Short answer: Root canal treatment is the cleaning out of the inflamed, infected or damaged nerve and blood vessel tissue (pulp) inside the tooth, shaping and filling the canals, and sealing the tooth. The aim is to try to keep the tooth in the mouth rather than extracting it. Whether it is needed and how many sessions it takes are determined by examination and X-ray.
What is inside the tooth?
The outer layer of a tooth is enamel, and the layer beneath it is dentine. At the innermost part is the pulp, made up of nerve, blood vessel and connective tissue. The pulp passes through thin canals that extend to the tips of the roots. When decay or a fracture reaches this area, bacteria can affect the pulp.
In which situations may it be needed?
- Deep decay reaching the nerve
- Toothache that comes on by itself and gets worse at night
- Sensitivity to hot or cold that lasts for a long time
- A broken or cracked tooth, or pulp damage after a blow
- Swelling or discharge on the gum (a sign of an abscess)
- Darkening of the tooth's colour over time
In some cases a problem at the root tip may be seen on an X-ray even without any complaint. For the signs of decay, you can look at our article on the signs of tooth decay.
Stages of root canal treatment
- Examination and X-ray: The condition of the tooth, the number of roots and the surrounding tissues are assessed.
- Local anaesthesia: The tooth and its surroundings are numbed; the aim is for you to be comfortable during the procedure.
- Access opening: A small opening is made in the upper part of the tooth to reach the pulp chamber.
- Removal of the pulp: The infected tissue is removed with fine instruments.
- Shaping and cleaning the canals: The canals are rinsed with disinfecting solutions in an effort to clear them of bacteria.
- Canal filling: The cleaned canals are filled with a biocompatible filling material.
- Sealing the tooth: The access opening is closed with a filling; if deemed necessary, the tooth is later supported with a crown.
How many sessions does it take?
In some teeth it can be completed in a single session; in teeth where the infection is widespread, the canals are curved or there is more than one root, two or more sessions may be needed. The number of sessions varies from tooth to tooth and person to person.
What is felt after treatment?
- When the effect of the anaesthetic wears off, there may be mild sensitivity or discomfort when chewing for a few days.
- Pain relief and medicines recommended by the dentist should be used according to the instructions.
- Hard foods should not be chewed with that tooth until the permanent filling has been placed.
If the complaints increase or last a long time, a check-up is needed. For details, you can read our article on sensitivity in root-filled teeth.
Is a crown needed after root canal treatment?
Teeth that have had root canal treatment, especially molars, can become more fragile over time. The more of the tooth structure that has been lost, the more support may be needed. This decision is made by the dentist according to how much sound tissue remains in the tooth.
Why is delaying treatment risky?
Infection can spread from the root tip to the surrounding bone; this can increase the risk of swelling, abscess and tooth loss. The pain going away on its own does not necessarily mean the problem is over. For general oral health, you can also look at our page on the importance of dental health.
Common misconceptions about root canal treatment
- “Root canal treatment makes you ill.” This view lacks scientific basis; the aim of the treatment is to eliminate the source of infection.
- “If my pain has gone, I don't need treatment.” When the nerve tissue dies, the pain may stop, but the infection at the root tip can carry on silently.
- “Every deep cavity means a root canal.” In some deep cavities the nerve may remain alive, and protective procedures may be used to try to preserve the vitality of the tooth. The examination determines this.
Preparing for treatment and before your appointment
When you come to your appointment, it is important to tell the dentist about the medicines you use, your allergies and your general health. If you have X-rays taken earlier, you can bring them with you. Eating a light meal before the procedure makes it easier to be comfortable during longer procedures.
Caring for the tooth after root canal treatment
A treated tooth can also decay and be affected by gum disease around it. For this reason daily brushing, flossing and regular check-ups should continue in the same way. Follow-up X-rays help monitor healing at the root tip.
Choosing between root canal treatment and extraction
Root canal treatment may not be possible for every tooth. Extraction comes up in situations such as a root fracture, very advanced bone loss, or a tooth that has broken down too much to be restored again. Keeping the tooth has advantages for chewing and jaw structure; however, it may not be possible to save the tooth in every case. For the space after an extraction, options such as a denture, a bridge or implant planning are assessed separately.
When should you seek help straight away after treatment?
- Swelling that increases in the face or gum
- Fever or difficulty swallowing
- The temporary filling falling out or the tooth breaking
- Pain that, as the days go by, increases rather than decreases
Frequently asked questions
Is root canal treatment painful?
The procedure is carried out under local anaesthesia and the aim is for the patient to be comfortable. There may be mild sensitivity for a few days afterwards; its intensity varies according to the person and the condition of the tooth.
Does a tooth that has had root canal treatment last for life?
In most cases, with an appropriate restoration and regular care, it can stay in the mouth for many years; however, the length of time depends on the person and the condition of the tooth, and no definite period can be given.
Can a tooth be extracted instead of having root canal treatment?
In some cases extraction may come up. The options and their consequences are discussed with the dentist by assessing whether the tooth can be saved.
How can you find out what suits you?
The information here is general; the right plan for you is determined through an examination and the dentist's assessment. For appointments and directions, you can look at our contact page. At our clinic in Oran, Çankaya, Ankara, we discuss your questions with you.
