Summary
In this video, endodontist Dr. Graham Locke explains how his office diagnoses tooth problems and helps nervous patients through a root canal.
His patient Jean had an odd feeling in a tooth that wasn’t really painful. Her X-rays looked fairly standard: a silver filling, with no major decay. Dr. Locke explains that X-rays are two-dimensional and are only one of many tests used to decide whether a tooth is infected and needs a root canal, so his team keeps testing and diagnosing to find where the symptoms come from.
Jean had never had a root canal and was nervous, so they discussed IV sedation. Dr. Locke says his office tailors sedation to each patient: some need only local anesthetic, some want “gas,” some want oral sedation and some want IV sedation. With IV sedation, he says, Jean never felt the injections in her mouth and never felt claustrophobic under the rubber dam, and it lets his team work more thoroughly while protecting the airway.
Working under a microscope, once the silver filling was removed, they found a slight vertical crack in the tooth that hadn’t shown up on the X-ray. Dr. Locke says the microscope lets him see down the root canal system, often to the tip of the root.
Jean says the IV needle was the only thing she felt. Afterward she was awake and aware, and was taken by wheelchair to her husband’s car to go home.
Key takeaways
- X-rays are only one of many tests used to diagnose a tooth that needs a root canal.
- Sedation can be tailored to the patient: local anesthetic, “gas”, oral sedation or IV sedation.
- With IV sedation, the patient in the video didn’t feel the injections or feel claustrophobic.
- A microscope can reveal problems, such as a small crack, that don’t show on X-rays.
Questions Dr. Locke answers
Can a tooth need a root canal even if the X-ray looks normal?
Yes. Dr. Locke says X-rays are two-dimensional and only one of many tests. In this case, a crack was found under the microscope that didn’t show on the X-ray.
What kinds of sedation are available?
Local anesthetic, “gas”, oral sedation or IV sedation, tailored to each person’s needs.
What are the benefits of IV sedation?
The patient in the video never felt the injections or felt claustrophobic, and Dr. Locke says it helps the team work thoroughly while protecting the airway.
