A root canal — the specialty now calls it non-surgical endodontic therapy — treats the soft tissue inside a tooth, the pulp, when it becomes inflamed or infected. Decay, a crack, a deep filling or an injury can all let bacteria reach the pulp. Left alone, that can lead to pain, swelling and an abscess. Treating it lets you keep your own tooth.
The pulp builds the tooth during childhood. Once a tooth is fully mature it can thrive without it, nourished by the tissues around it.
What happens during treatment
- A local anesthetic numbs the tooth, and a thin rubber dam (non-latex available) keeps it clean and dry.
- A small opening gives access to the canals. Working under a surgical operating microscope, the doctor locates every canal — front teeth usually have one, molars typically three or four.
- The pulp is removed and the canals are cleaned, shaped and disinfected with nickel-titanium rotary instruments and irrigation.
- The canals are filled and sealed with gutta percha and a sealer cement, and the opening is closed with a temporary filling or a build-up.
Many treatments are completed in a single visit. Some take two, and occasionally three, depending on the degree of infection and the complexity of the tooth.
What materials are used?
In the vast majority of cases the cleaned canals are filled with gutta percha, a rubber-like material, and a sealer cement (zinc oxide and eugenol). In a few special cases the canal space may be filled with mineral trioxide aggregate (MTA) or a resin. Any filling we place does not contain amalgam — we use composite, glass or resin ionomer, MTA and/or zinc oxide–eugenol.
After treatment
See your general dentist within about two weeks for the permanent restoration. A temporary filling is designed to last only a short time — about four weeks. Without a timely permanent restoration the seal can break down, which can lead to fracture, decay, infection, gum disease or even the loss of the tooth, and may mean another retreatment or an extraction. Back teeth almost always need a crown, because the access opening weakens the top of the tooth and chewing places tremendous stress on it. Front teeth can often be restored with a filling when enough natural tooth structure remains. Your endodontist will explain what your tooth needs.
If a temporary filling or build-up comes out, contact your dentist right away — within a month at most. You have invested in saving the tooth — protecting the seal protects that investment.
If an abscess was present before treatment, the bone around the tooth can take up to two years to heal completely.