What is root canal treatment?

What is root canal treatment?

The American Association of Endodontists describes the pulp as soft tissue inside the tooth containing blood vessels, nerves and connective tissue, running from the crown to the root tips, and says a fully mature tooth can survive without it because surrounding tissues still nourish the tooth. Healthline describes a root canal as a way to repair a tooth without removing it: the dentist removes the inflamed or infected pulp, cleans and disinfects the inside of the tooth, fills it and usually places a crown. Endodontic treatment is another name for the same thing.

What happens during the procedure?

The American Association of Endodontists lists four stages: examination and numbing, with an X-ray and a dental dam to isolate the tooth; access and cleaning, with an opening made in the crown and the pulp removed from the chamber and root canals; filling and sealing with a rubber-like material called gutta-percha and cement, with a temporary filling closing the opening; and restoration, when your general dentist places a crown or other restoration, sometimes with a post. It says treatment can take one or two visits, each about 90 minutes. Cleveland Clinic says most sessions take about 60 to 90 minutes and that you usually feel pressure and mild soreness.

What is an alternative to a root canal?

Healthline lists direct pulp capping, in which a mineral material is placed over minimally exposed pulp that looks healthy, usually suited to younger patients and followed by a filling; pulpotomy, in which only the inflamed pulp in the crown is removed; and extraction, with replacement by an implant, bridge or removable partial denture. The American Association of Endodontists says extraction often leads to implants, bridges or partial dentures that can take more time, and that ozone therapy and other holistic or biologic approaches lack strong scientific support as replacements. Our guide on how to avoid a root canal covers prevention.

What is a baby root canal?

Healthline says a pulpotomy removes only the inflamed pulp in the crown and preserves the root canals and nerve, is common in children with baby teeth or developing adult teeth, and is not appropriate if the pulp shows infection or irreversible damage. In adults it is usually an emergency measure for pain until a root canal can be done. The sources we read do not describe a full root canal for baby teeth, so ask a children's dentist what they recommend.

What is a failed root canal?

The American Association of Endodontists says a treated tooth can become reinfected months or years later, for example through a cracked or loose filling, a delayed crown, new decay, trauma or complex canal anatomy, and that a failed root canal can often be saved through retreatment or endodontic surgery. Cleveland Clinic says if damage was too severe the tooth may need another root canal or extraction followed by an implant or bridge. See our guide on why root canals fail.

Who is responsible for a failed root canal?

The sources we read do not address responsibility. If a treated tooth fails, ask the dentist who treated it what they offer, and whether an endodontist should retreat it. Practices and countries differ, so we cannot give a general answer.

What happens afterwards?

Cleveland Clinic says most people recover within about a week, some sensitivity is normal, lasting or throbbing pain should be reported, and a permanent crown is placed later, usually at one or two more appointments. It says most root canals are successful and can last many years, often a lifetime. The American Association of Endodontists says success rates are often reported above 90%.

Questions to ask your dentist

Take these to your appointment.

• Why do I need a root canal, and what is the alternative for this tooth?
• Should an endodontist do it?
• How many visits will it take?
• When will the crown go on?
• What happens if it fails?

Frequently asked questions