The Dentist Is Your Friend

The Dentist Is Your Friend

I've had my first experience with endodontic therapy this morning. That's a root canal to us non-dentist types. My husband having had several in recent years, I didn't worry too much about all the horror stories I'd heard growing up. Sure enough, it was quick and painless.

I asked my dentist why root canals get such a bad rap. It seems the procedures have changed markedly for the better. For one thing, the anesthetics are better and are being delivered more reliably, so as to achieve real pain suppression during the procedure. For another, dentists used to have to rout out the nerve and pulp with a little manual barbed file, whereas now it's more common to use low-torque titanium drills that work quickly without cracking the root. They have automatic feedback mechanisms that cut back on the power automatically when they encounter too much resistance.

Root canals sometimes sound fearsome more because of the excruciating symptoms that make them necessary, often an infected tooth pulp, than because of the treatment itself. Luckily for me, I was suffering only from a slowly dying nerve that made the tooth abnormally sensitive to heat and cold, instead of from a just-shoot-me-now torturous abcess, so the whole procedure was pain-free. It took less than two hours, of which less than half was the drilling, the rest of the time being used up in waiting for the pain-killing shot to take effect and mucking about with the packing of the empty root and formation of the temporary cap.

Although post-root-canal teeth reportedly hold up well over time, it's never a good thing to have to remove the pulp, which is supposed to serve a function in hydrating the tooth and keeping it healthy. Late last year some interesting research was published about a new method of delivery of antibiotics using propylene glycol to penetrate efficient through the dentinal tubules. If it pans out, many root canals may be avoided in the future. These guys seem to be among the Pros from Dover in the field today.

I consider dentistry one of the crowning achievements of civilization. They've come a long way since the dark ages of dentistry:

In 1725, Lazare Riviere introduced the use of oil of cloves for its sedative properties.

In 1746, Pierre Fauchard described the removal of pulp tissue.

In 1820, Leonard Koecker cauterized exposed pulp with a heated instrument and protected it with lead foil.

In 1836, Shearjashub Spooner recommended arsenic trioxide for pulp devitalization.

In 1838, Edwin Maynard of Washington, D.C. introduced the first root canal instrument, which he created by filing a watch spring.

In 1847, Edwin Truman introduced gutta-percha as a filling material.

In 1867, Bowman used gutta-percha cones as the sole material for obturating root canals.

In 1891, the German dentist Otto Walkhoff introduced the use of camphorated chlorophenol as a medication to sterilize root canals.

In 1895, . . . the scientist Konrad Wilhelm von Roentgen accidentally discovered a new form of energy that had the ability to penetrate solid material. Because of their unknown nature, he decided to call these rays “X”.

A few weeks later Otto Walkhoff, a dentist in Brunswick, Germany, took the first dental radiograph, making a contribution to dentistry that almost equaled Roentgen’s to medicine.

In 1908, Dr. Meyer L. Rhein, a physician and dentist in New York, introduced a technique for determining canal length and level of obturation.

All these advances came to an abrupt halt early in the 20th century, when many experts concluded that they posed an unreasonable risk of trapping bacterial infections below gold caps. For nearly forty years, therefore, the treatment of choice for an infected tooth pulp once again was extraction. Around 1950, endodontics got back on track and has brought us to our current enviable condition.

Now that my lips and tongue are no longer numb, I think I'll go have lunch using my newly pain-free tooth.