Root Canals / Endodontics

A root canal, also called endodontic therapy, treats teeth that have become severely damaged, allowing the nerves and soft inner pulp of the tooth to become infected. Your dentist may also recommend a root canal if a tooth has become so damaged or decayed that future infection appears inevitable. Root canals have a reputation for being painful, but modern endodontic techniques and anesthetics make the procedure no more uncomfortable than having a tooth filled. After completing the root canal, the tooth will also need a crown or filling to complete the restoration.

Because it spares at least part of the natural tooth, root canals are often the preferred way of handling significant damage. An extraction followed by bridgework or an implant is an alternative, but any replacement of a tooth may need maintenance after a number of years. A root canal procedure can ensure that the affected tooth lasts a lifetime.

Before performing any procedure, your dentist or endodontist will look at X-rays of your mouth to determine the best course of treatment for you. When it is time for a root canal, your dentist will start by anesthetizing your mouth. After applying a topical and a local anesthetic, the dentist will place a rubber-like dental dam in your mouth to isolate the tooth. If the tooth is far back in your mouth, you may also have a bite block in place to let your jaw muscles relax while still keeping your mouth open. The dental dam serves a twofold purpose; it protects your mouth from the cleaning solutions and drill debris from the affected area, and it also keeps the tooth dry.

When your mouth is sufficiently numbed, the dentist will open the top of the tooth and remove the soft pulp from its interior. The resulting opening will also be shaped for later filling and restoration work. Slim instruments fit into the channels or root canals through which the tooth’s nerves are connected, removing the nerve tissue that could form a reservoir for bacteria. It is vital to remove every bit of material from these passageways to prevent future infections, so this part of the procedure usually takes the longest time. You may feel some pressure during this part of the root canal procedure, but it is not painful.

When the tooth is completely free of pulp and nerve tissue, the dentist will clean the area with antiseptic solutions and seal it with a rubber-like material called gutta-percha. This material is non-reactive and bio-compatible. After it is sealed with gutta-percha, the tooth will be filled with a temporary filling until it is permanently crowned during your next appointment. Creating the crown takes time, but waiting to apply the permanent restoration has another purpose. Any signs of remaining infection can appear during the two to three weeks that the temporary filling is in your mouth. Although the need for additional cleaning occurs rarely, the procedure is significantly simpler when only a temporary crown must be removed.