Root canal therapy is needed when the nerve of a tooth is irreversibly affected by decay or infection, and it can also be necessary in cases of trauma and nerve necrosis (nerve death). In order to save the tooth, the pulp (the living tissue inside the tooth), nerves, bacteria, and any decay are removed and the resulting space is cleaned, shaped, and filled to restore the tooth to its full function.

Having a root canal done on a tooth is the treatment of choice to save a tooth that otherwise would die and have to be removed.  Many patients believe that removing a tooth that has problems is the solution, but often extraction proves to be more costly due to the resulting restorative necessities, and can cause significant problems for adjacent teeth.

Root canal treatment is highly successful and usually lasts a lifetime although, on occasion, root canal therapy can fail.  In those cases retreatment or an apicoectomy (root tip surgery) may be necessary to resolve the problem.  In very few cases a tooth has a vertical fracture and may ultimately require extraction.

Signs and symptoms for possible root canal therapy:

  • An abscess (or pimple) on the gums
  • Extreme sensitivity to cold or any sensitivity to heat
  • Severe toothache pain
  • Sometimes no symptoms are present
  • Swelling and/or tenderness

Reasons for root canal therapy:

  • Decay has reached the tooth pulp (the living tissue inside the tooth)
  • Infection or abscess have developed inside the tooth or at the root tip
  • Injury or trauma to the tooth

What does root canal therapy involve?

A root canal procedure requires one or more appointments and can be performed by a dentist or endodontist (a root canal specialist).

While the tooth is numb, a rubber dam (a sheet of rubber) may be placed around the tooth to keep it dry and free of saliva.  An access opening is made on top of the tooth and a series of root canal files are used to remove the pulp, nerve tissue, and bacteria.  If tooth decay is present, it will also be removed with special dental instruments.

Once the canals are thoroughly cleaned, shaped and filled, the tooth will be sealed with either a temporary or permanent filling.

At the next appointment a filling will be placed to seal the opening on top of the tooth.  In addition, all posterior, and some anterior teeth that have root canal treatment should have a crown (cap) placed.  This will protect the tooth and prevent it from breaking, and restore it to its full function.

After treatment, your tooth may still be sensitive, but this will subside as the inflammation diminishes and the tooth has healed.

You will be given care instructions after each appointment.  Good oral hygiene practices and regular dental visits will aid in the life of your root canal treatment.