There’s no easy root canals in endodontics
Meredith Y. Newman, DMD
August 27, 2020
Today I would like to focus on a statement that is often made by dentists when discussing root canals. “Oh, I don’t do molars. I only do root canals on premolars and front teeth – the easy ones.” I have thought about this comment a lot, because as an Endodontist who specializes in all types of root canals on all types of teeth, I have to disagree. Nowadays, as root canal specialists who are highly trained in anesthesia and technology, we can make the patient have a pleasant, pain-free, and easy root canal experience, but as a clinician, it is wise to remember that there is no such thing as an easy root canal.
The thing that makes root canals so interesting to root canal specialists is the fact that every tooth has different anatomy. This is both a blessing and a curse. One of the best parts of doing root canals for a living is being able to treat a wide variety of different dental anatomy. Every tooth has something special about it, and every tooth developed differently. Much like a snowflake, no tooth is the same as any other. As an Endodontist, this is my favorite part of my treatment – learning the different anatomy of the tooth as I perform the root canal. But it is also a curse, because teeth that many may consider to be “easy” can become extremely difficult.
In 1984, Vertucci studied root canal anatomy, and discovered that in the bicuspids, or premolars, there was not one single anatomy that was consistent amongst all teeth, but in fact eight different ways that teeth developed and presented. This means that every premolar has at least 8 different ways it can present when needing a root canal, which is a challenge! Eight different configurations means these teeth are actually pretty difficult, and not at all an easy root canal. This is why it is so important for root canal specialists to treat these teeth.
Recently I had a tooth that totally demonstrated this point. A young man presented to me for a root canal with a tooth #5 that was hurting him to hot and cold. The pain was waking him up at night and spontaneously hurting throughout the day. He had a large composite restoration that was close to the nerve and his dentist felt he was best served by a root canal. He had had several root canals in the past and was open to the idea of a root canal for this tooth. Based on his symptoms, and with our testing, he tested as having an irreversible pulpitis and he definitely required root canal therapy in order to treat the pain. Based on the initial x-ray, I thought the tooth looked different from a standard, “easy” root canal, but I couldn’t quite pinpoint what exactly was going on. When I got into the tooth, it became clear this tooth was anything but easy! Instead of having one, or even two canals, the tooth actually had three canals. I thought I could feel my small file catching into another canal as I was treating the buccal, but I wasn’t fully convinced until I took a cone shot that revealed an off-center canal in the buccal root with a sealer tract. As it turned out, three different nerve spaces were present in this root canal! But even more interestingly, the buccal canal split mid-way down into two separate canals, similar to a snake-tongue. Considering how root canal specialists deal in millimeters when they are working, it was very difficult to negotiate the split of the canals. I had to use an instrument that was only 6/100th of a millimeter in diameter in order to get down the nerve space and remove the irritated nerve. Sealing the tooth was even more difficult! It took several tries to ensure the split was adequately filled and sealed properly. When I called the patient the day after his root canal to check in on him, he was feeling great, and I was feeling great knowing that we had removed all the of the irritated nerve.
Cases like these reinforce why root canals should never be taken for granted as a clinician. You never know what anatomy you are going to discover and how difficult the root canal may be. It is best to ensure you have plenty of time and are fully trained in all the techniques for identifying root canal anatomy, even when attempting a root canal you may consider “easy” – no matter what tooth it may be in the mouth.
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Capistrano C. 
Dra Mate Moreno is a highly qualified professional. She runs an impeccable clinic with friendly staff and updated equipment. I had some implats done at her clinic in Tijuana 4 years ago, and every dentist in the San Francisco Bay Area that looked at my mouth complimented her work. Like me if you go to her clinic, you will be proud to say that you had dental implants done in México. Thank you.
Henrique Du Tiel
I have been coming here for years. I love this office. I feel at home when I come here. Dr. Askari is awesome and her staff is very friendly and helpful.
luvzlara
Cant say enough great things about Dr. Askari and team. I have had the best experience with everyone at the office and I highly recommend! Thanks Stephanie, Mercedes and Dr. Askari for the wonderful environment and service :)
Chris Conlon
Excellent staff, everyone makes you feel welcomed. I have been with Dental Care of Ventura for years. I recommend their service to everyone.
Kevin Brown
Great friendly service. They are concerned about your comfort and wellbeing. They do great work. Their staff is 2nd to none.
Tom Xedos
I have been a patient of Dr. Askari + team for the past 5 years and highly recommend her practice. Dr. Askari is friendly and it always a pleasure speaking with her. She always provides detailed information, explanations, and cost breakdown prior to doing any procedure. The rest of the team is just as amazing, always smiling and happy to see you. I was hesitant about going to the dentist during the COVID pandemic, however Dr. Askari made me feel completely comfortable and safe (hand sanitizer at front desk, sanitized pens, temperature checks, plexiglass barrier, open door for fresh air etc). If you are weary of the dentist, please be sure to check this practice out, you will not be disappointed!
Cassaundra Garcia
Dr. Newman was incredibly kind and compassionate. Dr. Newman and her assistant were very reassuring and talked me through the entire root canal. She made a stereotypically scary procedure very easy. The APEX office was beautiful and the staff were very friendly and exhibited the utmost professionalism. I cannot recommend Dr. Newman highly enough.
Thomas
From the moment you walk in your greeted by an amazing staff that I energetic and excited to help. They are highly educated to help with any questions you have on insurance coverage, or the specifics of certain surgery's. Coming to this dentist office set the bar so high, with the service Dr.Askari provides there is no way I'll ever go anywhere else.
The Mega Board
Ive been getting my teeth cleaned here for years everyone here is so awesome friendly they make you laugh they are very gentle when they clean your teeth or do any dental work its an awesome place to be I will never trade it for another dental office love this place and love everyone who works here!
Celeste Yuss
Dr. Askari is the BEST! Honest, professional, and precise. My family has been going there for 6 years. Every other dentist I went to before told me I needed fillings, crowns; even possibly a root canal. Immediately! Dr. Askari said, continue to floss/clean and you will be fine. Six years later, and not one filling. Unfortunately, this past year my mother passed away, we moved into a house, and we had a child. Good & bad stress. Hence, my teeth were neglected. This past month, I did have to have fillings and one crown (which I knew were my fault). I was nervous, since I hadn't had any work done. And, my previous dentists either left me in pain for days or the bill was excruciating that I was hindered financially. Neither happened! Dr. Askari did everything in 2 days, with the help of her amazing staff, and I was pain free! Also, our bill was large (not a surprise) but reasonable compared to others I had spoken to about what I had done. I feel like I am selling this place but I hope that's not what you perceive. My experience (over the years) have been so positive and I know how hard it is to find a GOOD dentist. I hope my feedback will help. I couldn't recommend Dental Care of Ventura enough. Good luck!
Jenny Urbanick
Saw Dr. Newman for an emergency root canal. I got seen right away and it didnt hurt. I hope i never need another root canal but if i do i will go back to her. She was really nice and explained things well.
user
Very disappointed with this office. They over charged me and my insurance. I have called them numerous times and the receptionist keeps saying the office manager will call me back but has not called me yet. It's been months now. Be careful with what they charge you, check with your insurance!
Sara Pacheco
Dr. Newman is really friendly and kind. I don't want to call a root canal wonderful, but it was really no big deal. I had no pain afterward and could chew on the tooth the very next day. Would totally recommend her. The office is super nice as well, totally brand new.
Paul V
I saw Dr Newman at her new office, Advanced Perio Endo experts. It was super nice, and she was so friendly. I was in a ton of pain and she saw me immediately. She talked me through everything and made me feel really comfortable. My dentist couldnt get me numb but she got me numb without any problem. I woke up the next day and felt a million times better! I would totally go back to see her for another root canal if I ever need one.
user
I had an overall nice experience, as far as dentist office visits go. The staff is courteous, kind, and they made sure that I felt safe during this COVID19 pandemic. I was happy with all of the work I had done because it was done right the first time. I have a million dollar smile! I highly recommend this office to anyone who needs dental work done.
Jerome Rabago
Love this place! So friendly and they make everything about visiting the dentist easy!
Abigail Michelini
It has been close to three years since I have been down there for dental work. Just a note to hope that you and your staff are in good health and that things are going fine for you and your dental Patrice. You and your staff take care and enjoy all things. It was a pleasure to meet you and your staff.
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