The Root Canal

matthew's picture

"Matt, I'm going to make your tooth cold. I need you to raise your hand when it feels cold. Then rub your tongue over the tooth, and tell me when it feels normal again."

Dr. Aaron Stobbe, my dentist, held an ice-cold Q-tip against one of my teeth. Within three seconds, I raised my arm, and after he removed the Q-tip, lowered it again about fives seconds later.

"Good, that's a normal tooth," he informed me.

Now the second tooth, immediately behind the one that was feeling some pressure sensitivity. Again, within three seconds, my arm was up, then down about five seconds later.

"Another normal tooth. Now let's check out the one that's having problems," Dr. Stobbe said.

He held the Q-tip against my tooth. And we waited.

And waited.

And waited.

After about fifteen seconds, he explained to me that this test told him that the nerve inside this tooth is probably dead. X-Rays were inconclusive, but the cold-test was: an earlier filling had led to the death of the root.

I would need A ROOT CANAL!

"Well, we have some time right now, if you like," Dr. Stobbe said, "we can always skip lunch".

"Sounds good to me!" I responded, and sat back in the chair.

Now, according to Aaron Stobbe, for root canals they usually use a "Dental Dam". This is a piece of rubber stretched over a frame to isolate a tooth from the rest of the teeth. But since the tooth was obviously already infected and dead, there was little need. He numbed me up (including a shot to the roof of my mouth that stung rather painfully), and then began the drilling.

Those of you who have had fillings before know what this is like. Really, at this point in my life, thirty years old, it's not nearly as traumatic as it used to be. No big deal.

But something was different this time. He went deeper. And suddenly, my mouth and nose were filled with the most disgusting flavor I'd ever encountered. However, I knew it well.

"'at hells like ro'en hotatos!" I exclaimed past his fingers.

"That smells like rotten potatos, huh? Yeah, it's pretty gross," responded Dr. Stobbe. "I think I mentioned, though, that there is usually a little outgassing when we break through to the nerve."

Then he began pulling out the files. Each file is about the size of a sewing needle, with a fat, round end about the width of your pinky to hold on to. He'd use each file for just a few seconds, then get a new one. He explained that these got down into the root of the tooth and scraped out all the gunk there.

Oy, veh, and gunk it was. That stink persisted the whole time. I mean, I've farted good in my time, and had some really ripe ones, so I know it's possible for my body to contain some repulsive smells. But this was just beyond imaginable, a combination of rotting fish with rotting potatos and terrible intestinal distress. I found it hard to believe my tooth harbored such foulness.

Once all the files were done (which took about fifteen minutes), he inserted a long, bended needle with a syringe of yellowish liquid. He explained it was basically bleach, similar to that used on clothes, to help disinfect the tooth. Given the smell, that makes perfect sense to me... I wouldn't want any of that cruddy stuff sticking around.

He finished up, after putting in the disinfectant, by capping it off with a soft Plaster-of-Paris like substance. He informed me this plug was just temporary, and he'd need to see me in two weeks to "build it up". I scheduled the appointment on the way out, rinsed with a glass of water to attempt to clear the lingering taste/smell from my mouth, called my wife, and got a ride home.

Ahh, then yesterday. I hope this story is moderately entertaining for those of you who haven't had a root canal!

Yesterday I saw the dentist again. This time, they used the Dental Dam because it is most important that no germs make it down into the tooth. It was actually kind of cool, like a little Dream Catcher made of rubber... well, OK, there are no holes or anything, but I could kind of talk around it. I also opted for the Bite Blocker, a piece of plastic to wedge my mouth open, because holding my mouth open for that long aggravates my Trigeminal Neuralgia horribly.

He broke out the drill to break up the Plaster-of-Paris-type stuff, then used some more files to scrape out lingering bits of nerve ending and fluff from down inside the tooth canals. There was only the slightest pain this time, other than that annoying "shoot the roof of your mouth" novacaine. Again he flushed it out with the bleach-like solution.

Now, this time, after filing and cleaning, he used tweezers and these tiny strips of paper. According to him, he needed to dry the inside of those canals for the next step. The next step was to inject a type of rubber into the canals. After he'd pump some in there, he'd use a sharp metal tool to push and spread the rubber more, then chop off the exposed lumps of rubber. I wish I could have watched :)

Once the rubber was in the canals, the rest of the operation was very much like your basic filling: pump in some filling material, use a little ultraviolet light to cure it, pump in some more, cure it, and more, cure it. Then, finally, he ground down the epoxy-like stuff to more closely resemble a tooth (I really have trouble seeing the difference, except that a dentist's work now is a bit "smoother" than a natural tooth), had me bite on the test strip to make sure my bite was even, ground a little more, and said "have a nice day!"

Total price: $650.

A root canal definitely wasn't the hellish ordeal I thought it would be. It's no picnic, but the second half of the procedure was peaceful enough that, actually, I fell asleep partway through it! I woke myself up because I was snoring!

I'm going to remember the "cold test", though. I think I may have a second tooth, that also had a "deep filling" that may have damaged the root, which may require the same treatment. This time, because so much of the tooth was saved, there was no need for a cap according to my dentist. We'll see how it goes I guess!


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Root canal

Never had one, never want one. Disgusting.

Could that bad tooth be the source of your trimenal [trigeminal] neuralgia?

Love ya. Mom.

I'm not trying to be secretive by posting anonymously, just can't remember my login. Love ya twice.

Edit by matthew: Fixed up your entry so it shows you posted it, and added some whitespace :)


matthew's picture

Correlated, but not necessarily causated

Well, whether or not root canals cause trigeminal neuralgia is the source of quite a great bit of debate in the medical community. It's a standoff at the moment: dentists acknowledge that they appear to be related, in that often root canals, tooth extractions, deep fillings, and implants correlate closely with the incipience of TNA. However, there's no evidence to suggest that they actually cause the disorder.

Most studies suggest a common cause for TNA is a blood vessel, generally an artery, migrating closer to the trigeminal nerve over time and rubbing part of the myelin sheath off. Realistically, it's virtually impossible to watch the process in action :) The most common cure for it is to isolate the damaged portion of the nerve and wrap it in Teflon. Generally that's good for at least 15 years of pain-free, or pain-reduced, living.

According to the doc, most people don't have a root canal due to the problem I had. If you have routine dental examinations, no cavity is going to get deep enough to approach the tooth's nerve. In my case, I went ten years between dental visits. They fixed a few of my teeth, but this particular tooth they missed the decay on the X-ray because it was behind a large filling already. We had no idea there was anything wrong until a large part of the tooth broke off one day when I was chewing gum. That was a bit of a surprise :)

In any case, the subsequent filling had to go deep enough to hit the nerve. The dentist warned me it might be root canal material if I had problems later, and he was right. Usually, the root is swollen and inflamed, resulting in severe pain in the tooth -- a classic "toothache". In my case, it was just dead. So most people when they get a root canal don't have that disgusting smell, but also deal with a lot more pain during the procedure. Other than some modest discomfort for two days afterwards (easily handled by a prescription of Lortab), mine was virtually pain-free.

There's an alternative explanation for facial pain, particularly if it is "atypical". That is, "typical" TNA follows a pattern similar to what I've described: pain radiating up from the back of my jawbone, through my teeth (both top and bottom sometimes, sometimes just the bottom), up my cheekbone, and terminating behind my temple. It kind of forms an upside-down isosceles triangle going up the right side of my face, and the pain comes in waves -- some people describe it as "lightning strikes", although I wouldn't use that terminology.

Atypical pain often includes neck pain, back pain, ear pain, or other associated pains as part of the attack. Some have an alternative explanation for non-typical facial pain in "Neuralgia-inducing Cavitational Osteonecrosis", sometimes called Ratner Bone Cavities, alveolar cavitational osteopathosis, Roberts bone cavity, trigger point bone cavity, interference field, and most commonly, NICO.

NICO is not generally accepted as a cause of Trigeminal Neuralgia by most medical and dental professionals. It is possible that NICO is involved in some cases of facial neuralgia, especially atypical facial pain.

My doc poo-poos the idea of it being NICO, but the bacteria that cause NICO are found in the bone and tooth tissue of virtually all tooth extractions and most root canals. It's an interesting theory, but the solution (basically, scraping away large amounts of bone tissue) is somewhat less than compelling :)

On the plus side, since the doc scraped that crap out of there, my pain is mostly reduced. I'll still have a really bad attack every so often, but by and large a minimal dose of Neurontin keeps me on my feet and functioning, and Lortab handles the pain once every few days when it's more than I can handle.

Long answer, short question, I know :) It boils down to that, as far as current medical research is concerned, my TNA was probably sparked or worsened by the tooth, but it would almost certainly have cropped up anyway regardless.

Matthew P. Barnson

Matthew P. Barnson

No Novacaine

Well my ordeal was similar except i opted out of the novacaine. I meditate and do energy work, so i decided to apply some of the principals before and during the root canal. I was able to make most of the area of the tooth numb, did this a few minutes before the work. But there was no pain at all, just some weird sensations going into the tooth and in the sinus cavity.

I did have some weird smells, it was not as bad as you described, but it smelts like something was infected.

I only need to have the procedure done once, not twice like you describe. thanks for the blog on it.

be careful

I had a root canal done with just a cap. A year and a half later it broke. Argh! I then had to go back for a really prolonged build up and capping process. This (new) dentist says that without a cap, a tooth without a root will almost always break. Hopefully this doesn't happen to you though.

I had a root canal done today

I had a root canal done today. I was searching websites to see if anyone had a similar experience and was comforted in knowing I was not the only one. I was going to throw up today it smelt so bad. I did not realize my teeth were capable of giving off such a bad smell. I did have an abcess and was relieved to finally have the root canal done. Thanks for the post Matt, I feel better.

thankyou for telling your

thankyou for telling your experience. 2 weeks ago i had 3 fillings have been in severe constant pain ever since went to get second opinion and was shown by new dentist just how deep fillings were;right on top of the nerve.i had obtained original x rays from first dentist by looking at these the second dentist told me he could see no earthly reason for fillings done this deeply.he said the cavities were small and that as a dentist he only drills as deep as he needs to .so now the nerves are damaged will most likely die.will either have to have root canals or teeth reason for telling this is that if anyone out there goes to dentist and is told they need cavities filled or root canals done get a second opinion and find a dentist that is caring and trustworthy because also i had been told by original dentist that i had 6 cavities 2 upper severely decayed but the second dentist said they saw no other cavities and that i had originally had only 2 small.anyway sorry so long but this just happened and i think its really wrong.i guess first dentist was getting me ready for future root canals she made sure of that.had to pay for flat screen tvs in her lovely office i guess.its about money greed for some drs and their hearts are cold what a sad way to live.

Just had the first part of a

Just had the first part of a root canal done today.
No kidding it smells bad when they open the tooth!
I could not compare the smell to anything, except it was bad.

I felt sorry for the dentist.

The sitgma behind getting a root canal done is simply a myth.
No pain, just a foul smell and a bit of embarassment.