In modern dentistry, dentists consider that the best teeth are our own. That is why they will do everything they can to help you keep your teeth. A successful root canal treatment allows that.

If the root canal treatment is unsuccessful (usually because it was detected too late), you will have no other choice than to extract the tooth. Unfortunately, this means you will need a dental bridge or an implant.

Losing a tooth may have these unfortunate consequences:

• Loss of alignment of adjacent teeth;
• Jaw problems;
• Gum diseases.

What is a root canal?

There is a space inside the hard layers of each tooth. It is called the root canal system and it is filled with soft dental pulp made up of nerves and blood vessels that help the tooth grow and develop. Once a tooth is fully grown, it can survive without the pulp. If the pulp of a tooth becomes infected, a root canal treatment (also called endodontic treatment) is needed and it involves removing the pulp.

When is a root canal required?

The pulp may be damaged by cracks in the enamel, a deep cavity or an accident. Bacteria can get into the tooth and infect the pulp, which may cause infection or inflammation. Sometimes the pulp becomes infected and dies without causing any pain.

Root canal treatment, step by step

1. A dental dam is placed around the tooth to protect it during the treatment from the bacteria in your saliva.
2. The dentist or endodontist gives you a local anesthetic (freezing), if there is a risk of pain.
3. The dentist makes a small opening in the tooth to reach the root canal system and the damaged pulp.
4. The dentist will take out the pulp by cleaning and enlarging the canal with very fine instruments.
5. The dentist will then fill and seal the canal with a rubber-like material called gutta-percha. He or she will use an obturator, which pre-regulates the instrument temperature to melt the rubber and make a better seal.
6. Lastly, the dentist will seal the opening of the tooth with either a temporary or permanent filling.

Points to consider

A root canal treatment may be completed in one appointment, or it may take several visits, depending on the complexity of the root canal system and on the degree of pulp damage.

Sometimes, if the infection has spread from the tooth to the bone (abscess), the infection may have to be drained before the root can be filled.

Your tooth may remain tender for one to two weeks after the treatment. Intense pain and swelling are uncommon. If you do experience them, call your dentist or endodontist as soon as possible.

After a root canal, your tooth must be restored with a filling or a crown to look and work as much like a natural tooth as possible. The type of restoration depends on how strong the remaining tooth is. A back tooth will likely need a crown because chewing puts a lot of pressure on back teeth. If not enough of the natural tooth is left, your dentist may use a post to help keep the crown in place. A discoloured tooth can either be bleached, crowned or covered with a veneer.