A root canal is necessary when a tooth’s nerve has become infected or the “pulp” has been damaged. This is an in-office procedure that doesn’t take long and usually requires local anesthesia. The patient is awake, but won’t feel anything besides pressure. The procedure includes removing the damaged nerve and/or pulp from inside the tooth, followed by a cleaning and sealing of the tooth.
Unfortunately, root canals have received a bad reputation over the years—and unfairly so. The reality is that most people say a root canal isn’t any more painful than getting a filling.
What’s the Problem?
Tooth “pulp” is the soft center of a tooth. Tooth nerves are in the root canals, which are deep in the “legs” of the teeth. The two are connected via vessels and tissue. The nerves aren’t actually necessary for a tooth’s vitality after it’s fully developed, but they remain as a sensor (which is why your teeth can “feel” hot and cold). If a nerve is removed, the function of the tooth won’t change.
However, when nerves or pulp are damaged, bacteria can grow. This can lead to an infection or an abscessed tooth. This means it can fill with pus, which collects in pockets at the tip of the roots. Infections can spread throughout the tooth causing swelling, bone loss and drainage problems. In severe cases, even the face, neck or head can be affected.
The “Root” of the Problem
Damage can occur from decay that isn’t well treated, too many dental procedures or trauma (such as cracking a tooth on a hard food). There are numerous signs of a problem tooth, including intense toothaches, hot/cold sensitivity, darkening of the tooth, swelling by the gums and “pimples” on the gums, but other times there aren’t any obvious symptoms at all.
Step By Step
First, an X-ray is taken to pinpoint where the infection is, then local anesthesia is used to numb the region. Patients get a rubber dam placed near the tooth to keep the area dry, and then a hole is drilled into the tooth to access the problem area. Special tools are used to clean the area and scrub out the canals. To flush the area, a water solution is used.
After the root canal is complete, the tooth is sealed—although some dentists prefer to wait a few days first. Infections might need medication for a week, or sometimes it’s just best to keep an eye on it before sealing things up. When it’s time, a sealer paste combined with a rubber material (gutta percha) is placed on top of the root canal. If the tooth has structural damage, a crown may be necessary to seal the tooth.