What is root canal therapy?

A root canal is done to correct problems of the soft tissue inside the center of the tooth. This soft tissue is called dental pulp. Dental pulp contains nerves, blood vessels, and connective tissue. In the past, teeth with abscessed or infected nerves were removed. But now the natural tooth can often be saved through modern endodontic procedures. Endodontists are dentists with specialized training in root canal therapy. They are sometimes called pulp specialists.

Why might I need a root canal?

You will need a root canal if your tooth has damage to its dental pulp, the soft tissue that surrounds nerves in the center of the tooth. The most common causes of pulp nerve damage are:

• Infection. This is often caused by tooth decay (cavity) reaching the nerve or a cracked tooth. This can allow harmful bacteria to reach the nerve, resulting in infection and decay.

• Injury. An injury to a tooth or the jaw can cause damage to sensitive nerve tissue in the tooth.

Without treatment, the infected dental pulp will spread to the bone around the tooth. This makes it unable to hold the tooth in place.

These are the most common symptoms of pulp nerve damage:

• Tooth pain when biting down

• Tooth pain while chewing

• Sudden pain for no reason

• Oversensitivity of the teeth with hot or cold drinks

• Facial swelling

The symptoms of pulp nerve damage may look like other oral health conditions. See a dentist or other oral health specialist for a diagnosis.

What are the risks of a root canal?

Sometimes a root canal needs to be redone because an offshoot of the diseased canal was missed. Or a filling instrument fractures. But these complications rarely occur. As with any invasive procedure, there is a risk of infection. 

Your own risk of complications may vary depending on:

• Your age

• Your other health conditions

Ask your dentist about the risks that may apply to you.

How do I get ready for a root canal?

Generally, no preparation is needed before the procedure. Once your dentist does the initial dental evaluation, they will do the procedure or refer you to an endodontist. Root canal treatment often takes 1 to 3 visits.

What happens during a root canal?

First, you will be given a medicine (local anesthetic) to numb the tooth being treated. Treatment begins with drilling an opening in the top of the tooth (crown) to reach the pulp tissue. Once the affected pulp tissue is exposed, it is removed. The area around and containing the pulp tissue is carefully cleaned, enlarged, and shaped. This is done to provide a clean surface for filling with a permanent filler. This stops any further infection and pain. After the root canal is filled and sealed, a crown is made. This is done to restore the natural tooth and prevent it from fracturing. The root canal may be done in 1 or more visits. Once the tooth is comfortable, the crown can be placed and adjusted so your bite will be normal.

What happens after a root canal?

Once the root canal therapy is done, there will be changes to get used to, including:

• Brittleness. A pulpless tooth is more brittle than an untreated tooth. Great care should be taken so the tooth doesn’t fracture or chip. The tooth is restored with a crown to prevent fracture.

• Discoloration. A nonvital tooth may become discolored over time. But it can be treated with internal bleaching. In most cases, the discoloration is not a risk to the tooth’s health.

In addition, soft tissue inflammation may be a source of irritation in the weeks after surgery. See your dentist or other oral health specialist for a treatment approach to help control any swelling and mild pain after surgery.

After your root canal, ongoing good oral hygiene is vital. Care for your teeth by:

• Brushing and floss your teeth at least twice a day

• Brushing your tongue each time you clean your teeth

• Getting a dental checkup twice a year or as advised by your provider

• Not using tobacco products, including smokeless tobacco

• Following medical advice for managing chronic illnesses, such as diabetes

• Eating a balanced, healthy diet

Next steps

Before you agree to the test or procedure make sure you know:

• The name of the test or procedure

• The reason you are having the test or procedure

• What results to expect and what they mean

• The risks and benefits of the test or procedure

• What the possible side effects or complications are

• When and where you are to have the test or procedure

• Who will do the test or procedure and what that person’s qualifications are

• What would happen if you did not have the test or procedure

• Any alternative tests or procedures to think about

• When and how you will get the results

• Who to call after the test or procedure if you have questions or problems

• How much you will have to pay for the test or procedure