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Root Canal Treatment


Do you have throbbing pain in one of your teeth, or have you recently been to a dentist and been told that you need a root canal? You are probably curious as to why you need a root canal, and what a root canal procedure actually entails. Before we discuss why root canal treatment is necessary and what happens during a root canal procedure, let's first begin with some simple dental anatomy.

Teeth are not solid objects in your jawbone. In fact, inside each tooth is a hollow space that contains the nerves, blood supply, and connective tissues which nourish the tooth and keep it alive and healthy. This hollow space is widest in the center of the tooth's crown (the part of the tooth that lies above the gum line) and is known as the pulp chamber. The pulp chamber leads into one or more tubes that extend down the length of the root called root canals. These canals are filled with the same blood vessels and nerves found in the pulp chamber. Every tooth has only one pulp chamber but the number of individual root canals varies depending on the location of the tooth. For example, front teeth (anterior teeth) normally have one root and one root canal, whereas back molar teeth usually have multiple roots and therefore, multiple root canals.
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What is a "root canal"?
A "root canal," or root canal therapy, refers to a procedure whereby a dentist or endodontist removes the nerve tissue and blood supply from the pulp chamber and root canal(s) of a tooth. Despite its negative reputation and misleading misconceptions, root canal therapy actually provides an amazing service. It allows a dentist to save a decayed or infected tooth that would otherwise have to be extracted.
During root canal treatment, the nerve, blood supply, and connective tissues are removed from the spaces inside the tooth and the tooth is cleaned with tiny files and sealed. The nerve and blood supply are not vitally important for a tooth's survival, and the absence of these tissues will not affect the tooth's ability to function.


Root canal files cleaning out the tissue within the root canals


Cleaned root canals are sealed with a root canal filling material
When people say they need a "root canal" they mean they need root canal treatment or root canal therapy.
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Why is a root canal necessary?
Root canal therapy is necessary to save a tooth whose nerve is damaged. It is also necessary to stop pain associated with an irritated or infected nerve. A nerve can become irritated or infected for a number of reasons, including a large area of decay (a cavity), repeated dental procedures on the same tooth, a large filling close to the nerve, a crack or chip in the tooth, or trauma to the tooth. When a nerve is damaged, bacteria can get into the pulp chamber of the tooth and start to multiply. The bacteria causes an infection in the tooth which can spread down the roots of the tooth and form an abscess at the end of the roots. An abscess is a build-up of infected material (pus) that forms at the ends of the roots of a tooth.
If a tooth becomes infected and root canal therapy is not performed, there can be serious consequences. Not only may the tooth need to be extracted, the infection may also spread to the face, jawbone, or other areas of the body leading to dangerous and potentially life-threatening complications. Avoid these complications by treating an infected tooth as soon as possible. And remember, even if the pain subsides, bacteria still exist inside the tooth and a root canal is still needed. Failure to treat a tooth simply because it does not hurt can over extend your immune system and can make you susceptible to other illnesses. Ignoring a tooth that needs a root canal can literally make you sick!
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What happens during the root canal procedure?
A root canal is performed by a general dentist or an endodontist and is completed in one or more visits. After an x-ray is taken and it is determined that the tooth needs a root canal, the dentist will use a local anesthetic to numb the tooth. The tooth is isolated to keep the area dry, and a hole is then drilled into the tooth. The nerve and pulp tissue are removed from the inside of the tooth, along with any bacteria and debris that is in the tooth. A series of small metal files are used to clean out the individual root canals, and the tooth is repeatedly rinsed with solution to flush away the debris and sterilize the canals. Once the tooth has been thoroughly cleaned, it is sealed with a cone of rubber material called gutta percha, which is cemented into the root canals. If the tooth is infected it may be necessary to wait one week before sealing the root canal to ensure the infection has subsided. Once the root canal is complete, a temporary filling is placed in the tooth until a permanent filling or crown is made.
Root canal procedure

Tooth broken down to the nerve chamber
  Nerve & Tissue removed from tooth with root canal file  
Tooth sealed with gutta percha
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Are root canals painful?
While root canals have the reputation of being painful, most people report little or no pain during the actual procedure. The reason root canals have a reputation for being painful is due to the severe toothache that many people experience leading up to seeing a dentist. The root canal procedure itself is relatively painless and actually relieves the toothache pain. Some slight tenderness may be felt for a few days following completion of a root canal, but this mild discomfort can usually be controlled with over-the-counter medications.
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Are root canals successful and are there any alternatives?
Root canal therapy is highly successful and many teeth saved with root canal treatment can last a lifetime. Although it is possible for root canals to fail and new infections to emerge, root canals have about a 95% success rate overall.
Once a tooth's nerve is damaged, root canal treatment is the only way to save the tooth. The only alternative to a root canal is to have the affected tooth extracted and to restore the space with a bridge, an implant and crown, or a removable partial denture. These alternatives are more expensive, take more treatment time, and affect adjacent teeth and/or supporting tissues. If possible, saving your natural tooth with a root canal is the best treatment option. By saving the tooth with a root canal, you are also saving the part of the jawbone which surrounds the tooth and which supports the oral soft tissues around the tooth. If the tooth is extracted, this supportive bone will shrink away leaving you with a visual defect.
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How do I know if I need a root canal?
Here are some of the common signs that a root canal is needed:
  • Spontaneous, throbbing pain
  • Sharp, shooting, or throbbing pain when chewing or applying pressure to the tooth
  • Prolonged pain or sensitivity to hot or cold temperatures
  • Tooth pain when lying down or pain that wakes you up at night
  • Swelling and tenderness of the gums near the tooth
  • A recurring or persistent pimple or abscess on the gums
  • Discoloration or darkening of the tooth
  • Pus in the mouth
  • Foul taste in the mouth
  • A dark shadow around the tip of the tooth's root on an x-ray
  • Many times a root canal is necessary even if no pain or obvious symptoms are present

If you have been told that you need a root canal or are suffering from the symptoms of an infected tooth, SEEK TREATMENT IMMEDIATELY. The consequences and risks of non-treatment can be complicated, expensive, and severe. You are not only putting your tooth in jeopardy, you are also risking your health, and possibly your life!

We can help! Call us at 201-447-9700.
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What happens after the root canal is completed?
After the root canal has been successfully completed, the tooth will need to have a permanent restoration made. In most cases, the tooth will need a crown. Once the nerve tissue and blood supply has been removed from the tooth, it no longer has its hydrating mechanism and it becomes brittle and prone to fracture. It is very important that teeth that have been root canal treated, especially back molars and premolars, be restored with crowns to prevent fracture. Crowns are made of porcelain, porcelain-fused-to-metal, or metal and they function just like regular teeth. All porcelain crowns look much more natural than porcelain-fused-to-metal or metal crowns.
Below is an example of an all porcelain crown and a porcelain-fused-to-metal crown. Notice how the all porcelain crown transmits light while the porcelain-fused-to-metal crown blocks light. All porcelain crowns have the ability to transmit light much like a natural tooth does. This property makes all porcelain crowns appear more natural and life like in the mouth.

All porcelain crown compared
to porcelain-fused-to-metal crown
If the tooth had a large filling or a big cavity prior to the root canal, it will most likely also need a post and core in addition to a crown. A post and core is a dental restoration used to build-up tooth structure when there is not enough tooth left to retain a crown. A post and core replaces tooth structure that has been lost due to decay or fracture and it holds the crown.
Tooth was decayed to
gum line
Root canal was completed
Post and core made to
replace tooth structure
Post and core cemented
in tooth
Porcelain crown cemented on
top of post and core
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We can help!
At the Kurpis Center for Advanced Dentistry, our dentists and specialists perform root canals all the time! From simple front teeth to complex back molars, we can handle your root canal needs. A major advantage that patients receive at the Kurpis Center for Advanced Dentistry is that we have additional dentists and specialists who can restore a root canal treated tooth with porcelain restorations. This eliminates the need to go to several dental offices to treat the tooth. Furthermore, our dentists perform advanced procedures that can save many "hopeless" teeth that have been condemned to extraction. If you have been told that you need a root canal, if you are experiencing the symptoms of an infected tooth, or if you have been told that you have a "hopeless" tooth that needs extraction, call us right away and set up an appointment with one of our gentle and experienced dentists.
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