Root Canal Treatment

A “root canal” is a procedure used to repair and save a tooth that is badly decayed or becomes infected. During root canal treatment, the nerve and pulp are removed and the inside of the tooth is cleaned and sealed. Without treatment, the tissue surrounding the tooth will become infected and abscesses may form. “Root canal” is the term used to describe the natural space within the center of the tooth that contains the tooth’s pulp. Pulp is the soft substance within the center of the root canal that contains the tooth’s nerve and nutrient supply.

A tooth’s nerve is not vitally important to a tooth’s health and function after the tooth has emerged through the gums. Its only function is sensory — to provide the sensation of hot or cold, as well as pain. Sometimes, removing the pulp will relieve painful symptoms while allowing you to keep your tooth. The presence or absence of the nerve does not affect the day-to-day functioning of the tooth.

Sequence of Appointments

A root canal may require one or more office visits.

The first step in the procedure is to 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. We will then use local anesthesia to numb the area near the tooth. Anesthesia may not be necessary, if the nerve is dead, but most patients prefer to have the area anesthetized so they can be more relaxed and at ease.

Next, to keep the area dry and free of saliva during treatment,  a rubber dam (a sheet of rubber) is placed around the tooth. An access is prepared the tooth to access the pulp chamber and canal system. The pulp along with bacteria, the decayed nerve tissue and related debris is removed from the tooth. The cleaning out process is accomplished using root canal files and inspection under a microscope. A series of root canal files of different sizes and tapers are each subsequently used in the root canal to shape and clean the inside of the root canal. Medicines are used through the procedure to help flush away the debris and to disinfect the tooth.

Once the tooth is thoroughly cleaned, it is sealed. In some cases we like to wait before sealing the tooth. For instance, if there is an infection, we may put a medication inside the tooth to help disinfect the tooth. Sometimes, we may choose to seal the tooth the same day it is cleaned out. If the root canal is not completed on the same day, a temporary filling is placed in the access cavity in the tooth to keep out contaminants like 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 is placed into the tooth’s root canal. To fill the exterior access hole created at the beginning of treatment, a filling is placed.

The final step will involve further restoration of the tooth, which is generally performed by your general dentist. Because a tooth that needs a root canal often is one that has a large filling or extensive decay or other weakness, a crown, crown and post, or other restoration often needs to be placed on the tooth to protect it, prevent it from breaking, and restore it to full function. Your general dentist will discuss the need for additional dental care to properly restore your tooth with you.