What is a root Canal?

Underneath your tooth's outer enamel and within the dentin is an area of soft tissue called the dental pulp, which carries the tooth's nerves, veins, and arteries. Root canals are very small, thin spaces that extends from the top pulp chamber in the crown of the tooth, down to the tip of the root. A tooth has at least one and up to four (rarely more) root canals.

Why do I feel pain?

When the pulp becomes infected due to a deep cavity or fracture that allows bacteria to seep in, or injury due to trauma, it can die. Damaged or dead pulp can cause an increase in blood flow and cellular activity, and pressure cannot be relieved from inside the tooth. Pain in the tooth is commonly felt when biting down, chewing on it and applying hot or cold foods and drinks. With a damaged, degenerating, or dead dental pulp, infection is imminent.

Why do I need root canal therapy?

An infected tooth will not heal by itself. Without treatment, the infection will spread, bone around the tooth will begin to degenerate, and the tooth may become loose. Pain usually worsens until one is forced to seek emergency dental attention. The only alternative is usually extraction of the tooth, which can cause surrounding teeth to shift, resulting in a bad bite. Though an extraction is cheaper, the space left behind will require an implant or a bridge, which can be more expensive than root canal therapy. If you have the choice, it's always best to keep your original teeth.

What is a root canal procedure?

A root canal is a procedure done to save the damaged tooth. The diseased pulp in the root canal portion of the tooth is removed and the remaining tooth is cleaned and shaped to receive the sealer. The canal is filled with gutta percha, a rubberlike material, and sealer to prevent recontamination of the tooth. The tooth is then restored, possibly with a post and crown. This enables patients to keep the original tooth.

What is involved in root canal therapy?

Once your general dentist performs tests on the tooth and recommends therapy, he or she can perform the treatment or refer you to an endodontist (a root canal specialist). Treatment usually involves one to three appointments. First, you will probably be given a local anesthetic to numb the area. A rubber sheet is then placed around the tooth to isolate it. Next, a small hole is drilled from the crown into the pulp chamber. The diseased pulp is removed, then the canal is sterilized and reshape to allow placement of the sealer. Medication may be inserted into the area to fight bacteria if the root canal system is severely infected. Once sterile and properly shaped, the canal can then be filled with the sealer, completing the root canal procedure. If the tooth is weak due to fracture or extensive cavity breakdown, a metal post may be inserted above the canal filling to reinforce the tooth. Finally, a gold or porcelain crown is normally placed over the tooth to restore and strengthen its structure and improve appearance.

What are the risks and complications?

More than 95 percent of root canal treatments are successful. However, sometimes a case needs to be redone due to diseased canal offshoots that went unnoticed or the fracturing of a canal filing instrument used-both of which rarely occur. Occasionally, a root canal therapy will fail altogether, marked by a return of pain.

What happens after treatment?

Natural tissue inflammation may cause discomfort for a few days, which can be controlled by an over-the-counter analgesic. A follow-up exam can monitor tissue healing. From this point on, brush and floss regularly, avoid chewing hard foods on a recently treated tooth, and see your dentist regularly.

This and other information on dental topics are available at the American Dental Association online and the Academy of General Dentistry