What is a Root Canal?

Updated: 2/24/2020

Root canal. Everyone knows those words as the cross-your-fingers-and-pray-you-don’t-need-it dental procedure, but what exactly is it?

It may have a bad reputation, but some things are only scary until you understand how they work (like math… or cooking). Root canal treatment, often referred to as “endodontic therapy,” is actually an effective way to save a damaged tooth. Here’s how it works.

What Situations Require Root Canal Treatment?

A root canal is actually the cavity inside a tooth’s root that houses the nerve and pulp tissue. If that area gets infected or decayed, it can be incredibly painful. In many cases, the tooth may even develop an abscess below the root. At this point, a simple filling will not rectify the situation. The dentist would need to enter the root canal and remove the rotted matter before the infection spreads elsewhere in the mouth. This is called root canal treatment (or endodontic therapy).

Several factors can contribute to the need for endodontic therapy, including:

• Repeated or large fillings
• Deep or widespread decay
• Multiple procedures or repeated irritation on the tooth
• Cracked or chipped tooth

In most situations, it’s better to save the natural tooth however possible, because false teeth are much more difficult and costly to anchor and maintain. Root canal therapy leaves the root intact so a cap or dental crown can cover the remaining portion above the gum line.

What Happens During Endodontic Therapy?

The dentist will first take an X-ray to determine the extent of the problem and see the shape of the root canal. After numbing the area, the dentist places a rubber dam around the tooth to keep it dry and protect the rest of the mouth from coming in contact with any infected matter.

A hole is then drilled into the tooth so the decayed nerve tissue can be removed. The dentist then uses thin files to scrape down into the root canal, gradually clearing the area of bacteria and debris. The dentist will periodically irrigate the hole with water or bleach to flush it clean.

Once the root canal is clear, the hole is filled with a sealant. Depending on the tooth’s stability after the procedure, the dentist may first need to place a post in the root for extra support. Typically, at this point the tooth’s surface is worn down or fragile, so a cap or crown must be placed over the remaining tooth structure. This might be done in the same visit or in a subsequent visit a week or two later.

Do I Need a Specialist?

You may know people who have had root canal treatment performed by their family dentist, and some people may say they had to find a specialist for their endodontic therapy. Will a general dentist perform the root canal treatment properly? Why pay for a specialist if a general dentist can complete the job? Here are some reasons for each:

• General dentist – General dentists are trained in dentistry school to treat infected root canals. Some may simply choose not to offer that procedure in their office because it’s time-consuming or they would rather focus on other procedures. Check with your dentist to see if he or she performs this treatment. This typically costs less than visiting a specialist. If your situation is complicated or they don’t feel comfortable doing it, however, they may need to refer you to a specialist.

• Endodontist – These specialists focus on endodontic therapy, continuing with a few years of additional education after dentistry school. If you have a complicated issue or would feel more comfortable with the additional expertise, it might be worth the extra money.

Ultimately, it’s between you and your dentist to decide whether you require the services of an endodontist or whether your general dentist feels comfortable performing your root canal procedure.

I found an interesting study in a post entitled “Bringing Teeth Back to Life.” It talks about the possibility of eventually bypassing root canals with new nanotechnology that could bring a dead tooth back to life and rebuild the root. It’s still in the research/testing phase, though, so don’t get your hopes up yet!

Root canal treatment is an important method for saving infected teeth, so don’t let the sound of it scare you away from getting necessary dental treatment. Do your research, find a dentist with whom you are comfortable, and take care of any oral problems before they get worse. With excellent dental health, you’ll also improve your overall wellness.