Root canal treatment saves a tooth that is heavily damaged or decayed. Often used as a last resort, root canal
treatment involves removing the living portion of a tooth - the pulp - then cleaning and filling the canal that it occupied.
Finally, a filling or restoration is placed on the tooth surface to block access to the treated canal.
To better understand root canal treatment, you need to have a brief understanding of tooth anatomy. Inside the tooth,
under the white enamel and a hard layer called the dentin, is a soft tissue called the pulp. The pulp contains blood vessels
and nerve tissue. The pulp creates the surrounding hard tissues of the tooth during tooth development. However, once a
tooth has fully matured, it can survive without the pulp.
A tooth's pulp may need to be removed for various reasons, but the most common are tooth decay, trauma, or tooth
sensitivity. Tooth decay, if left untreated, can advance past the outer shell of the tooth and reach the pulp. Since the
pulp contains the tooth's blood vessels and nerves, bacterial infection can cause the pulp to become inflamed and
irritated. This can in turn cause toothaches, and if left untreated, an abscess can form. An abscess is a pus-filled pocket
that forms at the end of the roots of the tooth. If left untreated, bone is lost around the tooth, swelling begins, and the
tooth, and perhaps surrounding teeth, may need to be extracted. A root canal can stop this cascade of bad events by
removing the pulp material, cleaning the chamber, and stopping the infection before it spreads.
Trauma to a tooth can behave the same way as an infection. If a tooth is damaged in an accident, the pulp may become
irreversibly inflamed, causing pain. Root canal treatment can remove this pain since removing the pulp also removes the
nerves that allow the tooth to feel pain. Similarly, patients who have tooth sensitivity to hot or cold, and have tried other
ways to control their symptoms, may have to resort to root canal treatments. Removing the pulp has the effect of
removing the nerves, which conduct cold/hot sensation from the tooth. Remember, following root canal treatment, a
tooth is essentially dead and cannot feel anything - the tooth can still function fully in everyday use though.
Who needs root canal treatment? Who does not?
As stated earlier, any tooth, which has an inflamed or infected pulp, may need root canal treatment. If you have pain on
biting, prolonged sensitivity to heat or cold, tenderness to touch and chewing, discoloration of the tooth, and swelling,
drainage and tenderness in nearby gingival tissues, you may require a root canal. Sometimes, however, there are no
symptoms, and a root canal may still be needed. By running various tests, your dentist will be better able to make a
In certain cases, an inflamed pulp can return to normal as long as the infection has not reached the pulp. As bacteria
make their way to the pulp, the pulp becomes inflamed before the bacteria have even entered the pulp canal. If the
decay is removed and repaired, the pulp may reverse itself and no longer be inflamed. If the infection has reached the
pulp canal though, root canal treatment is almost always required.
In certain cases, your dentist may want to do a root canal treatment, but it is not possible. If the infection has gone too
far and for too long, removing the pulp may no longer help the tooth since the infection has spread past the tooth in
question. Other times, the root of the teeth may bend at such sharp angles that removing the pulp becomes impossible.
An endodontic specialist may be able to perform the treatment though - ask your dentist about getting a referral.
Most root canal treatments take 1 to 2 appointments to complete, but might require more time if a crown or cap is being
placed on afterwards. To begin, your dentist will analyze x-rays to have an understanding of the tooth's root structure,
and will begin the procedure by administering local anesthetic. Following this, a root canal should be essentially painless
since all nerves leading to the tooth are now blocked.
Once the pulp chamber has been accessed, your dentist will remove the nerves and blood vessels, or pulp, and begin
cleaning and shaping the empty canal.
After the space is cleaned and shaped, the root canal is filled with a biocompatible material, usually a rubber-like material
called “gutta-percha.” The gutta-percha is placed with an adhesive cement to ensure complete sealing of the root
canals. This ensures that bacteria cannot gain access in the future.
Depending on how severe the case is, your dentist may opt to not fill the canal with gutta-percha on the first
appointment. Instead, he or she may place medication material within the canal, temporary seal the top portion of the
tooth, and give the antibiotic medication some time to work. Then in the next appointment, when the canal is clear of
bacteria, the canal will be filled and sealed.
In either case, once the root canal has been sealed, the crown of the tooth (top portion) is ready to be restored. Your dentist may place a simple filling if the cavity made is small, or may place a temporary filling if the tooth requires a crown or cap at a later date.
Don't waste time in pain, call us today to schedule and appointment!