Modern dentistry has become the incarnation of everything that our parents and grandparents hoped for: nearly pain-free and wonders of aesthetics with the needed boon of retaining teeth that in years past were lost, a ticket to longer life . . . Nirvana.

Well, not quite.

The devil is in the details. There are still thousands of people who needlessly suffer when it comes to root canal work. A person needs a root canal if the nerve in his tooth dies and/or becomes infected. Then cometh the pain, easily resolved by the right tooth guy. Even that very tooth can be retained for life and the dental experience related to that repair should be pleasant and agreeable.

Remarkably, the success rate for a root canal, done by a specialist, an endodontist, reaches up into the high 90 percent rates. So why is there a burr under so many saddles? In the 25-plus years that I practiced as an endodontist after being a general dentist, I saw incompetence in root canal work that was absolutely shameful. The reasons for these horror shows, and many people have been there, is that there are hosts of general dentists who attempt root canals who are clueless as to the skills and background needed for competency; the dental equivalent of a new intern trying heart surgery after one scrub in.

I have seen roots mangled, nerves permanently damaged, crowns and bridges lost, all needlessly. And of course, money and time wasted. Toss in real pain for the crusher. Quality root canal work rests within the tolerance of one millimeter, two-fifths the width of a dime. I've seen too many to count miss that mark by 10 times that number from incompetents, like a heart valve from a horse put into a newborn human baby.

The reasons for this kind of incompetence are many. Suffice it to say that this problem will not heal from within dentistry. Until the public becomes educated as to their rights, with some appreciation of the problems they face in the future when needing a root canal, this grief will continue.

In a recent national meeting of endodontists, there was a course in fixing root canals massacred by incompetent treatment. The course cost $250 for two hours and the room was full of endodontists, maybe 300! We want this to stop; it must stop. These guys, including myself, were not there for greenbacks. We were there to find out how to stop, or at least fix, this monster, a monster born in our own house!

I believe that only an informed public can cut to the chase through knowledge. Heaven forbid the mystery of some general dentist who gives the proverbial smile and tells you that he has your root canal covered, covered with ignorance.

The public must know that there are good guys out there when they hurt badly. The endodontists are the good guys. I believe that. They are so sick of cleaning up the garbage from general dentists that getting a case from the "get go" is a gift, a happy patient, pain free and not a refugee from a dentist who has no clue.

This is not an afterthought volley into the past. I fought against this tyranny my whole professional life. I sent letters to general dentists addressing this horrific incompetence and found few friends — make that no friends. I told them to take a week course or just send out their patients to endodontists. I never got a response, certainly never a patient. I knew that I'd be shunned by the incompetents. Not unexpectedly, patients were often grateful for my efforts because they were compensated for their terrible distress and loss.

A collage of lawsuits might send the correct message to the incompetent. Only patients can do that. Patients must be informed and stand up for themselves. No general dentist surrenders to the police station for being incompetent in a root canal massacre.

Endodontists are trained to deal with all aspects and variables of root canals and intractable pain. If your general dentist won't refer you, get out the phone book.

But for heaven's sake, don't come to me for your gall bladder. I'm untrained, unskilled; but I'll take you for my first case, as will my general dentist colleagues. I have case reports and X-rays on at least 100 of these root canal wannabes.

Jay Sorenson is a retired endodontist living in Murray.