- deep decay due to an untreated cavity
- multiple dental procedures on the same tooth
- a chip or crack in the tooth
- an injury to the tooth such as being hit in the mouth by a ball or a fist (even if the injury does not crack the tooth, it can still hurt the pulp)
A root canal is a procedure used to remove the soft center of the tooth—the pulp. The pulp is made up of nerves, connective tissue, and blood vessels that help the tooth grow. However, once a tooth has reached maturity, the crown of the tooth can remain without a living pulp.
If the pulp is injured or becomes infected, removing the pulp is the best way to save the structure of the tooth. A dental specialist called an endodontist will perform a root canal while you’re under local anesthetic.
A root canal is performed when the soft inner part of a tooth, known as the pulp, is injured or becomes inflamed or infected.
Common causes of damage to the pulp include:
The most common symptoms of damaged pulp include pain in your tooth, and swelling and heat in your gum. Your dentist will examine the painful tooth and take X-rays to confirm the diagnosis. If the dentist believes a root canal is warranted, he or she will refer you to an endodontist.
A root canal is performed in a dental office. When you arrive for your appointment, a technician will escort you to a treatment room, help you get situated in a chair, and place a bib around your neck to protect your clothes from stains.
The endodontist will then place a small amount of numbing medication on your gum near the affected tooth. Once it has taken effect, he or she will inject local anesthetic into your gum. You may feel a sharp pinch or a burning sensation, but this will pass quickly. You will remain awake during the procedure, but the anesthetic will keep you from feeling any pain.
When your tooth is numb, the dentist will remove the top part of the tooth with a drill. Once the infected or damaged pulp is exposed, the dentist will carefully remove it using special tools called files. He or she will be especially careful to clean out all the pathways (called canals) in your tooth.
Once the pulp has been removed, the endodontist may coat the area with a topical antibiotic to ensure that the infection is gone and to prevent reinfection. He or she may also prescribe a course of oral antibiotics.
The endodontist will end the procedure by filling the tooth with a soft, temporary material.
When the numbing medication wears off after the procedure, the tooth and gum may feel sore, and the gum might swell. Most dentists will have you treat these symptoms with over-the-counter pain medications such as acetaminophen (Tylenol) or ibuprofen. If the pain becomes extreme or lasts for more than a few days, call your dentist.
You should be able to resume your normal routine the day after the procedure. However, avoid chewing with the damaged tooth until it is permanently filled or a crown is placed over the top.
You will see your regular dentist within a few days of the root canal. He or she will take X-rays to ensure that any infection is gone. Your dentist will also replace the temporary filling with a permanent. If you prefer, the dentist may place a permanent crown on the tooth.
It may take you several weeks to get used to how the tooth feels after the procedure. This is normal and no cause for concern.
A root canal is performed in an effort to save your tooth. Sometimes, however, the damage is too deep or the enamel is too frail to withstand the procedure. These factors can lead to loss of the tooth.
Another risk is developing an abscess at the root of the tooth if some of the infected material remains behind or if the antibiotics are not effective.