lingering questions or fears, bring them to me or your dentist. We are here to help you navigate your dental health with confidence. A healthy, pain-free smile is waiting for you on the other side of treatment.