Root Canal Therapy

Root canal therapy is performed by an endodontist — a dentist who specializes in tooth pain, disease, and infection. Endodontists have extra training that helps them diagnose and treat tooth pain and perform root canals, a special procedure designed to save an infected or decayed tooth.

Endodontists treat problems involving the inside of the tooth, an area known as the “tooth pulp.” It has blood vessels, nerves, and connective tissue. It can get inflamed or infected because of deep tooth decay, traumatic injury to a tooth, and repeated dental work on a tooth. When that happens, an endodontist is the specialist to see.

The most common procedure endodontists perform is a root canal, a procedure in which they remove the tooth’s nerve and tooth pulp that has become damaged or infected. 

Root Canal Treatment

Root canal therapy is a treatment used to repair and save a tooth that is badly decayed or infected.

Root canal therapy is performed when the pulp which is composed of nerves and blood vessels in the tooth becomes infected or damaged. During root canal therapy, the pulp is removed, and the inside of the tooth is cleaned and sealed.

What is dental pulp?

The pulp or pulp chamber is the soft area within the center of the tooth and contains the nerve, blood vessels, and connective tissue. The tooth's nerve is in the "root" or "legs" of the tooth. The root canals travel from the tip of the tooth's root into the pulp chamber.

A tooth's nerve is not vitally important to a tooth's health and function after the tooth has emerged through the gums. Its only function is sensory — to provide the sensation of heat or cold. The presence or absence of a nerve will not affect the day-to-day functioning of the tooth. However, after treatment the tooth is less viable and more susceptible to fracture.

Why does dental pulp need to be removed?

When pulp is damaged, it breaks down, and bacteria begin to multiply within the pulp chamber. The bacteria and other dying pulp remnants can cause an infection or abscessed tooth. An abscess is a pus-filled pocket that forms at the end of a tooth’s root. In addition to an abscess, an infection in the root canal of a tooth can cause:

  1. Swelling that may spread to other areas of the face, neck, or head

  2. Bone loss around the tip of the root

  3. Drainage problems extending outward from the root. A hole can occur through the side of the tooth, with drainage into the gums or through the cheek into the skin.

Additional Procedures

After a root canal is completed, in most cases additional procedures are needed to complete the root canal. This may include restorative procedures such as core buildup or post and core and a porcelain crown. In select cases periodontal procedures, such as crown lengthening, may be recommended.

Root Canal Retreatment

With proper care, even teeth that have had root canal treatment can last a lifetime. But sometimes, a tooth that has been treated doesn't heal properly and can become painful or diseased months or even years after treatment. If your tooth failed to heal or develops new problems, you have a second chance. An additional procedure may be able to support healing and save your tooth. If you have pain or discomfort in a previously treated tooth, talk to an endodontist about retreatment.

What happens during root canal retreatment?

To perform a root canal retreatment, the endodontist will reopen your tooth to gain access to the root canal filling material. In many cases, complex restorative materials—crown, post and core material—must be disassembled and removed to permit access to the root canals.

After removing the canal filling, the endodontist can clean the canals and carefully examine the inside of your tooth using magnification and illumination, searching for any additional canals or unusual anatomy that requires treatment.

After cleaning the canals, the endodontist will fill and seal the canals and place a temporary filling in the tooth. If the canals are unusually narrow or blocked, your endodontist may recommend endodontic surgery. This surgery involves making an incision to allow the other end of the root to be sealed.

After the retreatment is completed, you will need to complete treatment by having a new crown or other restoration placed on the tooth to protect and restore it to its full function.