Advertisement - Click to support our sponsors.
Root canals:
Man from Molokai wins top honor
No longer a
synonym for pain
Grab that knocked-out tooth
Don't ignore pain -- relieve it By Helen Altonn
Star-BulletinMore than 2,000 specialists are here to tell you there's no need to fear a root canal.
Despite the horror stories, "it can be done virtually painless today," says Dr. Carl Newton, Indiana State University professor of endodontics and immediate past president of the American Association of Endodontists.
"Fear of root canal treatment truly is fear of the unknown," says Dr. Harmon R. Katz, current association president.
About 17 million teeth are saved each year with root canal procedures, according to the association, holding its annual conference this week at the Convention Center.
Endodontists -- specialists in root canal treatments -- are here from 36 countries discussing research and techniques to give patients a pleasant experience.
Hawaii has about 16 endodontists in active practice statewide and they are "trying to extend the aloha spirit to everyone," said Dr. Gary Yonemoto, Honolulu endodontist on the association's national board.
He said one of the points being made at the conference is that anxiety plays a big role in a patient's perception of pain, although root canal treatment is virtually painless.
Endodontists in Hawaii, as well as around the nation, use simple techniques to reduce patients' anxiety, Yonemoto said.
Dr. Andre K. Mickel headed a study at Case Western Reserve University in Cleveland showing simple relaxation techniques reduce anxiety and perception of pain.
Mickel, who directs an advanced specialty education program in endodontics at Case Western Reserve, said he's a "big baby" when he's in the dental chair, so he understands how patients feel.
He uses soft lighting, light classical music and scented candles to create a calming atmosphere for patients. He also offers them an eye mask, massaging pillow and herbal teas.
Scents such as lavender also reduce anxiety and pain perception, he found in an earlier study.
Yonemoto said he uses music to relax patients. "Classical music is popular but sometimes a teen-ager wants to use contemporary rock music."
He also uses visual aides, such as a gel-filled eye mask. "People are afraid of what you're doing and they'd rather close their eyes and have a warm gel mask over their eyes."
Katz said fearful patients may have had a bad experience years ago, heard an exaggerated story, or they may dread the drill -- a small part of the root canal procedure.
Endodontists have many high-tech ways to prevent and relieve pain, he said. "But just talking to our patients and listening to them is one of the easiest and most effective techniques we have."
A root canal saves a tooth by removing infected or inflamed pulp, which extends from the tooth's crown to the tip of the roots where it connects to tissues surrounding the root.
Deep decay usually is the cause of the infection, although endodontists say chipped teeth and other dental trauma injuries are becoming more common.
The endodontist X-rays the tooth, administers a local anesthetic, cleans and shapes the inside of the tooth, then fills and seals the space. Afterward, the patient must go to a dentist for a crown or other tooth restoration.
Newton said endodontists try to avoid pain with anesthetic techniques including computerized "wands."
The wand varies the rate at which the anesthetic goes into the tissue by measuring resistance just below the threshold where a person might feel it, he said.
Yonemoto said the perception of pain has to do with the rate and temperature of the anesthetic going in. The wand controls the fluid going into the tissue and decreases the amount of pain a patient perceives, he said.
The wand doesn't look like a traditional syringe, he said. "It actually looks like fairy wand with a small little needle on the tip."
Yonemoto said endodontists also are using computer technology to increase efficiency and distract patients. For instance, they can watch what's happening with digital radiography, he said.
"There are a lot of ways to relax the patient but the main thing we want patients to know is they should not fear having root canal treatment ... and we certainly want people to try to save their teeth."
Dr. James C. McGraw of Bellevue, Wash., who was raised on Molokai and went to high school at Mid-Pacific Institute, has received the highest award given by the American Association of Endodontists. Man from Molokai
wins top honorThe Edgar D. Coolidge Award recognizes outstanding leadership and accomplishments by a member in their specialty and their community.
McGraw, whose parents were Baptist missionaries on Molokai in the 1940s, is past president of the AAE, past vice president of the American Dental Association and past president of the Washington State Dental Association.
Grab that knocked-out
By Helen Altonn
tooth -- it probably
can be saved
Star-BulletinIf your child falls from a bicycle, gets hit by a ball or has any other accident knocking out a tooth, don't throw it away.
The same advice applies to adults who lose a tooth in an accident.
Endodontists have been trying to get that message out to people for more than a year, said Dr. Leif Bakland, chairman of endodontics at the School of Dentistry, Loma Linda University, Calif.
Bakland, here for the American Association of Endodontists' annual meeting, said in an interview that the tooth can be saved by following a few simple steps.
The best is to try to put the tooth back in the socket from which it was knocked out, he said. If this is done within 15 minutes, he said, "there's better than a 90 percent chance that the tooth would successfully reattach and last as long as any other tooth.
"Just rinse it off if water is available. If there is no water and the person is aware enough, they can lick the tooth off.... Be careful not to touch the root of the tooth. Put it gently back in the socket.
If a person is unable to do that, the tooth can be saved by putting it in a cup of milk, Bakland said.
Water or another liquid can be used to keep the tooth from drying out but it will probably last only a half hour to an hour, he said.
Cells don't last very long if the tooth is put in water, he said. "Cells will absorb water and pretty soon like a balloon, they will burst. There goes the likelihood of the tooth being able to reattach."
With milk, he said, there is a good chance of keeping the tooth viable for several hours.
"Milk is a very friendly environment for cells on the surface of the root of the tooth that need to stay alive," he explained. "They support the vitality of these cells. That's critical in reattaching the tooth."
If the tooth is placed back in the mouth right away, a dentist or endodontist should be seen within a day or so, he said.
Normally, it's a front tooth that's knocked out, noted Dr. Carl Newton, endodontics professor at Indiana University, Indianapolis.
He recently did root canal treatment on a teen-ager who lost a tooth in an auto accident, he said. Fortunately, emergency technicians found her tooth on the floorboard and put it back in, he said.
"I couldn't help but think of all the treatments she would have had to go through if she had to have a replacement tooth."
Newton said the most common thing he sees, with girls as well as boys, are tooth injuries from basketball. Most sports facilities have tooth-saver kits, he said.
Bakland said the kits are a good idea but often sit on shelves unused.
"The beauty of milk is that it's usually available," he said.
Suffering from a toothache? Endodontists offer these tips to relieve dental pain: Don't ignore pain -- relieve it
Don't ignore minor pain, which could signal a serious problem. Sharp pain on biting may be caused by a cracked or loose filling, a crack in a tooth or decay.
Source: American Association of Endodontists. For more information, send a self-addressed, business-size envelope to the AAE, 211 E. Chicago Ave., Suite 1100, Chicago, IL, 60611, or see the association's Web site at www.aae.org.
