Can Root Canals be Pain-Free? How Dr. Alexa Martin is Redefining Root Canals in Beverly Hills
By: Suzanne Kvilhaug
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Ah, the dreaded root canal—the dental procedure that sounds like a thrilling adventure to the center of the earth, but in reality, it's more like a journey through the depths of dental despair. Picture this: You're reclined in a chair that rivals the comfiness of a La-Z-Boy, and your dentist, armed with enough dental tools to open a hardware store, is about to embark on a mission to the mysterious underworld of your tooth.
I’d love to take credit for that captivating(ish) opening paragraph but it came from an AI tool. A funny AI tool that seems to be on its A-game today. When it comes to an opener about root canals, I felt tongue-tied. The classic “writer’s block” if you will. All I could think of was how the root canal is universally perceived as one of the worst procedures to have done but I couldn’t put it into words. It made me wonder how the root canal became known as the ultimate doomsday activity in the first place.
Once I learned more details about root canals, I was surprised about the process. Yes, I mean pleasantly surprised. No, it doesn’t sound like heaven on earth by any means but it doesn’t sound as terrible as one may think after hearing the societal chatter and references. It could be that most of the so-called dental despair comes from general assumptions and lack of detailed knowledge. All of this made me really excited to get the opportunity to interview Dr. Alexa Martin of Martin Endodontics in Beverly Hills and ask detailed questions about root canals, dental health, teeth whitening, and how to get over the fear of going to the dentist.
Dr. Alexa Martin of Martin Endodontics earned her undergraduate degree from UCLA and her dental degree from Tufts University School of Dental Medicine. She completed a Hospital Residency at Cedars-Sinai Medical Center in Los Angeles and then practiced general dentistry locally before moving back to Boston once again to pursue her specialty training. Dr. Martin is an active member of the American Association of Endodontics, the California Dental Association, and the Los Angeles Dental Society. She is board-certified as a Diplomate of the American Board of Endodontics and currently serves on the executive board of the Los Angeles Dental Society.
Martin Endodontics has been providing comprehensive endodontic and root canal therapy services to patients around the Los Angeles County area for 30+ years. It's their mission to flip the script when it comes to endodontic procedures. So many patients assume that root canal procedures are painful and unpleasant, but they're determined to ensure that patients’ experience is comfortable and as pain-free as possible.
Did you always know that you wanted to be an endodontist?
I actually avoided the idea as long as I could, until I realized it was kind of my fate. My father is an endodontist, but I always wanted to be a neurosurgeon like on Grey's Anatomy. I don't think I really understood what an endodontist does - they basically are doing neurosurgery on your teeth!
What procedures do endodontists perform the most?
Endodontics is the branch of dentistry dealing with the inside ("endo") of the tooth and roots, where the circulation and nerve endings are. We deal with disease that happens in this area, whether from infection or inflammation, and treating that is what is most commonly known as a "root canal." We do other types of endodontic procedures to treat these teeth, such as surgeries or internal bleaching, but root canals are our bread-and-butter endo therapy.
What makes you passionate about performing root canals?
It is such a predictable, modern, conservative way to treat a toothache. Root canals have come a long way - now we use 3D guided imaging, microscopes, and advanced cleaning techniques to disinfect teeth so they are squeaky clean. The common notion that "you have a dead tooth" is really no longer a thing, and it's such a great procedure to resolve a toothache without having to pull your tooth.
There have to be many misconceptions about root canals that you want to clear up. Share a few.
The "dead tooth". The only time you have a dead tooth is if you have an infected tooth that NEEDS a root canal - that's when there's dead tissue in the tooth roots. Once treated, the circulation around the tooth is restored to health and the tooth is preserved healthy in its gum ligament. It's just that small collateral circulation that is cleaned and sealed off in a root canal. We aren't killing any teeth. Another one is that root canals hurt. Honestly, I love doing endo because it's one dental procedure where you are ABSOLUTELY numb the entire time or I'm not doing it. The pain people get is often before the tooth is treated, or minor postoperative discomfort just from having treatment in the area, but I have patients falling asleep almost daily while I'm working that go, "Wow I fell asleep, that was easy!"
I know that you want to spread the message that root canals don't hurt. Can you elaborate on that?
Don't get me wrong, root canals CAN hurt if they are not done correctly. The reason there's a whole dental specialty devoted to this is because there are so many intricacies that need to be dealt with to make sure the patient is as pain-free as possible. We review 3D imaging ahead of time to predict where the roots and nerves are so we can be minimally invasive in terms of treatment, we have specialized anesthesia injection techniques to get you numb, we have electronic handpieces so we're not "screwing out" the nerve like you hear in the olden days. Everything is really a light touch, gentle, and it's quiet the whole time except for the first few minutes with the drill (Plus, you'll have headphones on and you'll be listening to Spotify in my office). We are experts in managing pain, so we determine what pain and antibiotic regimen to follow after treatment to minimize any chance things flare up after treatment.
If someone prefers to remove a tooth and get a dental implant vs. having a root canal, what's your opinion on which method to choose and why?
Remember, there is a ton of blood circulation around the tooth in the ligament it sits in, so removing the tooth removes this circulation, too, and thus decreases the circulation to your jaw bone. Saving the tooth preserves circulation health in your jaw, and is also less invasive, and a much faster process, than removing the tooth and placing an implant. Root canals and implants have about the same long-term success, over 90%, as long as there are no compromising factors (such as large cracks, bone loss, etc.). Your endodontist can help determine if you have any of these compromising risk factors, and help you decide if a root canal or an implant may be a better option for you.
For women who want to whiten their teeth at the dentist, are there any procedures that won't harm or weaken your teeth?
Whitening procedures at the dentist's office are totally safe. The treatment is often a bit stronger than the over-the-counter whitening kits you can get, but they are administered and monitored until the doctor's supervision. Veneers may be another minimally invasive option to change the appearance of your smile.
Dentistry has changed rapidly over the years. What's the best way to identify if a dentist uses state-of-the-art equipment and modern techniques?
When you're looking for an endodontist, the best way to determine this is to see if they are board-certified diplomates of the American Board of Endodontics. The gold standard these days is 3D Cone Beam CT imaging when evaluating a tooth that may need an endo, and it's amazing what you can see on these scans that you just can't see on 2D X-rays. There is too much overlap with 2D x-rays - from your sinuses to the jaw bone, and the 3D scan allows us to go slice by slice through the tooth. An endodontic microscope is also considered the gold-standard. Most endodontists use one for every single procedure. The long-term success of root canals has drastically increased with the introduction of CBCTs and microscopes.
What are your top five tips for creating and maintaining good dental health?
1. See your dentist every 6 months. It's not really like going to the doctor where, if something is wrong, you often feel it. Dental disease can be developing for years before you notice it, and if it's been a few years since you've seen your dentist, any cavities that have developed may now be large enough that you need a root canal or crown.
2. Get an electric toothbrush and a bunch of replacement heads. Replace them every month. It feels like a bougie little treat/reward to yourself.
3. You have to brush twice a day. You just have to, plus it's gross if you don't.
4. Ask your dentist if you clench your teeth and if it is affecting your bite. A lot of times we don't realize our cheek muscles are overactive, and it takes a toll on our teeth, causing cracks and chips. Your bite may need to be adjusted, your cheek muscles may need some Botox, or you may benefit from a nightguard.
5. Brush your gums. Think about it, they're collecting just as much if not more debris and bacteria than your teeth. They're like sponges. Focus on moving your electric toothbrush not just over the teeth surfaces, but really vibrating into your gums, too.
6. Get a tongue scraper. Instant refresher and takes 2 seconds to use.
How can people get over their general fear of going to the dentist?
I start every single new patient visit as a consultation only. It's really the fear of the unknown, that we're going to pounce on you with pliers and torture you, and it's scary not knowing what is going to happen at the visit. I love getting the chance to understand why the patient thinks they need to see me if they are having pain or worried about pain management, and explaining the process of what is going on exactly in their teeth that is causing their symptoms, and how treatment will work to treat this. I think just getting in and talking, taking some x-rays, and getting educated on what you might need, can really help. You're not committed to anything, you can go home and "digest" it, and you'll be prepared next time you need treatment. For patients who see me, usually, it's only once or twice, so it's important they know they will be seeing a provider who really takes care of them and explains everything.
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