Root canal treatment saves a tooth whose nerve has become infected or damaged, a tooth that would otherwise have to come out. The dentist removes the infected tissue from inside the tooth, cleans the root canals and seals them so that the infection cannot return. With modern techniques and careful anaesthesia it is far more comfortable than its reputation suggests.
Why a tooth needs it
At the centre of every tooth is the pulp: a soft core of nerve and blood vessels. Deep decay, a crack, a leaking filling or a knock can let bacteria reach it. The signs are toothache that lingers after hot or cold, pain when you bite, a tooth that has turned darker, a swelling or a small spot on the gum that comes and goes. Sometimes there are no signs at all and the problem is found on an X-ray. An infected pulp cannot heal by itself, and antibiotics do not reach inside the tooth. The choice is between treating the root canals and removing the tooth.
What happens
- An X-ray shows the shape and number of the root canals
- The tooth is numbed with local anaesthetic and isolated with a thin rubber sheet, which keeps it clean and dry
- The dentist opens the top of the tooth, removes the pulp and cleans and shapes each canal with fine instruments and disinfectant
- The canals are filled and sealed, and the tooth is closed with a filling
It takes one or two visits, depending on the tooth and on how much infection there is. Back teeth have more canals and take longer. A tooth with unusually curved or narrow canals may be referred to a dentist with further training in root canal work.
Afterwards
Expect the tooth to be tender for a few days, particularly when you bite. Ordinary painkillers are usually enough. A root-treated back tooth is more brittle than a living one, so your dentist will often recommend a crown to protect it from splitting. Until that is fitted, avoid chewing hard food on it.
The alternative
Taking the tooth out removes the infection too, and it is the right answer for a tooth that cannot be restored. It leaves a gap, though, which can be left or filled with a bridge, a denture or an implant. Keeping your own tooth, where it can be kept, is usually the simpler path. Your dentist will give you an honest view of the chances for your tooth before you decide.
Common questions
Is it as bad as people say? For most people it feels much like having a filling, only longer.
How long will the tooth last? Many root-treated teeth last for years. A good seal on top, whether a filling or a crown, makes the difference.
I am in pain now. What should I do? Book an emergency appointment. The first visit gets you comfortable; the treatment can be completed afterwards.
