Column: Do I really need a root canal?

By Thomas C. Westrick

“My dentist told me that I need a root canal, but I have no pain, and I am wondering if I really need to do it?”

Usually, the answer is yes, for several reasons. One could be that we caught the problem before it has a chance to cause a debilitating toothache, and then it is a great service to do the treatment before the tooth causes missing work or lost sleep.

Sometimes the tooth has established a route to drain the pus, usually from a small pimple next to the tooth, and sometimes alongside the tooth root. This is nature’s pressure relief mechanism, to allow the pus to drain, and since it isn’t building up in the bone, this is frequently a painless situation. Yes, this offending tooth needs a root canal.

It is practically always an option to have a given tooth extracted, instead of root canal treatment. A scenario that is more and more frequent, is if the patient is taking a bisphosphonate drug for osteoporosis, or sometimes for metastatic cancer treatment, there is sometimes a painful non-healing wound situation after an extraction, and then the root canal should be more strongly considered.

The IV bisphosphonates have a higher incidence of this problem, as compared to the oral tablet forms taken by mouth. These include pamidronate (Aredia) and zoledronic acid (Reclast and Zometa). Ibandronate comes in both IV and tablet form. Other tablet forms include alendronate (Fosamax) and risedronate (Actonel).

Please ask your dentist specific questions regarding the need of a root canal, as they will always be interested in clearing up any confusion.

We can also “pulp test” your teeth and explain the situation at a problem-focused exam. We are the specialist of root canals.

Thomas C. Westrick, DDS, can be contacted at Central Wisconsin Endodontics, 2329 Main St., Stevens Point, 715-345-7740.