Welcome to Am I Dying, a column that hopes to save you from your late-night WebMD spiraling. You can email us your hypochondriac questions at firstname.lastname@example.org.
Okay, well … I was supposed to get a root canal like two years ago, but it would have cost thousands of dollars, so I did not. (Also I’m afraid.) Since then, my broken tooth has been getting progressively worse. It doesn’t hurt, but could it be causing me other damage? Like … to my ear canal, or something? Or jaw? How fucked am I at this moment, do you think?
People like you — who recognize their right to just not do something a doctor or other authority figure has told you to do — amaze me. And I mean that in a mostly complimentary sense. For TWO YEARS you’ve just gone about life, knowing you disregarded someone’s actual medical advice? And the guilt alone hasn’t killed you? Incredible!
But, uh, yeah, you should really get that root canal. If the word of a professional blogger isn’t good enough for you, take it from Dr. Matthew Malek, the program director for the department of endodontics (the field of dentistry focused on the study and treatment of dental pulp) at NYU, who tells me — in so many words — that it will only get worse from here.
There are a number of reasons a dentist might recommend a root canal, says Malek. If, as you’ve stated, a dentist recommended a root canal for a broken tooth, it’s because the break is pretty substantial. “Not all broken teeth require root canal treatment,” says Malek. “Sometimes you can just get a crown on a filling to repair the broken part of the tooth. But if the clinician suggested a root canal treatment, that suggests to me that the fracture line is very deep, and perhaps very close to the pulp, which all the nerves and blood vessels run through.” If the fracture is left untreated, says Malek, you risk exposing that live tissue to the outside environment, at which point they can easily become inflamed (which is when it would probably start to hurt a lot) or infected.
Infections, in fact, are the most common reason for a root canal, says Malek, and while it’s rare, such infections can become life-threatening if left unaddressed, as the proximity of large arteries and veins can facilitate their spreading to vital organs like the brain. (I’m sorry to link you to something called “Understanding How a Dental Infection May Spread to the Brain,” but you gotta go to the dentist!)
The reason it’s essential to treat broken and/or infected teeth early, says Malek, is because, unlike most other parts of the body, teeth don’t heal themselves, even with antibiotics. Antibiotics can help a tooth infection, but they won’t eradicate it. Not until the infected or fractured pieces are removed can the issue be fully resolved. And while you wait, you might be making that eventual, inevitable treatment all that much harder for the dentist or endodontist to perform. “If there has been a cavity on the tooth already, or it’s a broken tooth, it’s more prone to [get a cavity], actually,” says Malek. “Then, during the root canal treatment, it will be very difficult to isolate the tooth, or reconstruct the lost tooth structures, and the worse the condition gets, the more difficult it is to treat, and the lower the success rate of the treatment.”
(Is it sinking in yet?)
Malek also wants me to let you know that you don’t need to be afraid of a root canal anymore. “Unfortunately we’ve inherited this perception of root canal treatment from decades ago, which was a terrifying, torturous procedure in many people’s minds,” says Malek. “It’s a real misconception nowadays, with the [improvements in] technology, and understanding of pain control, and our equipment. Almost all my patients when they leave the room say ‘I did not think it would be as easy as it was.’” While Malek stops short of promising a painless procedure — you’ll still need that Novocaine shot in the mouth, after all — he insists it’s not nearly so bad as you’re imagining. And, need I remind you, the alternative is worse.
While you’re working up the nerve, Malek recommends making an appointment for a consultation — just to talk about a root canal. “I highly suggest reaching out to an endodontist,” he says. “Although general dentistry provides education for root canal treatment, if you’re really concerned with the quality of the treatment, you might want to reach out to a specialist, especially for a tooth that’s a bit more compromised. You want to have your tooth taken care of by the best.” And you do, don’t you? Don’t we all?