Talk:Root canal treatment

Advice for patients requiring root canal treatment

I a tooth requires root canal treatment it is unlikely that any other form of therapy (other than extraction of the tooth) will be successful in the long term.

In the short term, for controlling pain and discomfort, many over the counter NSAIDs (non-steroidal anti-inflammatory drugs) such as ibuprofen can be used.

In certain cases (if prescribed by the dentist) antibiotic therapy may be of benefit to control infection of the tooth.

Despite popular belief to the contrary, modern root canal treatment can be performed quite comfortably. Avoiding or delaying the treatment can reduce the chances of a positive outcome for the infected tooth.

The most recent medium-scale (~200) patient followup study from the Journal of the American Dentistry Association was published in 1996.

This should be reinserted within the article as prose, rather than as a list of medical advisatory directives.

References

DRosenbach (Talk | Contribs) 12:45, 19 June 2007 (UTC)

Image

On the "root canal" page, the following picture exists: http://upload.wikimedia.org/wikipedia/commons/thumb/3/39/Root_Canal_Illustration_Molar.svg/400px-Root_Canal_Illustration_Molar.svg.png

Why is this image not part of the article that describes the procedure it actually shows? It certainly aids in understanding. Meta

Criticism

The graph showing the advantage of using crows in preventing Fractures of endodontically treated teeth, is nowhere to be found in the cited reference. I’m afraid this might be a gross case of FRAUD where credible academic publications are misquoted to support a view or a service provided by a practicing professional. In any case, care must be taken, or the cited article must be read, before being cited.

I copied the graph from a graph presented during a lecture at NJDS and the source for the material was on the slide of the graph, as cited by the professor. I did not read the article; but the graph doesn't have to be in the article, only the information recorded in the graph. DRosenbach ^{(Talk | Contribs)} 03:43, 25 June 2010 (UTC)

Picture of the broach file

That scared the shit out of me! I thought the blade of that thing was like 3 inches long. Someone please put in measurements or an image of a broach with a penny as a reference or something! Now I'm more relieved... Ahh...

F15x28 (talk) 07:19, 19 March 2008 (UTC)

i just had the first part and see that picture with the icepick and blood and im shitting it. it is uneccessary and rank —Preceding unsigned comment added by 94.196.102.36 (talk) 18:06, 30 March 2011 (UTC)

Jesus, I thought the same thing when I saw this! It is shocking, and Wikipedia has some guidelines about not shocking people. I am going to remove it (again?) for this reason. A loose noose (talk) 12:46, 28 April 2018 (UTC)

Flouride question

In the middle of the section on endodonic therapy, the author states "A tooth with a root canal still has the ability to decay, and without proper home care and an adequate fluoride source the tooth structure can become severely decayed" without any qualification. How does flouride reach the inside of the tooth if the blood supply is no longer reaching it? Has any conclusive study been done to show that teeth that somehow magically get flouride inside them, last longer than teeth that do not? If this is indeed the case, then surely it should be the dentist's job to apply a flouride solution to the open tooth before a filling or crown is applied? freddie (talk) 16:25, 30 July 2008 (UTC)

A tooth with or without a root canal treatment can decay. Good home care and fluoride are very important preventive measures to prevent decay. A tooth without a blood supply can take up topical application of fluoride...as well as teeth with a blood supply. The confusion here is simply the mechanism by which fluoride protects teeth. Fluoride is layed down in the development of the tooth...not to the inside of the tooth after development. What the author is saying here is that topical application of fluoride will further protect the tooth.

Teeth do not last longer because they have fluoride inside them...but because the fluoride ion was laid down in the development of the tooth structure itself. This happens due to systemic fluoride intake. This can reduce tooth decay up to 65%. It is absolutely moronic to me that people fight to keep fluoride out of the water suppy. Anything is a poison if too much is injested. One part per million prevents tooth decay...period. The topical application of fluoride further protects the tooth as it is taken up into the tooth surface to fight demineralization. If you think dentistry is too expensive, yet vote to keep fluoride out of the water supply...then neglect your home care and drink sugar, what are your expectations?? User:DDS1984. —Preceding unsigned comment added by DDS1984 (talk • contribs) 01:27, 11 June 2009 (UTC)

terms, consistency

In the first paragraph, we are told that "root canal" isn't the proper term for "endodontic therapy", but then in the rest of the article, we call it by the "imprecise" term root canal. Shouldn't all of those other occurrences to the procedure "root canal" use the proper term "endodonic therapy?" 72.213.137.61 (talk) 05:00, 6 March 2009 (UTC)

The term "root canal" is used properly throughout the article. When an individual states: "I had a root canal", they are speaking improperly. The proper phrase is: "I had a root canal treatment" or endodontic therapy. When the author is discussing the "root canal" in the article, it is in terms of discussing the treatment of the canals within the root; or more specifically, the author is discussing what is being done in the hollows or within the canals which are located in the roots. A root canal is an actual hollow space (or an actual canal) inside the roots of the tooth. User: DDS1984. —Preceding unsigned comment added by DDS1984 (talk • contribs) 01:43, 11 June 2009 (UTC)

I think maybe you meant "IM-properly", and this is not the only time that someone has mentioned this inconsistency (see below). I have gone over the article and addressed this. A loose noose (talk) 12:42, 28 April 2018 (UTC)

Procedural accidents

Seems to me we need more sourcing for this paragraph. The sole source is a patent, and patent summaries aren't particularly good sources -- certainly not good enough that we can say "occurrence of tool breakage is well documented". --jpgordon^∇∆∇∆ 14:50, 20 May 2009 (UTC)

There are more procedural accidents than the breakage of an instrument. What about perforations?? Opening the wrong tooth? Missing canals? User: DDS1984 —Preceding unsigned comment added by DDS1984 (talk • contribs) 01:46, 11 June 2009 (UTC)

Controversies from Meinig's "Root Canal Cover-Up" and a historical review

Copying this from Talk:Root_canal#Controversies_from_Meinig.27s_.22Root_Canal_Cover-Up.22_and_a_historical_review since here is more appropriate. I noticed George Meinig's Root Canal Cover Up (see summary) on Amazon. Haven't read the book, but did some research and found a 2000 California Dental Association article which has a good review of the "focal infection theory" (root canals leak bacteria into the blood, causing chronic illness). So if this controversy ever gets big, the 2000 CDA is an excellent resource - although it doesn't reference the book specifically, it is about the same "focal infection theory". Shankland seems to be a modern advocate of the theory who has published in peer-reviewed journals (see his summary).

Some more searching turned up Microbiology of endodontics and asepsis in endodontic practice, an excellent article which references Meinig specifically. I will look into incorporating into the article. II | (t - c) 05:57, 27 November 2009 (UTC)

If your dentist has recommended preventative root canal work

This is not the appropriate forum for even your verified, sourced medical advice. DRosenbach ^{(Talk | Contribs)} 18:41, 25 June 2010 (UTC)

Broad scope of "Endodontic therapy"

As I understand the term "endodontic therapy" it refers to a variety of treatment options (eg direct pulp capping) and not just to pulpectomy and obturation. Would it be worthwhile discussing the other treatments that fall under endodontic therapy, or even giving each their own article or am I mistaken about the term's definition? GadBeebe (talk) 19:03, 1 May 2011 (UTC)

Clarify language on irrigants

Article reads: The following substances are used as root canal irrigants during the root canal procedure: 5.25% sodium hypochlorite (NaOCl); 6% sodium hypochlorite with surface modifiers for better flow into nooks and crannies; 2% chlorhexidine gluconate (Perioxidina Plus-2); 0.2% chlorhexidine gluconate plus 0.2% cetrimide (Cetrexidin); 17% ethylenediaminetetraacetic acid (EDTA); Framycetin sulfate (Septomixine); Biopure MTAD Mixture of citric acid, Docycline, and Tween-80 (detergent) by Dentsply USA (MTAD)

It's not apparent to this layman whether ALL of these are used (in the sequence given) or whether the treatment may use only one or perhaps several. Somebody please clarify. Casey (talk) 14:09, 25 March 2012 (UTC)

Garbled text

The seventh paragraph of the Root Canal section contains some garbled text which I am not qualified to correct. "After removing as much of the internal pulp as possible, the root canals can be temporarily filled with calcium hydroxide paste. This strong alkaline base is left in for a week or more to disinfect and reduce inflammation in surrounding tissue.but still patient may complaint of pain in that case dentist left pulp devitalizer over canal thus one visit increased[8] Ibuprofen taken orally is commonly used before and/or after these procedures to reduce inflammation." --72.79.224.47 (talk) 00:57, 18 October 2013 (UTC)BE

See below regarding that 7th paragraph, issue has now been fixed (I think). A loose noose (talk) 12:38, 28 April 2018 (UTC)

About "Types of canal instrumentation"

Hallo people! I'm considering about the advisability of building up pages about K-files and Gates Glidden drills and other specific terminology here used, obviously inserting internal links; this will require time but it can be done. What do you think about? And, ahem... is my English correct? Articioch (talk) 22:33, 10 December 2013 (UTC)

endodontic retreatment merger

I came accross this article Endodontic retreatment which has been previously deleted apparently, and has a merger proposal since last year. I agree that it should be merged with this one. Anyone can do it, I'm working on something else. Bouncingmolar (talk) 03:11, 14 January 2014 (UTC)

Strange quotes

Why does this article use « » and “ ” quotes?  Stepho  talk  04:15, 10 March 2014 (UTC)

Some languages in Europe use double arrows for quote marks (Germany?), and if a person has used a word processor that automatically inserts "corrected" quote marks into a document and then copies and pastes the new content into Wikipedia, the original style of quote mark may be retained. Neither, however, is standard use anywhere on the English Wikipedia, the former because it is not English usage and the latter because it interferes with the way that text gets reused elsewhere on the Internet. The Wikipedia Manual of Style makes pretty clear that only " should be used for any quote mark anywhere, never double arrows and never "corrected" quote marks. A loose noose (talk) 12:35, 28 April 2018 (UTC)

Inaccurate / Unscientific information

I have concerns about the section which reads:

"After endodontic surgery the tooth will be "dead", and if an infection is spread at the apex, root end surgery is required. Although the procedure is relatively painless when done properly,[2] the root canal remains a stereotypically fearsome dental operation."

1) A tooth is not dead after endodontics - there are still plenty of vital cells within the root cementum and within the periodontal ligament

2) If infection extends beyond the apex typical treatment involves orthograde (conventional) endodontics. If this is unsuccessful, recommended treatment is usually repeat orthograde filling [Carotte, P. British Dental Journal 2005]. Only then is retrograde (surgical) endodontics generally considered.

3) The statement: 'Although the procedure is relatively painless when done properly,[2] the root canal remains a stereotypically fearsome dental operation' is conjecture and the reference is not of high quality.

Cheers Thomas Friar (talk) 12:26, 25 March 2014 (UTC)

...There are many other points which need attention here also e.g. 'At this first visit, the dentist must ensure that the patient is not biting into the tooth, which could also trigger pain'... That information has no real basis. Whilst a tooth may be eased from the bite this is certainly not regular or generally good clinical practice. I would suggest this sentence is removed — Preceding unsigned comment added by Only1tomfriar (talk • contribs) 19:58, 25 March 2014 (UTC)

Hi and welcome. Yes this article needs a lot of work. Would comment on these specifics:

1. Yes this is true. However, this is the phrase commonly used to explain what root canal treatment is. Perhaps it would be more accurate to say the dentinopulpal complex is devitalized by endodontics, if it was not already nonvital.
2. Agree
3. Many patients do tend to say they have heard horror stories about "having a root canal done", but then this is also true of extractions, or most dental treatment for that matter. Perhaps best to take out unless a good source.
4. Taking teeth out of occlusion is routine, esp during the acute phase of pericoronitis when immediate extraction may be undesirable. It can mean the difference of someone being able to eat again after not being able to for a few days before the emergency appointment. Have to disagree. Taking an endodontically treated tooth out of occlusion until a full coverage occclusal restoration is placed also seems sensible, as access cavities significantly weaken teeth and predispose to fracture. Lesion (talk) 20:50, 25 March 2014 (UTC)

Yep, I agree on point 4. I'm playing devil's advocate a bit! ;) Maybe the statement could be reworded, perhaps - 'A root treated tooth may be eased from the occlusion as a measure to prevent tooth fracture prior to the cementation of a crown or similar restoration'

thanks Thomas Friar (talk) 21:04, 25 March 2014 (UTC)

I've changed the section: 'Starting with 15 number H, which is also called a pathfinder, and after that the files' number increases up to 35 in molars and up to 50/55 in anterior teeth to widen the canals for a successful treatment'. Reason: file size selection is dependant upon tooth anatomy and does not always follow this sequence, particularly if greater taper/rotary instruments are utilized. Thanks Thomas Friar (talk) 09:33, 27 March 2014 (UTC)

Use of the term 'root canal'

I feel the use of the term 'root canal' is confusing within this article. I appreciate 'root canal' is a lay term for 'root canal therapy' but it's use here is not helpful when there are multiple references to 'root canal' as an anatomic structure. I would suggest that 'root canal' is used only for description of the tooth's anatomic structure and 'root canal therapy' for description of the treatment. cheers Thomas Friar (talk) 20:56, 25 March 2014 (UTC)

Agree. Sorry I can't help on this article right now... maybe sometime soon I can help. I did recently add some material on endo to wikiversity however: [2]. Lesion (talk) 21:42, 25 March 2014 (UTC)

 Done The article had a LOT of casual mistakes regarding this-- I have now gone over it and tried to fix each one, using "root canal" for the anatomical object and "root canal therapy" or "root canal procedure" for each instance where a procedure (as opposed to a structure) is meant. Future editors are likely to still come along and bungle this, but at least for now it is taken care of. A loose noose (talk) 12:27, 28 April 2018 (UTC)

Typographical error, missing content, or just medicalspeak?

In the Treatment procedure section, there is the following sentence:

The patient may still complain of pain if the dentist left pulp devitalizer over canal thus one visit increased.

Is that correctly written, or is something missing or mistyped? Particular concerns appear to be:

• Does it mean to say "over the canal"?
• What is the relationship between having "left pulp devitalizer over canal" (or whatever is ultimately meant) and the patient's pain complaint? That is, how is the pain continued, and is it a new cause or merely failure to fully eliminate the original cause?
• What does "thus one visit increased" mean? I'm not medically trained (only rhetorically trained), but, for example, does it mean to say "thus another visit is required"? (If that is the case, then the functional reason for the revisit should also be stated.)

Even if the language is intelligible to medical professionals, can it be stated in a more generally understandable way? In fact, that entire paragraph is a bit unclear. The term "devitalizer" is not used or explained elsewhere (i.e., earlier) in the article. Does it refer to calcium hydroxide? If so, the article states that the calcium hydroxide is "temporary"; perhaps a sentence should be added (probably before the cited sentence) to describe the follow-up (permanent) procedure. Maybe it is the absence of such explanation that is making the cited sentence obscure? Eplater (talk) 20:27, 31 January 2015 (UTC)

It looks like this paragraph was edited to try to make this wording more clear, but even so, the reference attached to it had very little to do with the paragraph itself. I have gone over the reference and made the paragraph match its content more closely and hopefully removed any lingering confusion about what is meant. The original wording was clearly unclear (!). A loose noose (talk) 12:03, 28 April 2018 (UTC)

Root canal rotary technique treatment

Hi.

If someone could add info about the rotary machine treatment as opposed to the classic needles to this article that would be great. — Preceding unsigned comment added by 92.18.35.79 (talk) 12:44, 17 October 2018 (UTC)

Yes, esp as this is the norm nowadays. Matthew Ferguson (talk) 20:02, 19 October 2018 (UTC)

Needs a history section

Article needs a section on the history of root canal treatment. Mikedelsol (talk) 06:30, 12 May 2020 (UTC)

Reorganize and rewrite

The article needs to be reorganised and rewritten according to WP:MEDMOS#Surgeries and procedures.

1. Indications
2. Contraindications
3. Risk/Complications
4. Technique/procedure (avoid step-by-step instructions)
5. History
6. Society and culture
7. Special populations
8. Other animals

I think above format is more useful to readers.-Nizil (talk) 07:31, 15 January 2019 (UTC)

Requested move 4 February 2019

The following is a closed discussion of a requested move. Please do not modify it. Subsequent comments should be made in a new section on the talk page. Editors desiring to contest the closing decision should consider a move review after discussing it on the closer's talk page. No further edits should be made to this section.

The result of the move request was: consensus not to move this article to Root canal. There is also no consensus to move Root canal in the discussion below. However, there is broad support for moving this article to a different title. Per WP:THREEOUTCOMES, moving Endodontic therapy to Root canal treatment at this juncture, with no bias against a new proposal to rename this article (e.g. to Root canal surgery) at any time. Dekimasuよ! 04:27, 18 February 2019 (UTC)

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• Endodontic therapy → Root canal
• Root canal → Root canal (anatomy)

– This article is currently called endodontic therapy, but the WP:COMMONNAME for the subject of this article is "root canal". There is another article called root canal which covers another meaning of that term, which is that a root canal is an anatomical feature.

This therapy article is getting about 20k views a month and the anatomy article is getting about 30k views a month, which places them among the opt 0.1% of Wikipedia articles by popularity. I think that the demand is actually about 45k a month for the therapy and 5k or less a month to learn about general mouth anatomy. The article currently called root canal cites 1 source, and there are 1000s of WP:MEDRS sources covering the concept of the therapy. Because of the weight of the sources, and because this is top article by popularity because of the medical procedure, and because this procedure has popular recognition by the name "root canal", I propose that this article take the title "root canal" and the anatomy article get moved to "root canal (anatomy). Blue Rasberry (talk) 15:47, 4 February 2019 (UTC) --Relisting.  — Amakuru (talk) 15:27, 11 February 2019 (UTC)

• I think the only previous discussion of this was in 2007 at Talk:Root_canal#Proposed_name_change_to_'Root_canal_therapy'. Blue Rasberry (talk) 15:48, 4 February 2019 (UTC)
• Absolutely incorrect. Root canal is an anatomical term not a procedure. All teeth have root canals naturally. Root canal treatment / therapy, or endodontic treatment / therapy is the procedure of removing the root canals and sealign the space left behind. This is as incorrect as a patient saying they have "TMJ" (anatomical term for the jaw joint) when they mean TMD (a disorder of the jaw joint). I would also add that in my experience this confusion does not happen in all english speaking countries equally. If you must rename this article then name it root canal therapy or root canal treatment not root canal. Consider also placing a hatnote to clearly distinguish the anatomical article from the procedure. Endontic therapy / treatment is the term used in dental literature however. It will be incredibly rare for a scientific publication or textbook to call the procedure "root canal". Therefore when you state that there is an alternative meaning of the term root canal this is not correct. It is a term which is being confused by laypersons and perhaps some websites and advertising material specifically directed at consumers/patients rather than professionals. Kind regards, Matthew Ferguson (talk) 19:18, 4 February 2019 (UTC)
• Oppose root canal treatment if anything. In ictu oculi (talk) 07:54, 5 February 2019 (UTC)
• I would go with root canal surgery, or (distant second choice) maybe "root canal treatment". It is very true that "endodontic therapy" fails WP:COMMONNAME and WP:RECOGNIZABLE, but it's also very true that "root canal" by itself refers to the anatomical feature, even if people casually say things like "I badly need a root canal". It's just like "I have a bad case of hemorrhoids" when the speaker really means "I have bad case of inflamed hemorrhoids". That said, I don't think "treatment" is the common name for the procedure, but that "surgery" is. (This could have ENGVAR aspects of which I'm unaware). "Root canal therapy" is definitely not it, even if if "therapy" is common in technical medical jargon collocated with "endodontic". (In this respect, it's like "heart attack" and "myocardial infarction"; the two collocations cannot be mixed – people don't have heart infarctions or myocardial attacks.)  — SMcCandlish ☏ ¢ 😼  01:49, 8 February 2019 (UTC)

That term is in not in common use. Rename it root canal treatment / therapy. Matthew Ferguson (talk) 18:19, 9 February 2019 (UTC)

• Move to Root canal (dental surgery). The WP:COMMONNAME is "root canal" and the parenthetical disambiguation should match the title of the main article Dental surgery. Rreagan007 (talk) 20:07, 11 February 2019 (UTC)
• Oppose. The current title is correct. The proposed title is incorrect. Root canal therapy would be okay, but is already a redirect (and objected to, above) so no real benefit to that. The hatnote on root canal takes care of those who land there by mistake. Station1 (talk) 08:01, 13 February 2019 (UTC)
• Move to Root canal (dental surgery) and Root canal (anatomy) with Root canal redirecting to the anatomical feature and a hatnote disambig. Per WP:COMMONNAME, Endodontic therapy shouldn't be used at all, and the anatomical feature should be more clearly specified. Smith(talk)

What name is used in scientific/dental publications is of prime relevance for the naming of the encyclopedia article. The scientific/dental publications do not call the procedure a "root canal". "Root canal treatment", "root canal therapy", "endodontic therapy" or "endodontic treatment" are all factually correct terms. You could legitimately rename to any of those. To name the article "Root canal" to refer to the endodontic procedure is factually incorrect, only some laypersons will mistakenly use that phrase for that meaning. The encyclopedia should absolutely cover a common misconception, but until the academic sources also adjust their terminology it is not correct to use that title for the encyclopedia article. I suggest a hatnote on the root canal article to direct users to the procedure article when they have arrived at the anatomical article. I also suggest a brief discussion of this confusion that some patients make within the article, with appropriate sourcing. Renaming this article to "root canal" is analogous to the renaming of the tonsillectomy article to "Getting your tonsils out" simply because that phrase might be more commonly used and understood by laypersons. Medical articles on wikipedia are not Patient information leaflets, something I have previously tried to point out to the OP. They are encyclopedia articles which should use official terminology and give encyclopedic coverage of the topic. They should not be written solely for the benefit of patients but for encyclopedia readers. Matthew Ferguson (talk) 20:25, 13 February 2019 (UTC)

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The above discussion is preserved as an archive of a requested move. Please do not modify it. Subsequent comments should be made in a new section on this talk page or in a move review. No further edits should be made to this section.

paraformaldehyde sentence

This bit reads poorly (at best) and has some red flags for bias (at worst).

> However, long and proven knowledge has shown that the results will increase dramatically if a small dose of paraformaldehyde is added to the zinc oxide. This was clearly demonstrated in a retrospective study (Telander 1966) who showed a success rate of 92 % at a six year follow up. No signs of infection were seen. Several studies in the 21 century have confirmed the high success rate. (A. Steup 2001, U. Teeuwen 2007, P. Venuti 2014)

"long and proven knowledge" sounds like someone trying too hard, the reference formatting is weird and it is overly detailed (and defensive) for the intro text.

I'm not an expert, but I would guess that replacing with something like: > paraformaldehyde is sometimes added to the zinc oxide [ref] would be appropriate.

Da5nsy (talk) 17:47, 18 October 2021 (UTC)

Sargenti method

There are a couple of paragraphs under "Filling the root canal" on the Sargenti method. As far as I can tell, consensus in the dental community is that this is harmful and it is supported only by a small fringe of dentists. I don't see any reason why we should mention it at all, unless we're going to add a section on historical, proposed, or pseudoscientific methods of root canal treatment. Does anyone think we should keep it in the article? Dakane2 (talk) 21:49, 2 June 2022 (UTC)

References