What is a root canal treatment?

A root canal treatment is used to repair the damaged inside of a tooth. It is also called endodontic treatment.

It involves drilling a hole into the tooth and removing the soft centre, known as the dental pulp. The dental pulp is made up of connective tissue, nerves and blood supply, and extends into the roots of the tooth. After the pulp is removed, the space is filled and sealed.

The crown, or surface of the tooth that is used for chewing, may also be replaced if necessary.

Root canal therapy can be performed by your regular dentist or a specialist endodontist.

When is a root canal treatment needed?

A root canal treatment can save a badly infected or damaged tooth. The tooth may have become infected or damaged by decay, repeated dental work, wear and tear, gum disease, cracked fillings or an injury to the tooth.

When the dental pulp is damaged, bacteria can start to multiply inside the tooth. This can lead to an infection or abscess, which is a pocket of pus that forms at the end of the tooth’s root.

Saving your own tooth if possible is important. It works better than an artificial tooth for biting and chewing. Losing a tooth can lead to other problems in the mouth. Replacing a lost tooth with an artificial one often needs more complex dental procedures. Root canal treatment is often the best way of saving a tooth.

What are the signs I might need a root canal treatment?

Sometimes there are no symptoms that a tooth needs root canal treatment. More commonly, the signs include:

• severe toothache when biting or chewing
• sensitivity to hot or cold that lasts after the heat or cold has been removed
• darkening of the tooth
• swollen and tender gums
• pus around an infected tooth
• swelling of the face or neck
• a loose tooth

What happens during a root canal treatment?

First, the dentist takes an x-ray of the tooth to see the shape of the root canals and determine whether there is any infection in the bone around the tooth.

A sheet or rubber called a rubber dam is placed over the tooth to prevent contamination. You will be able to breathe normally.

The dentist will use a local anaesthetic to numb the area around the tooth before drilling a hole in the tooth to remove the pulp. Each tooth has between 1 and 4 canals, depending on the tooth. All of the canals will be cleaned, shaped and disinfected.

It can take several appointments for the dentist to clean and shape the hole inside the tooth before placing a sterile filling inside. Between treatments they will seal the tooth with a temporary filling and may place a metal band around the tooth to protect it.

When the treatment is finished, they will fill the canal space with a material called gutta percha. They may also insert a small support into the root canals to strengthen the tooth. They may cap the tooth with an artificial crown if necessary.

Root canal therapy can be more uncomfortable than a normal filling, because it takes longer, but it is often no more painful.