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Choosing a Root Canal Therapy Option

When it comes to root canal therapy, patients often have a lot of questions—from the type of therapy to pursue to what to expect before, during and after treatment.

The GentleWave® team set out to answer these questions by going straight to the source—a board-certified endodontist! Read through our Q&A session below with Dr. Anne Wiseman, owner of Wiseman Endodontics.

Ask the Endodontist: Dr. Anne Wiseman

GentleWave ProcedureQ1: If a patient is diagnosed with an infected root canal system, which options do you typically outline for them?

A1: The treatment plan for an infected root canal system, which often is the question of root canal or implant, is always developed around the prognosis of the tooth.

Technically, an endodontist could perform root canal therapy on every tooth, but if the tooth doesn’t have a good prognosis, the therapy will likely be unsuccessful. With that said, depending on the prognosis of a patient’s tooth, there are typically three therapy options:

  1. Root Canal Therapy or Retreatment: This is typically the option for straightforward root canal system infection cases.
  2. Tooth extraction: Extraction is the removal of the tooth. Once the tooth is removed, the patient has the option of receiving a dental implant. Some dentists place implants and some refer to an oral surgeon or periodontist to place the implant. Once the implant heals, the dentist will place a crown on the implant.
  3. Root end surgery (apicoectomy): This procedure involves opening the gum tissue near the tooth, allowing the endodontist access to the underlying bone. This gives the endodontist the ability to remove infected tissue and the end of the root.*

Q2: Of the options you’ve just outlined, which do you most advise, and for what reasons would you advise a patient to seek one option over another?

A2: The option I advise is always the one that is best for the longevity of the patient’s tooth.

If standard root canal treatment—or an alternative such as the GentleWave® Procedure—is going to provide the patient with many years of tooth function and health, that’s enough reason, in my opinion, to move forward with root canal therapy to save the tooth.

On the other hand, if the patient has a history of cracks or fractures within their teeth, it’s likely that the tooth in question also has a fracture and other options, such as tooth extraction, may be better suited for the patient.

The most important thing is to advise the procedure that is going to best help the patient. The goal is to help each patient get back to functioning normally, whether that’s with a root canal or implant.

Q3: You mentioned standard root canal treatment and the GentleWave Procedure as root canal therapy options. Are there benefits to receiving standard root canal treatment (RCT) vs. a procedure such as the GentleWave alternative?

A3: First, I will say that I’ve used the GentleWave Procedure almost exclusively for three years so that may begin to answer the question.

The main issue with standard root canal treatment is a phenomenon called vapor lock, which is gas entrapment in the apex of the tooth. What this means is that there are bubbles present that prevent the irrigants—the fluids meant to help clean and disinfect the root canal system—from reaching the root tip where bacteria is hiding. But with the GentleWave System, the fluids reach through the entire root canal system,1 so cleaning is profoundly improved. I’ve noticed a significant visual improvement in what the tooth looks like before and after treatment when using the GentleWave Procedure.

I’ve also noticed a decrease in calls about discomfort from patients post-procedure when using the GentleWave alternative compared to when I performed standard RCT. After being a GentleWave provider for several years, I don’t want to go back to performing root canals using standard RCT with what I know now—the GentleWave Procedure prevents vapor lock and effectively cleans the areas I can’t see.

Q4: We’ve talked a lot about standard RCT and the GentleWave Procedure, but what about dental implants? Are there pros and cons to a root canal or implant?

A4: Implants are a good course of action when patients don’t have another option, for example, if their tooth is fractured.

There are pros to implants, mainly when compared to a dental bridge as dental bridges are difficult to floss around. You also cannot form a cavity around a dental implant because it is titanium, which is another positive. However, there are also some negatives about dental implants.

The process of receiving a dental implant can sometimes take as long as a year. In addition, aesthetics can be challenging for patients as the gum surrounding the implant never truly looks the same. And, when the tooth is removed, patients lose a portion of their gum, so the papilla, or the gum tissue that comes to a peak between two teeth, is no longer the same height—this could result in a black triangle between the teeth.

Q5: What has been the most impactful differentiator of the GentleWave Procedure among patients?

A5: Patient comfort.

Most patients who have received the GentleWave Procedure have said it was easier or faster than they expected. I’ve also had patients say that they were surprised at how comfortable they were throughout the procedure. In fact, it isn’t unusual for patients to fall asleep during the procedure, which I consider to be the biggest compliment!

When I implemented the GentleWave System into my practice, one of the other things I noticed right away was that I am able to visualize a cleaner tooth compared to when using standard RCT. The anatomy of the root canal system is very complex, which makes it difficult for many dental instruments to reach throughout the root canal system. Thankfully, by using fluid dynamics and broad spectrum acoustic energy to clean and disinfect the root canal system,2 the GentleWave System can reach even the deepest and most complex portions of the root canal system.1, 2

It gives me peace of mind knowing I’ve done everything I can to help patients save their natural tooth.

Q6: What have you noticed post-procedure in regards to discomfort after treating many GentleWave patients?

A6: I’ve noticed that my GentleWave patients experience more immediate relief and sustained comfort.

I typically call my patients the night of or the day after their GentleWave Procedure to see how they’re feeling, and they’re always shocked at how comfortable they are, especially those who came into the office with significant pain. This shift has impacted the amount of pain medication patients require post-procedure.

Q7: Since you implemented the GentleWave System into your practice, are there any patient testimonials that come to mind?

A7: Our patients often leave very nice feedback about the treatment we offer.

If you read through our practice’s Google Reviews, you will gain better insight into what patients think. I believe that the GentleWave System, paired with our patients’ willingness to share their experience, is helping to change the reputation of root canals for the better.

Q8: If you were diagnosed with an infected root canal system, which option would you choose for yourself and why?

A8: I would seek an endodontist who uses the GentleWave System, without a doubt—I’d fly to another city if I had to!

As a board-certified endodontist, I understand the importance of performing treatment that is backed by Sound Science® and research. Having used both standard RCT and the GentleWave Procedure, I’ve seen the level of cleanliness that exists before and after each therapy option is performed—and have witnessed an improved patient experience with the latter. With what I’ve learned, I would definitely seek a GentleWave provider if I were diagnosed with an infected root canal system.

An endodontist’s files can’t clean what they can’t reach. Thankfully for my patients, the GentleWave System reaches into microscopic spaces that standard root canal treatment frequently cannot.2,3

Receive a Higher Level of Clean

Many endodontists today are adopting the GentleWave System into their practice as it allows them to provide efficient cleaning1 and a better patient experience.

If you have an infected root canal system, use our Provider Locator to find a dentist or endodontist in your area with the GentleWave System.