A root canal (RCT), or endodontic, treatment is the proper term for a procedure that treats the nerve of the tooth, and is a treatment that is carried out on the pulp of a tooth that is either inflamed, infected, or dead.
While it has earned itself a poor reputation, it’s one of the most reliable, predictable treatments in dentistry. It’s also one of the most effective means of preserving a tooth so as not to resort to removing it.
Root canals are one of the best-known, yet most-feared, dental treatments. It’s important to note that modern root canal treatment is nowhere near as uncomfortable or painful as its reputation suggests.
Why Do People Need Root Canals?
Dental canals treat tooth pulp that is infected, inflamed, or simply dead. The pulp is a soft substance in the center of the tooth that consists of nerve, blood vessels, and connective tissue, and is contained within the pulp chamber.
This chamber is a hollow pocket in the center of the tooth that merges with canals which extend through the roots of teeth and into the surrounding bone. Additionally, while most teeth have a single root canal, some teeth may have several.
Tooth pulp can become infected and inflamed for a number of reasons. These include:
- Deep decay that has allowed bacteria to reach the inner structure of the tooth.
- Trauma to the tooth, such as chips and cracks, hard knocks and faulty crowns that don’t distribute pressure to the underlying structure properly.
- Abscesses at the root of the tooth
Symptoms to Look Out For
The biggest sign that you might need a root canal is a persistent tooth ache, often severe. Cavities, chips, and cracks accompanying the tooth ache can also point to needing a root canal, but are not necessary symptoms. Sometimes the damage is entirely internal, with no outward obvious signs.
Benefits of a Root Canal
The two most important goals of a root canal are to end pain and restore normal, healthy function to the tooth.
When you have pain in one tooth, you typically avoid chewing with it. This puts additional strain on the teeth on the opposite side of your mouth, which can lead to them wearing down or becoming damaged.
A root canal lets you start using that tooth as normal once again, so you can chew and eat properly without risking the other, healthy teeth in your mouth.
Root canals also help preserve a tooth. When a tooth is too severely damaged, it’s usually necessary to remove it. Root canals present a last line of defence to treat a tooth and restore function without removing and replacing it. A root canal is much cheaper and quicker than a dental implant.
Root Canal Procedure
During a root canal treatment, a hole is made in the crown of the tooth through which tools are inserted. These tools remove the pulp of the tooth and clean out the pulp chamber completely. This removes the effected tissue, along with any bacteria that might result in further flare-ups.
The now-empty chamber is filled with a rubber-like material that preserves the tooth’s integrity while preventing any further bacterial infections. A cap is then placed over the tooth to help maintain its structure.
Local anesthetic is used during the procedure to numb the tooth. In extreme cases, referral to a specialist endodontist or the use of general anesthetic may be required. A root canal should be no more painful than getting a filling. Generally speaking, however, a root canal should be no more painful than a filling.
Root Canals and Pain
One of the most enduring beliefs about root canals is that they’re incredibly painful procedures that will leave your face bandaged for days afterwards.
In reality, tooth canals are designed to alleviate pain. The procedure itself is no more uncomfortable than getting a filling. Local anesthetic should be all that’s needed to perform the procedure in a comfortable way for the patient.
So where does the idea that root canals are painful come from? In the past, it wasn’t far from the truth. Today, most of the pain associated with the procedure has to do with pre- and post-operative discomfort.
Firstly, people associate root canals with pain because pain is why people get root canals. The pain comes first, then the procedure, but the two are still linked in the mind of the patient.
Secondly, even after clearing out the affected area, and even removing the tooth nerve, the surrounding area is still sensitive. This will result in some discomfort, up to a few days after the procedure is performed. Generally, this should be manageable with regular painkillers, and at worst, your dentist may need to prescribe you something.
Alternatives to Root Canals
Saving the natural tooth is usually the best option, so root canal treatment is generally the treatment of choice. The only alternative to having a root canal is a tooth extraction and having it replaced with an implant, bridge, or denture. These procedures are more expensive than a root canal and often require more time and additional procedures to treat the surrounding teeth and tissues. If a tooth is extracted and not replaced with some type of restoration, chewing function will be impaired and teeth may shift.
Root Canal FAQ
How do I know if I need a root canal?
Your dentist will let you know. The biggest warning sign is severe, persistent pain in one or more teeth, signaling infection.
How long will the treated tooth last? Will I still need an extraction later?
A properly treated tooth, if looked after and cared for, can last for the rest of your life. Without proper oral hygiene, chances are the infection will reappear and the tooth will need to be extracted. If the tooth is damaged again due to injury, it may need to be extracted. If the healthy tissue isn’t regrowing properly and nourishing the tooth, it may need to be extracted.
It will be important to make your regular hygiene visits to the dentist to ensure your root canal-treated tooth is remaining functional and healthy.
How painful is it, really?
The procedure itself is virtually painless. Anesthetic is used to numb the area while work is performed.
Post-operative pain may be more severe, due to tenderness and inflammation. It will also depend on how infected and injured the tooth was prior to treatment. This is generally easily managed with simple pain medication. Post-operative discomfort normally only lasts a few days.
If it’s an infection, can’t antibiotics work?
Because the infection is inside of the tooth where there’s no blood supply, there’s no means to get the antibiotic to the bacteria.
Can’t I just get the tooth pulled?
Keeping your natural teeth is always the best option. Removing teeth can cause a lot of problems with your jaw and bite, which often need to be fixed or prevented with the use of a dental implant. Preserving the teeth is the ideal solution.