Myths About Root Canals and Root Canal Pain

There are many misconceptions surrounding root canal (endodontic) treatment and whether patients experience root canal pain. As always, when considering any medical procedure, you should get as much information as you can about all of your options. Your dentist or endodontist can answer many of your questions, and if you still have concerns, it is often wise to seek a second opinion.

Myth #1—Root canal treatment is painful.

Truth—Root canal treatment doesn’t cause pain, it relieves it.
The perception of root canals being painful began decades ago but with the latest technologies and anesthetics, root canal treatment today is no more uncomfortable than having a filling placed. In fact, a recent survey showed that patients who have experienced root canal treatment are six times more likely to describe it as “painless” than patients who have not had root canal treatment.
Most patients see their dentist or endodontist when they have a severe toothache. The toothache can be caused by damaged tissues in the tooth. Root canal treatment removes this damaged tissue from the tooth, thereby relieving the pain you feel.

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Myth #2—Root canal treatment causes illness.

Truth—Root canal treatment is a safe and effective procedure.
Research studies performed in the 1930s and 1940s and those conducted in later years showed no relationship between the presence of endodontically treated teeth and the presence of illness. Instead, researchers found that people with root canal fillings were no more likely to be ill than people without them.1,2
Over the past several years, however, a very small number of dentists and physicians have been claiming that teeth that have received root canal (endodontic) treatment contribute to the occurrence of illness and disease in the body. This claim is based on the outdated research performed by Dr. Weston Price from 1910-1930. His research stated that bacteria trapped in the teeth during root canal treatment can cause almost any type of disease, including arthritis, heart disease, kidney disease and others.
The presence of bacteria in teeth and the mouth has been an accepted fact for many years. But presence of bacteria does not constitute “infection” and is not necessarily a threat to a person’s health.3 Bacteria are present in the mouth and teeth at all times, even in teeth that have never had a cavity or other trauma.
More recent attempts to copy the research of Dr. Price (and to check its accuracy) have been unsuccessful. Researchers now believe that the earlier findings may have been caused by poor sanitation and imprecise research techniques that were common in the early 1900s.1
These more recent studies support the truth we report today—that teeth that receive proper endodontic treatment do not cause illness. Over 16 million root canals are performed in the United States annually.

Myth References

Easlick K. An evaluation of the effect of dental foci of infection on health. JADA 1951 Jun;42(6):615-97.

  1. Grossman L. Pulpless teeth and focal infection. J Endodon 1982;8:S18-S24.
  2. Schonfeld SE. Oral microbial ecology. In: Slots J, Taubman M, eds. Contemporary oral microbiology and immunology. St. Louis: Mosby Year Book, 1992:267-274.
  3. Grossman L. Root canal therapy. 4th ed. Philadelphia: Lea & Febiger, 1955:15-40.
  4. Grossman L. Focal infection: Are oral foci of infection related to systemic disease? Dent Clin N Amer 1960:749-63.
  5. Bender IB, Seltzer S, Yermish M. The incidence of bacteremia in endodontic manipulation. Oral Surg 1960;13(3):353-60.
  6. Goldman M, Pearson A. A preliminary investigation of the “hollow-tube theory” in endodontics: Studies with neo-tetrazolium. J Oral Therapeutics and Pharm 1965;1(6):618-26.
  7. Torneck C. Reaction of rat connective tissue to polyethylene tube implants. Part I. Oral Surg 1966;21(3):379-87.
  8. Torneck C. Reaction of rat connective tissue to polyethylene tube implants. Part II. Oral Surg 1967;24(5):674-83.
  9. Phillips J. Rat connective tissue response to hollow polyethylene tube implants. J Canad Dent Assoc 1967;33(2):59-64.
  10. Davis M, Joseph S, Bucher J. Periapical and intracanal healing following incomplete root canal fillings in dogs. Oral Surg 1971;31(5):662-675.
  11. Baumgartner J, Heggers J, Harrison J. The incidence of bacteremias related to endodontic procedures. I. Nonsurgical endodontics. J Endodon 1976;2(5):135-40.
  12. Ehrmann E. Focal infection: The endodontic point of view. Oral Surg 1977;44:628-34.
  13. Wenger J, Tsaknis P, delRio C, Ayer W. The effects of partially filled polyethylene tube intraosseous implants in rats. Oral Surg 1978;46:88-100.
  14. Delivanis P, Snowden R, Doyle R. Localization of blood-borne bacteria in instrumented unfilled root canals. Oral Surg 1981;52(4):430-32.
  15. Torabinejad M, Theofilopoulos A, Kettering J, Bakland L. Quantitation of circulating immune complexes, immunoglobulins G and M, and C3 complement component in patients with large periapical lesions. Oral Surg 1983;55(2):186-90.
  16. Delivanis P, Fan V. The localization of blood-borne bacteria in instrumented unfilled and overinstrumented canals. J Endodon 1984;10(11):521- 24.
  17. Benatti O, Valdrighi L, Biral R, Pupo J. A histological study of the effect of diameter enlargement of the apical portion of the root canal. J Endodon 1985;11(10):428-34.
  18. Wu M, Moorer W, Wesselink P. Capacity of anaerobic bacteria enclosed in a simulated root canal to induce inflammation. Internat Endodon J 22:269-77, Nov./Dec. 1989.

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Myth #3—A good alternative to root canal treatment is extraction (pulling the tooth).

Truth—Saving your natural teeth, if possible, is the very best option.
Nothing can completely replace your natural tooth. An artificial tooth can sometimes cause you to avoid certain foods. Keeping your own teeth is important so that you can continue to enjoy the wide variety of foods necessary to maintain the proper nutrient balance in your diet.
Endodontic treatment, along with appropriate restoration, is a cost-effective way to treat teeth with damaged pulp and is usually less expensive than extraction and placement of a bridge or an implant.
Endodontic treatment also has a very high success rate. Many root canal-treated teeth last a lifetime.
Placement of a bridge or an implant will require significantly more time in treatment and may result in further procedures to adjacent teeth and supporting tissues.
Millions of healthy endodontically treated teeth serve patients all over the world, years and years after treatment. Those healthy teeth are helping patients chew efficiently, maintain the natural appearance of their smiles and enhance their enjoyment of life. Through endodontic treatment, endodontists and dentists worldwide enable patients to keep their natural teeth for a lifetime.

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