The best teeth are you own and the dental treatment team wants to help you keep your teeth. When the decay of a cavity has spread to the nerve of the tooth, you will need a root canal if the tooth is to be preserved in the mouth.

In order to understand what root canal treatment is, let me take you through a dental health lesson. Teeth are made up of three layers:

• Enamel
• Dentin, and
• Cementum

There is a space inside the hard layers of each tooth. It is called the root canal system and it is filled with soft dental pulp. This pulp is made up of nerves and blood vessels that help the tooth grow and develop. Once a tooth is fully grown, it can survive without a pulp. If the pulp of a tooth becomes infected, then a root canal (or endodontic treatment) is needed. When this is done, the pulp is removed.

The pulp inside a tooth can be damaged by cracks in the tooth, deep cavities or accidents. Germ (Or bacteria) can get into the tooth and can lead to infected tooth pulp. This may cause you pain and/or swelling. Sometimes, a pulp becomes infected or dies, but does not cause any pain. Your dentist may notice:
• Changes picked up by a dental e-ray
• Changes in your gums
• Changes in the color of the tooth.

Sometimes if a great dental of dental work is needed, your dentist can tell from you exam and x-rays that the pulp of a tooth is not likely to survive. In all these cases, root canal treatment can ease or prevent symptoms and save the tooth.
Root canals can be performed on permanent (adult) or primary (baby) teeth. If you notice a problem with a tooth, do NOT wait until it hurts. Call your dental team as soon as you notice a cavity or loose filling or if you inure your tooth. If you act quickly there is a better chance that damage can be prevented and the tooth can be saved.

How is a root canal done?

Your dentist may give you “freezing” (or anesthetic). In some case, anesthetic is not needed. Your dentist will make a small opening in the tooth to reach the root canal system and the damaged pulp. He or she will take out the pulp by cleaning and enlarging the root canal system with very fine dental tools (or instruments) in order to eliminate bacteria. The, he or she will fill and seal the root canal with a rubber-like material (called gutta-percha) after it has been cleaned. This will prevent re infection by bacteria. Your dentist will seal the opening of the tooth with either a temporary or permanent filling.

Root canal treatment may be done in one appointment or it may take more. It depends on how complex the root canal system is the degree of pulp damage or the presence of acute infection and/or pus.

Sometimes, if the infection has spread from the tooth to the bone (or abscessed), the infection may have to be drained before the root can be filled. After root canal treatment, your tooth may be tender for the first week or two. Bad pain or swelling is not common. If this happens, call your dentist.

After a root canal, your tooth has to be fixed (or restored) to look, feel and work as much like a natural tooth as possible. Your dentist may use a filling or a crown to restore you tooth. This will depend on the strength of the part of the tooth that is left. Teeth at the back of the mouth will likely need a crown. Chewing puts a great deal of force on back teeth. A post may also have to be used to help hold the crown on. Teeth that have become dark may be bleached, crowned or covered with a veneer.

You can still get a cavity or gum disease after a root canal. It does not protect your tooth from other types of damage.

In more than 90% of cases root canals will be successful. But in some cases, a second root canal is needed. This is called retreatment. The root canal filling material is taken out, and the canal is recleaned, reshaped and refilled.

In the most extreme cases surgical endodontic treatment might be required. In most cases, this would involve seeing an endodontist (dentist whose specialty is in root canal therapy).