I was supposed to have root canal today but it didn't happen because they could not numb the tooth all the way. Apparently the nerve is inflamed. It was suggested to use an oral steroid decadron to bring down the inflammation and try again.

I tend to be a very anxious dental patient so they also gave me prescription for Halcion to take the night before and day of appointment.

I will be calling my dentist later today to discuss this with him but I'm still pretty numb and talking is a challenge.

I am wondering if this is the right thing to do for me or should I just get it pulled? I am wary of steroids and pretty much all drugs. Has anyone gone this route?

Thanks.

Hi Marlene,

I am in the dental field and can offer you some information here.

Why are they recommending a root canal on this tooth? Is is decayed.... fractured..... broken down to the pulp.... abscessed?

You are wise to be concerned about using the steroid medication as with all medications it can have some unpleasant side effects and it may not be at all effective in reducing the nerve inflammation inside of this tooth.

The suggestion of halcion, again a medication that comes with the possibility of side effects, is prescribed "carefully" to patients who are extremely anxious in the dental chair. The notion is to have you sedated enough to perform the root canal procedure even if the steroid does not take affect. This is not necessarily a negative thing if you are comfortable, but they have no way of telling how you will respond to the medications and once the tooth is opened up and the procedure is started, they will want to continue with it. These are things they should have informed you of.

You raised the question of having the tooth removed instead having the root canal. Your dentists should offer you both options along with information on the long term differences between the two.

Re the root canal procedure: This procedure can only attempt to remove the nerve tissue that is visible in the large canals. The problem with that is without exception, it leaves behind the dead nerve tissue inside of the many hundreds++ of tiny canals called the dentin tubules. This results in a chronically inflamed and bacteria ridden tooth. Eventually the bacteria spreads from the tooth and irrelevant of any symptoms, the original tooth problem now becomes more widespread. So a root canal cannot "cure" an infection... it is performed to attempt to "retain" an unhealthy tooth for an undetermined amount of time. There are systemic (whole body) consequences associated with keeping an unhealthy tooth and replacement options for a chronically infected tooth are limited due to the bone loss that occurs from the bacteria.

Re the extraction: This procedure eliminates the source of the problem. If there are no subsequent issues with the jaw bone and the patient heals well, the original problem is taken care of and more replacement options may be available.

If you are anxious about having the tooth extracted.... consult with an oral surgeon and discuss some light IV sedation (called twilight sedation) with low dose oral valium the night and morning before the appointment. Patients tend to do really well with that combination with no long lasting side effects.

I hope this information is helpful to you.
Please keep us posted.
Bryanna

Hi Bryanna,

Thanks for the quick reply. This tooth was capped about 30 years ago because I had pain when I bit down on things. So the dentist back then said I probably have a hairline fracture and the cap would help that. This tooth was alway sensitive but I guess looked ok. Now it needs to be replaced and it had some decay below the gum line. The cap was removed, the decay also removed and a tempy cap is on it. The dentist could not fully numb the tooth when he was doing all that. The endo said the root is inflamed and in bad shape and needs a root canal. There is no infection.

Steroids to "save" a tooth is not sitting right with me. I've alway felt steroids are over used and should be reserved for more serious issues.

I'm not new to root canals and have read about how they impact your health. I had three done in the 90's. I often think about getting them removed but never do. I've never had an abscess or tooth infection. It's always been structural.

Luckily, I have time ponder this.