Endodontic treatment, often called a root canal procedure, is a filling process that addresses problems involving the soft-tissue inside of a tooth called the pulp.  The pulp inside a tooth contains nerves and blood vessels and is the tissue responsible for creating the hard structures, the enamel and dentin, as the tooth grows.  A normal pulp shrinks in size as a tooth matures and becomes unessential so that once tooth development is complete the pulp can be removed if necessary.

One reason a pulp might need to be removed is when the pulp becomes infected.  Repeated dental procedures on the tooth, a crack or chip, deep decay, or trauma to the tooth are some of the reasons a pulp may become infected.  If left untreated an infected or inflamed pulp can produce significant discomfort for the patient and can lead to a dental abscess.

The most common symptoms caused by a damaged pulp are sensitivity to heat or cold, a throbbing or achy feeling, and tenderness to touching or biting on the tooth.  Other signs that a tooth is in trouble would be discoloration, localized swelling, looseness, or possibly a feeling that the tooth is too high and hitting before other teeth.  Occasionally there are no outward signs or symptoms that a tooth is in trouble, which is why dentists suggest taking x-rays periodically to check the status of the teeth.

Endodontic treatment involves removing the infected pulp from within the tooth, including the small bit of pulp tissue that extends down the canal in each root of the tooth.  Before that process begins an exam and x-rays are done to be sure the correct tooth has been identified and that the tooth actually needs treatment.  Once the diagnostic process is complete the tooth is completely anesthetized.  Then a dental dam, which is a protective barrier used to isolate the tooth from the rest of the mouth, is placed over the tooth.  This allows work to be done easily inside the tooth without contamination from saliva.  A small hole is cut in the tooth to gain access to the pulp.  Then the canal of each root, between one and four of them depending on the tooth, is carefully cleaned and shaped so it can be thoroughly sealed with a special filling material.

A routine root canal procedure takes between an hour to an hour and a half at our office and is usually performed in one visit. The process sounds straight forward and it usually is.  When the root canal procedure is complete, the access opening that was cut in the tooth is sealed with a temporary filling.  Then patients need to return to their general dentist for a final restoration, which might be a simple filling or possibly a crown depending on circumstances of the tooth.

Occasionally an addition surgical procedure is necessary to complete the treatment of a tooth after the routine root canal procedure has been finished.  Unfortunately not all teeth can be saved and fractures are the most common reason.  When a tooth can’t be saved all options are reviewed, including replacement alternatives for that tooth, so that the patient can make an informed decision on how they want to proceed.