Short answer: Root canal treatment is a treatment that aims to save a tooth without extracting it when the pulp, the tissue of nerves and blood vessels inside the tooth, becomes inflamed or infected due to deep decay, a crack or a blow. Under local anesthesia, the pulp is removed, the root canals are shaped and disinfected, and they are sealed with a special filling material. Treatment is usually completed in one or a few visits; afterward, in most cases a filling or crown is placed to strengthen the tooth.
The sentence “You need a root canal” causes anxiety in many patients. Much of this anxiety comes from experiences of years ago and from hearsay. Today, however, root canal treatment is one of the routine procedures in dentistry, carried out with good anesthesia and modern instruments, and it is an effective way to keep a natural tooth in the mouth. In this article we explain in plain language what root canal treatment is, which symptoms call for it, its steps and what to keep in mind after treatment.
What is root canal treatment, and why is it needed?
Root canal treatment is a treatment in which the pulp, the living tissue inside the tooth, is removed and the root canals are disinfected and filled; its aim is to eliminate the infection while saving the tooth without extracting it. In dentistry this field is called endodontics.
The outside of the tooth is made of hard enamel, with dentin underneath. At the very center is the pulp, made up of nerves, blood vessels and connective tissue. The pulp is connected to the jawbone through thin canals that run along the roots of the tooth. As a result of deep decay, a crack in the tooth, a blow or repeated procedures on the same tooth, bacteria can reach the pulp. Once the pulp is inflamed, it cannot heal itself; if left untreated, the inflammation can spread to the root tip and cause an abscess in the bone and swelling in the surrounding tissues.
At this point there are two options: extracting the tooth or saving it with root canal treatment. Preserving the natural tooth is the preferred path in most cases for chewing function, the position of neighboring teeth and the preservation of the jawbone.
A common misconception is that a tooth that has had a root canal becomes completely “dead” and useless. Although the pulp is removed, the root membrane that attaches the tooth to the jawbone and the surrounding tissues remain alive; the tooth continues to take part in chewing and to maintain the bite together with the neighboring teeth. What changes is that the tooth no longer senses hot and cold and may become somewhat more brittle over time. That is why the decision about the restoration after treatment is at least as important as the root canal itself.
Which symptoms call for root canal treatment?
Situations that require root canal treatment often show themselves through clear complaints; sometimes, however, they cause no symptoms at all and are noticed only on an X-ray. Common symptoms include:
- Pain that lingers for a long time after a hot or cold stimulus has been removed
- Throbbing pain that starts on its own and gets worse especially at night
- Tenderness when chewing or touching the tooth
- Swelling, a pimple-like bump or discharge on the gum
- Gray or dark discoloration of the tooth (especially after a blow)
- Swelling of the face or jaw
None of these symptoms on its own means that a root canal is needed; the same complaints can also come from gum problems or dentin sensitivity. The final decision is made through a clinical examination, testing how the tooth responds to stimuli and an X-ray assessment.
What are the steps of root canal treatment?
The steps of root canal treatment are, in order: examination, anesthesia, accessing the pulp, cleaning and shaping the canals, filling them and restoring the top of the tooth. Depending on the number of roots and canals and the state of the infection, treatment may be completed in a single visit or may take more than one.
- Examination and X-ray: The condition of the tooth, the number of roots and whether there is inflammation at the root tip are assessed.
- Local anesthesia: The tooth and surrounding area are numbed.
- Isolation: A rubber sheet (rubber dam) is often used to protect the tooth from saliva and bacteria.
- Access cavity: A small opening is made in the top of the tooth to reach the pulp chamber, and decayed tissue is removed.
- Cleaning and shaping the canals: Inflamed tissue is removed with fine files, the canals are shaped and rinsed with disinfectant solutions. Canal length is measured with electronic devices and X-rays.
- Interim dressing (if needed): If the infection is widespread, an antibacterial medication is placed in the canals temporarily and the tooth is closed with a temporary filling.
- Root canal filling: The cleaned canals are filled and sealed with a biocompatible filling material and a sealer paste.
- Final restoration: The top of the tooth is closed with a permanent filling; if much tooth structure has been lost, a crown is planned.
Does root canal treatment hurt?
Because root canal treatment is done under local anesthesia, most patients feel no pain during the procedure; what they feel is usually only pressure and vibration. In fact, for patients who had severe pain before treatment, root canal treatment is the procedure that removes the source of the pain.
In some cases, especially when there is intense inflammation in the tooth, it can be harder to achieve full anesthesia; in that case the dentist may give additional anesthesia. Tenderness when chewing or a mild ache in the tooth during the few days after treatment is normal and usually eases on its own. Your dentist will recommend a pain reliever for this period if needed. Pain that increases as the days go by, swelling or fever, however, is not normal and should be reported to your dentist.
Why are aftercare and a crown important after root canal treatment?
Protecting the tooth with a suitable filling or crown after root canal treatment is decisive for the long-term success of the treatment. Teeth that have had a root canal can become more brittle because of the removal of the pulp and the loss of tooth structure before treatment. Especially in large molars, where chewing forces are high, a crown is recommended in most cases.
Here is what to keep in mind after treatment:
- Do not eat until the anesthesia wears off; this is important to avoid biting your lip and cheek.
- Do not chew hard foods with a tooth sealed with a temporary filling.
- Do not delay the permanent filling or crown; if a temporary filling stays in place too long, the risk of leakage and reinfection increases.
- Brush and floss the tooth regularly like your other teeth.
- Come to your follow-up appointments; healing at the root tip is sometimes monitored with X-rays over months.
Common questions about root canal treatment
Does a root canal-treated tooth last a lifetime? Properly treated and well-restored root canal teeth can stay in the mouth for many years. However, new decay, fractures or gum disease can affect these teeth too; regular care is essential.
What happens if root canal treatment fails? Although rare, healing may not occur. In that case, options such as redoing the root canal treatment or root-end surgery are considered. Extraction is usually the last option.
Can root canal treatment be done during pregnancy? When necessary, it can be done with appropriate precautions, especially in the second trimester. You must tell your dentist that you are pregnant. For other questions, take a look at our frequently asked questions page.
When should you see a dentist in Ankara for a toothache?
If the pain in your tooth continues after the stimulus is removed, wakes you up at night, or if you notice swelling and discharge on your gum, it is important not to put off an examination; early intervention increases the chance of saving the tooth. At our clinic in Oran, Çankaya, we identify the source of the pain with an examination and X-rays and, if a root canal is needed, go over each step with you before we begin.
Frequently asked questions
How many visits does root canal treatment take?
Depending on the number of roots, the structure of the canals and the state of the infection, treatment may be completed in a single visit or may take two or three. The number of visits is estimated by the dentist after the examination and X-rays.
Why does a tooth change color after root canal treatment?
Nerve death after a blow, blood products inside the pulp or certain root canal materials can cause the tooth to darken over time. In front teeth, this can be corrected with internal bleaching of the tooth or a crown.
Couldn't the tooth just be extracted instead of having a root canal?
Extraction is an option, but the extracted tooth then needs to be replaced with a treatment such as an implant or bridge; otherwise, the neighboring teeth can shift and the bone resorbs. When possible, saving the natural tooth is preferred in most cases.
When can you eat after root canal treatment?
You can eat once the anesthesia has fully worn off. Until the permanent filling or crown is placed, it is recommended not to chew hard foods with the treated tooth.
