What Is Root Canal Treatment?
Root canal treatment saves a tooth when the soft tissue inside it becomes infected. That tissue is called the pulp, and it holds the nerve and blood supply.
Your dentist opens the tooth, clears out the infected pulp, disinfects the narrow canals inside the roots, then seals them. The tooth stays in your mouth.
This is the treatment that stops a deep, throbbing toothache. The alternative is losing the tooth.
Signs You May Need One
- A deep ache that wakes you at night
- Lingering pain after something hot or cold, rather than a quick twinge
- Pain when you bite down on one particular tooth
- A tooth that has darkened on its own
- A pimple or small blister on the gum near a tooth
- Swelling in the gum or the side of your face
See a dentist the same day if your face swells. Swelling means the infection is spreading beyond the tooth.
Some infected teeth stop hurting altogether. That is not recovery. It usually means the nerve has died, and the decay carries on underneath.
What Happens During Treatment
- Your dentist takes an X-ray to see the roots and the infection around them.
- You get a local anaesthetic, so the tooth and gum go numb.
- Your dentist makes a small opening in the top of the tooth.
- The infected pulp comes out and the canals are cleaned and shaped.
- Your dentist disinfects the canals, then fills and seals them.
- A filling closes the opening, and a crown usually follows later.
Treatment takes one or two visits depending on the tooth. Back teeth have more canals, so they take longer than front teeth.
Does a Root Canal Hurt?
The reputation is worse than the reality. You are numb throughout, so the treatment itself feels much like having a large filling done.
The pain people remember is the toothache that sent them to the dentist. Root canal treatment is what takes that pain away.
Expect the tooth to feel tender for a few days afterwards, especially when you bite. That settles.
Why the Tooth Needs a Crown Afterwards
A treated tooth has no blood supply left inside it, which makes it more brittle. Back teeth take heavy chewing force and can split without protection.
Your dentist will usually recommend a crown to cover the tooth. Front teeth sometimes manage with a filling instead, because they take far less force.
After Your Root Canal
- Avoid chewing on that side until the permanent restoration is in place
- Take pain relief as your dentist advises if the tooth feels tender
- Keep brushing and flossing the tooth normally
- Come back for the crown appointment rather than leaving it
Come back sooner if the pain gets worse instead of better, if swelling appears, or if the temporary filling comes out.
What Happens If You Leave It
An infected pulp does not clear up on its own. The bacteria carry on down the canals and out through the tip of the root into the bone.
That is how an abscess forms: a pocket of infection at the root tip. It can push the tooth slightly out of line, so it feels high when you bite. Left longer, the infection spreads into the surrounding bone and the soft tissue of the face.
At that stage the tooth is often no longer savable. Treating early is what keeps root canal treatment an option rather than an extraction.
Root Canal or Extraction?
Patients sometimes ask if pulling the tooth is simpler. It is quicker on the day, but it leaves a gap.
A missing back tooth changes how you bite. The teeth beside it drift, and the tooth above or below drifts down into the space. Replacing it later means an implant or a bridge, both of which involve more treatment than saving the tooth would have.
Keeping your own tooth is almost always the better outcome where the tooth can be saved.
Related Reading
- Dental Crowns – usually needed after treatment
- Tooth Decay – what leads to an infected nerve
- Tooth Fillings – the repair when decay is caught early
- Pulpectomies – the equivalent treatment for baby teeth
- Chipped, Cracked or Broken Tooth – a crack can expose the nerve