You’ve probably heard a dozen jokes about and comparisons to root canals, which, given their reputation, sound like the worst procedure in the dental field. In reality, root canals (also called endodontic treatments) are a routine procedure to save an infected or damaged tooth.
In the center of the tooth is a cavity filled with soft tissue, known as the pulp. The pulp is filled with blood vessels and nerves, and as the tooth grows and develops when it first comes in, the pulp provides the nourishment it needs. Once the tooth is fully formed, however, it’s no longer dependent on the pulp. A root canal refers to the process of emptying the pulp cavity to clear it of infected tissue or inflamed nerves.
Damage to the tooth that can lead to the need for a root canal can happen as a result of chipping, cracking, a large filling, repeated dental work, infection or decay, or trauma to the face from an accident.
Once the nerve or pulp is damaged, it begins to decay, breaking down into bacteria that can multiply and spread, leading to an infection or abscess, a pocket of pus that develops at the end of the root. Once the abscess forms, it’s a sign that infection has spread more deeply than the root, which can lead to complications like swelling in the face and neck, bone loss, and the creation of a hole in the tooth that drains fluid into the cheek or gums.
In some cases, there are no painful symptoms and the need for a root canal is discovered during examination, but signs that you may need one include: severe aching that occurs while chewing or when pressure is applied, sensitivity to heat or cold that continues after the source of the temperature is removed, pimples on the gums, changing tooth color, or inflammation and tenderness in the gums.
Root canals usually require only one or two appointments, and general anesthesia is unnecessary – in many cases, even local anesthetics are unnecessary since the nerve is dead, but it’s often used to put patients at ease. A hole is drilled into the tooth through which the pulp and nerve are removed and cleaned out; after being sanitized, the hole is refilled. In some cases, such as those where infection requires the cavity to be filled with medication, the dentist may choose to fill the tooth at a separate appointment a week or so after the procedure.