Root Canal Treatment: How It is Performed?

Root canal treatment, also known as endodontic treatment, is a dental procedure which involves the removal of infected, inflamed pulp tissues and microbes by cleaning the inside of the tooth. Inside the tooth beneath the tooth hard substance (enamel & dentin), there is a soft tissue mass known as dental pulp. It contains nerve and blood vessels. Dental pulp inflammation (pulpitis) is often caused by dental caries. Caries bacteria decompose carbohydrates from diet and produce acids that destroy the enamel and dentin. If dental caries is left untreated, it can spread to the dental pulp causing inflammation of pulp soft tissues. In this stage, root canal treatment is needed. If the tooth is left untreated, bacteria can spread to the surrounding tissues and lead to a dental abscess and severe infections.

Tooth Anatomy
Tooth Anatomy

How Does The Dental Pulp Become Inflamed?

The tooth nerve injuries are mainly triggered by dental caries and trauma (accidents). When bacteria spread to the inside of the tooth, they can cause inflammation of the pulp (pulpitis) and it can be quite painful. The blood vessels expand and make a pressure on the sensitive tooth nerve causing toothache. Also, the tooth nerve can become infected and inflamed due to deep tooth fillings close to the nerve, deep caries close to the nerve, a crack in the tooth, extreme sensitivity, or crown preparation that makes the pulp (almost) exposed.

Symptoms Of Teeth That May Need A Root Canal Treatment

A toothache is one of the most obvious symptoms indicating that a tooth may need a root canal treatment. The inflammation expands the blood vessels in the tooth that press on the sensitive tooth nerve. Also, the symptoms may include:

  • Extreme sensitivity to hot and cold.
  • Spontaneous and throbbing pain.
  • Pain that interrupts sleeping.
  • Tenderness to touch and chewing.
  • Development of a dental abscess.
  • Swelling of the cheek, the jaw or even the neck.

In addition, root canal treatment can be performed if the dental pulp becomes inflamed due to deep tooth fillings close to the nerve, deep caries close to the nerve, a crack in the tooth, extreme sensitivity, or crown preparation that makes the pulp (almost) exposed.

Root Canal Treatment Procedure

Root canal treatment is a complex process that requires several steps. So, it may require one or more office visits.

  • Local anesthesia: a local anesthesia is first applied to numb the tooth. local anesthesia is necessary to make the root canal treatment painless as possible. Then, a so-called rubber dam is used to isolate the tooth. The rubber dam is an elastic rubber sheet that is used to keep the tooth clean and dry during the procedure. This prevents bacteria from entering the tooth and minimizing the risk of complications.
  • Cleaning the root canals: the dentist opens the pulp chamber with a drill. Then, he/she introduces small, flexible files into the root canals and makes an X-ray to determine the length of root canals. The inflamed or dead tooth pulp is removed with files of various sizes. The dentist cleans and disinfects the entire root canal system to remove the remaining pulp tissues and make the tooth germ-free.
  • Root filling: only when the tooth is germ-free, the canal system is filled with a root filling. The dentist fills the cleaned root canals with a special material called gutta percha. The dentist may place a so-called dental post in a root canal to stabilize the crown or restoration. After root canal treatment, a dental crown may be needed to protect, rebuild, and restore the function of the tooth.

Advantages of Root Canal Treatment

A successfully performed root canal treatment has the following advantages:

  • The natural tooth is preserved.
  • Preservation of normal chewing function and force.
  • If a dental bridge is needed, the root canal treated tooth can be used for support.
  • It prevents the spread of infection to surrounding tissues and other complications. Because it involves the cleaning of entire root canal system to remove the inflamed or dead pulp tissues and bacteria.