The root canal of a tooth is the chamber inside the tooth which contains soft tissue – pulp and the nerve. A badly decayed tooth or one damaged by trauma to the mouth may become infected and require a root canal procedure which cleans and seals the opening lest pus-leaking abscesses form at the root under the gum line. The tooth’s nerve is removed during the treatment because it is usually already dead and unnecessary after a tooth has broken through the gum – its main purpose in adults is to judge temperature of food and beverages and the patient will normally not even notice its absence. The pulp must be removed because it is a breeding ground for bacteria which can pose further health risks such as loss of bone mass in the jaw or drainage problems which extend from the root and affect the gums or cheek.
Extreme sensitivity, especially in a tooth which already has large fillings, chips, or other damage is usually the first sign of an issue requiring a root canal. Discoloration of the tooth can also occur, as can swelling and tenderness of surrounding soft tissue (gums in particular), and a persistent or recurring pimple on the gums. Although the procedure is notorious for being painful, most patients do not find it more uncomfortable than a getting a filling. The dentist or endodontist (a specialist in dental pulp and nerves) takes an x-ray to assess the damage and determine if there is any infection at the root. A local anesthetic is then administered and a rubber dam is positioned to keep the area free of saliva. An access hole is drilled into the tooth and a series of dental files are used to clean out the decay, pulp, and nerve. The hole is flushed out with water or sodium hypochlorite continuously during the procedure to wash away debris. Once the tooth is clean it is sealed using a filling, crown, or temporary filling which is replaced with a permanent solution at the next visit. Temporary fillings are used more commonly in cases of infected teeth which need medication inside the tooth to fully heal. As always, patients are asked to practice good oral hygiene habits and take particular care of the treated tooth. Any minor pain or sensitivity following the procedure can be treated with over-the-counter pain medication and rarely lasts more than a day or two. Mouth guards are recommended when playing sports in order to avoid injury which may lead to problems with the root canal.