Root Canal Therapy

What Is a Root Canal?

A root canal is a treatment used to repair and save a tooth that is badly decayed or infected. A tooth’s nerve and pulp can become irritated, inflamed, and infected due to deep decay; repeated dental procedures on a tooth; or large fillings, a crack, or chip in the tooth. It also can happen because of trauma to the face.

During a root canal procedure, the nerve and pulp of the tooth are removed and the inside is cleaned and sealed. Without treatment, the tissue surrounding the tooth will become infected and an abscess may form.

A tooth’s nerve is not vitally important to a tooth’s health and function after the tooth has come through the gums. Its only function is sensory — to give the sensation of hot or cold. The absence of a nerve won’t affect how your tooth works.

Root canal procedures have the reputation of being painful. But the procedure itself is no more painful than having a filling placed.

Why Does Tooth Pulp Need to Be Removed?

When a tooth’s nerve tissue or pulp is damaged, it breaks down and bacteria begin to multiply within the pulp chamber. The bacteria and other decayed debris can cause an infection or abscessed tooth. An abscess is a pus-filled pocket that forms at the end of the roots of the tooth. An abscess happens when the infection spreads all the way past the ends of the roots of the tooth. An infection in the root canal of a tooth can also cause:

  • Swelling that may spread to other areas of the face, neck, or head
  • Bone loss around the tip of the root
  • Drainage problems extending outward from the root. A hole can occur through the side of the tooth with drainage into the gums or through the cheek with drainage into the skin.

root Canal Procedure

A dentist or endodontist can perform a root canal. An endodontist is a dentist who specializes in the causes, diagnosis, prevention, and treatment of diseases and injuries of dental pulp or the nerve of the tooth. If your root canal may be more difficult, your general dentist may suggest you see an endodontist.

The procedure will follow these steps:

Your dentist will take an X-ray to see the shape of the root canals and determine if there are any signs of infection in a surrounding bone. They’ll use local anesthesia to numb the area near the tooth. You may not need anesthesia since the nerve is dead, but most dentists still anesthetize the area to make you feel more relaxed.

To keep the area dry and free of saliva during treatment, your dentist will place a rubber dam (a sheet of rubber) around the tooth.

The next step is drilling an access into the tooth. The pulp, bacteria, and decayed nerve tissue are removed from the tooth. The area is cleaned out using a series of root canal files. They’re placed into the access hole and work down the full length of the tooth to scrape and scrub the sides of the root canals. As the work is done, water or sodium hypochlorite will be sprayed in the area to flush away the debris.

Once the tooth is thoroughly cleaned, it’s sealed. Some dentists like to wait a week before sealing the tooth. For instance, if there is an infection, your dentist may put a medication inside the tooth to clear it up. Others may choose to seal the tooth the same day it is cleaned out. If the root canal isn’t done on the same day, a temporary filling is placed in the exterior hole in the tooth to keep out saliva and food between appointments.

At the next appointment, to fill the interior of the tooth, a sealer paste and a rubber compound called gutta percha are placed into the root canal. A filling will be put in to close the access hole created at the beginning of treatment.

The final step may involve further restoration of the tooth. A tooth that needs a root canal often is one that has a large filling or extensive decay or other weakness. Because of that, you may need a crown, crown and post, or other restoration to protect it, prevent it from breaking, and restore it to full function. Your dentist will discuss the need for any additional dental work with you.