What is a Root Canal?
Root Canal Therapy

Why would a tooth need a root canal?

Understanding root canals: the tooth pulp chamber

The pulp chamber is located within the top portion of the tooth or the ‘crown’. Inside the tooth crown is the hollow pulp chamber that contains the ‘pulp’, which is made up of nerves, blood vessels and soft tissue.

In the early stages of tooth development, the pulp helps the tooth grow and form roots. In a fully mature tooth, a healthy pulp supports the tooth dentin, a layer of the tooth structure below the hard outer enamel that helps the tooth detect pressure, pain and sensitivity.

The pulp extends into the walls of the tooth roots or ‘root canals’ and passes through the root tips to connect with the nerve and blood systems that surround and support the tooth.

What causes a tooth to become infected?

A dental cavity, or tooth decay, is caused by harmful bacteria that destroy tooth enamel. If the decay and bacteria progress past the dentin and into the tooth pulp, the pulp tissues become inflamed and infected; this infection quickly spreads into the root canals. If the tooth infection is not treated, it can progress into the gum tissue and jaw, forming a dental abscess or ‘gum boil’.

As you can imagine, an infected tooth and abscess can be painful. Often, this condition is what a patient is experiencing when they have a ‘toothache’. If not treated, this pain can worsen into a throbbing pain that will wake the patient up at night.

If root canal therapy can be performed before the infection has advanced too far, it may be possible to save the tooth and restore it to proper function for chewing and speaking. If the decay is not stopped, the damage to the tooth structure could be too extensive to restore and require that the tooth be extracted to stop the pain and infection.

Tooth Injury

When a tooth is hit due to a fall or blow to the mouth, this can also cause irreparable damage to the tooth nerve. If the tooth is fractured and the pulp is exposed, this is a painful dental emergency that requires treatment right away. Depending on the location and extent of the fracture, the tooth may require root canal therapy to save the tooth.

In some cases, the effect from the impact of tooth trauma is not immediate. There may not be any visible tooth damage and the area may be a little sore following the injury, but feels better over time. Later, the nerve of the tooth can reveal itself as diseased or non-vital (necrotic) on a dental x-ray, or, a flare-up of infection may cause a root abscess on the tooth. If the tooth is not fractured, it may be possible to perform root canal therapy and preserve tooth structure.

Do Root Canals Hurt?

When patients refer to root canals as ‘painful’, they are referring to the initial infection phase and not the root canal procedure itself. Root canal treatment can be as comfortable and routine as a dental filling.

Why not just have the tooth extracted instead of having a root canal?

The primary benefit of root canal therapy is that it allows the tooth to be restored to maintain the health of the bite and spare the patient from needing additional procedures to replace the tooth.

As an example, patients that have fallen and injured the nerves in their front teeth are always relieved when Dr. Anderson can repair the teeth with root canals and protect them with dental crowns vs. having them extracted and replacing them with dental implants or a dental bridge.

Root Canal Therapy

If you are experiencing tooth pain, have signs of deep tooth decay or a history of tooth trauma, Georgia Dental Medicine general dentist Dr. Chris Anderson will examine the area and use dental x-rays or 3D CBCT imaging technology to determine if the tooth nerve is involved. If this is confirmed, he may recommend root canal therapy to eliminate the infection and save the tooth.

Root canal therapy can be completed in 1-2 visits depending on the type of tooth being treated and the level of infection:

• The first step in root canal treatment is to make sure the patient is out of pain. This may require an initial procedure to drain some of the infection, combined with medication until the tooth calms down.

• To begin the root canal, Dr. Anderson will first administer local dental anesthetic to get the area numb. Once the patient is comfortable, he will make a small opening into the crown of the tooth to access the pulp chamber.

• Using fine dental instruments and technology tools, Dr. Anderson will remove the infected nerve tissue from the pulp chamber and root canals. After disinfecting the canals and pulp chamber, he will inspect the tooth visually and radiographically to verify the location of the roots and ensure they are free of bacteria and infection.

• Dr. Anderson will place medicated root sealer (gutta percha) in the pulp chamber and canals and close the tooth with temporary filling material to complete the root canal procedure.

The final step following root canal therapy is to restore the tooth with a dental crown. The dental crown will completely cover the top portion of the tooth to help keep the tooth sealed and prevent re-infection.