dentist with patient

A Loma Linda University Health Endodontist, Tory Silvestrin, DDS, MS, MSD, breaks down the facts about root canals.

More than 15 million root canals are performed every year, according to the American Association of Endodontists. Although millions of people undergo the procedure annually, it still suffers from many misconceptions. A Loma Linda University Health endodontist provided some facts about root canals.

A root canal is needed when the nerve of the tooth is damaged when penetrating bacteria interrupt its blood supply and cause inflammation and infection. This usually occurs when a large cavity exposes the nerve in the center of a tooth to contaminants. That’s when most people experience pain. Tory Silvestrin, DDS, MS, MSD, an endodontist at Loma Linda University School of Dentistry, says this infection in the tooth must be treated if the tooth is to be saved. 

“If a patient has an infection in their foot, they go see their primary care doctor because they see it as a priority,” Silvestrin says. “Dental care doesn’t always get the same attention. But if it did, a lot of the root of dental issues could be taken care of before they cause so much damage that a root canal is needed.”

Here are four things Silvestrin wants patients to know in hopes of encouraging more frequent tooth (and money) saving visits to the dentist.

  1. Not all teeth that need root canals hurt. Silvestrin says nearly 40 percent of the time a nerve dies in a tooth without its owner’s awareness until a dentist obtains radiographs and performs diagnostic testing. The presence of a ‘dead nerve’ and bacteria inside the tooth causes different symptoms in different patients, so pain doesn’t always signal the need for a root canal. 
  2. Post root-canal concerns. Whenever endodontists perform a root canal, they access the infected tooth’s interior through the chewing surface to clean out the decay and bacteria. After this treatment, a crown is placed to protect the tooth from fracture or leakage. The mouth is a hostile environment because of the chewing forces placed on teeth and their regular exposure to temperature and chemical variation. 
  3. What if an infected tooth is not treated? A compromised tooth can be asymptomatic for some time. Just because a patient isn’t experiencing pain today doesn’t mean there will be no pain tomorrow. An infected tooth can cause bone loss in the mouth, can lead to pain and swelling or, in extreme cases, to a patient’s hospitalization from infection that becomes systemic. Silvestrin says that in most cases root canal infection is localized.
  4. Best prevention: don’t get a cavity. Unfortunately, a root canal is usually needed when a deep cavity reaches the nerve. Although proper oral hygiene improves the odds, even optimal preventive maintenance does not guarantee anyone freedom from cavities.  

Silvestrin encourages patients to schedule semi-annual dental checkups and routine x-rays that will give their dentist the opportunity to catch any cavities early, before a root canal becomes necessary. Most importantly, Silvestrin wants patients to realize that dentistry should not be considered an elective form of healthcare. 

To schedule an appointment with either of the LLU School of Dentistry’s endodontic clinics contact the Loma Linda University School of Dentistry Graduate Endodontic Clinic website or call 909-558-4670. You can also schedule an appointment at the LLU School of Dentistry Faculty Dental Practices by visiting their website or calling 909-558-4960.