Root Canal Basics

By Katherine Ladny Mitchell

At the center of the tooth, beneath the enamel and dentin layers, lies the pulp—soft tissues which contain blood vessels, nerves and connective tissue. Sometimes, tooth decay, injuries or successive dental procedures can cause deep cavities, chips or cracks in a tooth which may allow bacteria to infect the pulp. Infection often results in pain and swelling, and may also lead to bone damage, abscesses (collections of pus at the ends of tooth roots), and pulp cell death. While extraction used to be the primary treatment for unhealthy tooth pulp, endodontic treatment, commonly referred to as a root canal, allows dentists to remove unhealthy tissues from the tooth without removing the tooth itself.

Endodontic treatment is a common dental procedure. According to the American Academy of Endodontics, Americans receive over 15 million root canal treatments each year. There are several symptoms that may indicate the need for a root canal, although some people may not experience any symptoms prior to a dentist’s diagnosis. Symptoms include toothache and pain, tooth darkening and discoloration, gum swelling, sensitivity to pressure, and prolonged sensitivity to heat or cold.

Dentists may perform root canals or choose to refer a patient to an endodontist, or dental pulp specialist. After assessing a patient’s X-rays, a dentist or endodontist will first administer local anesthesia. Next, he or she will drill a hole through the tooth’s surface to access and remove the diseased pulp. The dentist or endodontist then cleans out and enlarges the empty space in the tooth using root canal files. He or she may insert medication to fight infection and add a temporary filling for protection until a following office visit. If the diseased tooth requires no further treatment, the dentist or endodontist will fill and seal the tooth. Finally, a protective crown will be added to the surface of the tooth.

Patients may experience some sensitivity, pain and swelling after having a root canal. Taking over-the-counter pain medication may alleviate these symptoms. Patients between root canal procedures should avoid chewing with a partially treated tooth until the dentist installs the crown.

Root canals typically have over a 95 percent success rate. Regular dental visits, brushing and flossing can help a restored tooth last a lifetime.