Root canal treatment—colloquially referred to as ‘a root canal’—is a dental procedure whereby infection is removed from a tooth’s interior. Although the phrase ‘root canal’ has become better associated with this procedure, in actuality, the phrase refers to tooth pulp—which is where the procedure takes place.
Another term for ‘root canal treatment’ is ‘endodontic therapy’. It is an alternative to tooth removal, and it is often cheaper than replacing a tooth with a dental crown. Although it is thought to be painful in the short term, it is a long-term investment in pain relief. Here is everything you need to know.
The tooth of the matter
Before we explain root canal treatment, we’ll give a quick rundown on tooth pulp. This will better aid understanding of how the process works.
Tooth pulp is the guts of a tooth. It’s the interior containing cells, nerve tissue, and blood vessels. The pulp moistens the tooth’s surroundings and provides it with nourishment. It is the nerves inside this pulp that detect pain, as well as hot and cold temperatures.
Not that kind of nourishing pulp.
A three-step program
To rid your tooth of infection, you’ll need to undertake a three-step program. Root canal therapy has three phases, and these can take up to three dental appointments to complete.
Step 1: Cleaning
Step 1 involves cleaning out the root canal itself. This is an invasive procedure, and your dentist will knock you out with local anesthesia throughout. They will then proceed to create a hole atop your tooth to access and remove the dead and diseased pulp.
Step 2: Fill ‘er up
Your tooth will now be hollow—which is not useful for anyone. Your dentist will then prepare your tooth for a filling by shaping, irrigating, and decontaminating your hollow husk of a tooth.
Once it’s safe, your dentist will fill your teeth with a rubbery material. However, this rubber will never see the light of day. It will be forever encased in adhesive cement designed to seal the canals with finality.
Please note that, although your tooth’s exterior will remain, it can be officially announced dead at this stage. Without its ‘internal organs’ such as its nerve cells, it can no longer nurture itself or detect pain. On the bright side, your tooth will be free of pain and infection altogether.
Step 3: Your crowning moment of fulfillment
Without self-sourced nourishment, your tooth will need to eat into its skeletal stores. The ligament that attaches the tooth to the jaw bone is your tooth’s version of a savings account. It’s okay to withdraw from here for a while, but it’s not sustainable. That’s why it’s important to finish the job with another filling or a dental crown.
Until your now-frail tooth has been adequately filled or crowned, ensure not to use it for its intended purposes (i.e. chewing or biting). It sounds counterintuitive but it makes sense. Would you work your legs the day after leg day? Some people do, but it’s not advisable.
All going to plan, you should be good to resume regular chewing after one session. Please note that complications (such as larger infections or abnormal canals) may call for further appointments, in which case, you may want to look into a temporary liquid diet. Rest the tooth until the crown or fillings are adequately affixed.
Does it hurt?
Root canal treatment doesn’t hurt in the way you may think it does. In fact, the infected tooth is more likely to cause pain than the procedure itself—which, by the way, is performed under local anesthesia. Moreover, the affected tooth is numbed throughout the procedure, so you shouldn’t feel anything.
Your dentist or doctor can help you with post-procedure pain. Image: Primary Dental
Post-procedure pain is more prevalent. If you’re experiencing tenderness or pain post-procedure, try some over-the-counter pain relief. If it’s a problem not even paracetamol can fix, you may want to speak to your doctor about prescription pain medication (e.g. codeine).
Should I get a root canal?
Once your tooth pulp is infected, it’s irreparable. It needs to be removed to prevent the spread of infection. If you are unfortunate enough to have infected tooth pulp, you have two options: root canal treatment or tooth extraction.
Sometimes root canal treatment can’t cover it. Tooth extraction is an alternative.
Sometimes the tooth cannot be saved, in which case extraction is the only option. This makes for a clean break and negates the need to replace the tooth pulp. However, it’s advised to get a root canal if possible. Even if you can’t save its functional insides, nothing beats the original. Even a dead tooth exterior will be more self-sufficient than a porcelain replacement*.
(*Please note that porcelain dental crowns are great options—and you may need one in addition to root canal treatment anyway—but it’s always best to recover what you can.)