Root Canal Treatment
The root canal is one of the most common endodontic treatments performed, and it can mean the difference between keeping or losing a tooth
About the author, Dr. Stella Kim
The materials on this page were prepared and medically reviewed by Dr. Stella Kim, DDS, a San Francisco dentist and a graduate of the UCSF School of Dentistry.
A root canal is one of the best treatments for resolving infection of the dental pulp. In many cases, a successful root canal treatment means you will be able to keep a tooth that would otherwise be extracted. It is a simpler, less invasive, and much less costly procedure than a dental implant or a dental bridge.
What is a root canal?
The root canal is the central part of the tooth that holds the dental pulp, and root canal treatment involves removing that pulp.
There are several layers to your teeth, with the dental pulp in a central canal that usually extends through each tooth root. The pulp consists of blood vessels, connective tissue, nerves, and other cells. It is the living part of your tooth, and it is responsible for tooth growth in your younger years as well as much of the sensation we feel in our teeth.
The inflammation of the pulp is called pulpitis, and it is usually caused by infection. Common reasons for pulp infection include:
- Traumatic injury
- Deep caries (cavities) that extend into the pulp area
- Cracks or chips that cause the pulp to be exposed
- Side effects of other dental treatments
If a pulp infection is left untreated, it can spread through the rest of the tooth and beyond, causing tooth loss or other medical emergencies such as cellulitis, Ludwig’s angina—or, rarely, even death.
However, if the pulp is removed and the cavity cleaned and sealed, the tooth can often be saved, giving it extra years of use and preventing other health complications.
What are signs of pulpitis
There are a number of warning signs to look for that may indicate the need for root canal treatment. The most common of these include:
- Pain in the tooth
- Discoloration of the tooth
- Gum tissue swelling
- Infection visible by x-ray
How is a root canal performed?
The procedure is similar to what takes place for a filling or a crown:
- The tooth and the tissue around it is numbed to prevent sensation, and it is isolated with a rubber dam to keep the area clean.
- The tooth nerve is accessed from the top, removing any decay and eliminating diseased nerve tissues as we proceed into the pulp chamber and the root canals.
- Specialized endodontic tools are used to remove the pulp from each of your canals.
- A disinfecting fluid is irrigated into the root canals to kill bacteria and rinse out debris.
- The canals are then filled and sealed, and the rest of the tooth is restored with a composite filling and a crown.
What you can expect following root canal treatment
The side effects of root canal treatment are generally mild. You may feel some soreness once the numbing wears off and the bite sensitivity on the tooth can persist for a few weeks. However, many patients find that these side effects are much less unpleasant than the acute pain of the diseased nerve that made the root canal treatment necessary in the first place.
In most cases, post-treatment symptoms can be treated with over-the-counter pain medications, but we will provide specialized instructions for your specific situation.
Some time after the treatment, we will take x-rays to be sure that all infection is removed from the canal.
Root canal treatment versus tooth extraction
Not all cases of pulpitis can be effectively treated with a root canal. For example, if a crack on the tooth has propagated beyond the pulp chamber floor, the tooth is deemed unrestorable and it will need to be extracted.
When the prognosis for root canal treatment is guarded or poor, it may be prudent to consider the extraction of the tooth rather than waiting for the tooth to become a more serious threat to your health.
The most common tooth replacement options are bridges and implants, and the best choice will depend on which teeth are present around the missing tooth and how much interarch space exists. You can read our Implants and Bridges section for more details regarding these treatment options.
Further Reading
- American Association of Endodontists. (n.d.). What is a root canal?
- Columbia University Dental Faculty. (n.d.). Treatment of teeth with necrotic pulp.
- Dye BA, et al. (2012). “Selected oral health indicators in the United States, 2005–2008.” NCHS Data Brief.
- Kontakiotis EG, et al. (2015). “A prospective study of the incidence of asymptomatic pulp necrosis following crown preparation.” International Endodontic Journal.
- Mayo Clinic. (2015). Root canal treatment.