Root canals now better than jumping off a cliff Root canals now better than jumping off a cliff (March 11, 2005)

by Jeb Bing

M utter the words root canal and most of us shudder, convinced that this must be the most painful of all dental procedures. But in the real world, an estimated 14 million of us have root canals each year, and I joined that group late last month. Thanks to today's technology and the expert skills of the endodontist I was referred to, Dr. William Palank, the procedure was painless and completed in just three days from start to finish. Except for having the mouth propped wide open most of the time, which left me with little to do but count ceiling tiles, the treatment was as unremarkable as having a cavity filled, yet it saved a tooth that not too many years ago would likely have been extracted.

I'm writing about this because so many friends and colleagues shook their heads in sympathy as I headed out the door to Palank's office. Some of them had a metaphor comparing a root canal to falling off a cliff, not sure which they would choose. Those who had the procedure 20 years ago would be pleasantly relieved at how much it has changed. And while I hope no one needs a second one, the fact is that any of us could. As Palank explained, all teeth have at least one root canal and many have four. Even in this age of fluorides and fewer cavities and fillings that can someday dislodge and lead to tooth infection, the number of root canals keeps increasing. The crowded patient schedule at Palank's practice shows no shortage of patients, with Palank, himself, handling root canal treatment on an average of five patients a day plus consultations and follow-up visits for even more. His partners in his endodondics practice handle just as many.

Of course when you're stretched out in a nearly prone position with lights glaring and Palank and those working above wearing magnifying glasses and facial masks, there's not much opportunity to get acquainted or ask questions. That's why I waited until after my treatments to catch up with Palank at his San Francisco home to learn more about him and root canals. With 23 years in the profession, he's seen the technology improve with better anesthetics; pliable, unbreakable electric-powered nickel titanium files that can accurately and gently move through curving root canals; and high-magnification goggles and low-exposure X-rays that follow the progress to show when the procedure is completed. Palank admits that because of his schedule and the preparatory work needed to start the procedure that he seldom gets to know his patients like a dentist or primary care physician might. In fact, he sees most patients only once, plus on a follow-up visit six months later. He jokes that there've been times when a patient greets him at a coffeeshop and he's tempted to ask them to open their mouths wide so that he can recognize them.

Palank says that with many in the Bay Area opting for costly caps, whitening procedures and other cosmetic dental work, they're seeing their dentists more frequently, who spot cracks and loose fillings and repair them quickly. Even so, the numbers needing root canals are growing, particularly among the young who more frequently engage in extreme sports, including skateboarding, occasionally taking nasty spills that result in almost undetectable cracks and loosened teeth until the gap becomes infected. They may not have jumped off a cliff, but at least they can now correct the damage painlessly and without fear.
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Correction: Although the online edition was correct, my column in last week's last week's print edition left out an important date. It was 109 years ago that Pleasanton's own Phoebe Apperson Hearst founded the PTA.

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