During a root canal procedure, the narrow channels below the pulp chamber in the inner part of the tooth are hollowed out, cleaned, and "packed" with a flexible nickel titanium pin-like device so that the area remains sanitized and free from debris buildup inside. This is all done to preserve the life of the tooth. In fact, if a root canal is not performed, the tooth can die. A dying tooth may be signaled by severe or minimal pain, tooth discoloration, swelling and irritation in the surrounding gum tissue, and nerve degeneration visible on an x-ray.

2. Why Are the Associated Toothaches So Painful?

Located inside each tooth are pulp chambers that funnel into root canals that house nerve fibers, blood and lymph tissues. The pulp chambers serve the purpose of sensory perception - heat and cold. A root canal can become infected for several reasons, including severe tooth decay, old amalgam (silver) fillings that can expand and cause fractures in the tooth, and a crack or chip in the tooth. When pus and debris fill these narrow roots, the pressure from the bacteria causes pain, and the nerve begins to die. In the case of a toothache that requires a root canal procedure, the pulp may be inflamed or infected. Without a root canal, the tooth may die. If a tooth dies, it must be extracted and replaced with a dental implant or dental bridge to maintain a proper bite and avoid teeth shifting.

3. The Types of Dentists Who Perform Root Canals

Simple root canals may be performed by a general or family dentist. Root canals in which the canal is curved or calcified require an endodontist, a dentist who focuses on diseases of the pulp chambers and root canals of the tooth. An endodontist also performs root canals on teeth that have more than one canal, such as a molar.

4. The Root Canal Procedure

At the first dental visit, you may be given antibiotic treatment for a number of days before a root canal procedure is performed. To start, your dentist will numb the tooth with newer anesthetics that are able to penetrate hard tissue. The tooth is completely numbed after a pinhole-size hole is made in the bone of the tooth to insert the anesthetic.

Then a drill is used to make a very small hole on the top or back of the tooth so that the canal can be cleaned with the flexible nickel titanium pin-like device mentioned above. It is important that the dentist delicately cleans out the bottom tip of the root, to prevent damage to the tissue and remove even the tiniest amount of debris or pus. To accomplish this, the dentist may use additional tools to measure the root. These tools may be digital x-rays that are taken during the cleaning phase, an apex locator that works as a sonar probe to locate the tip of the root, and a microscope providing up to 32 times magnification.

Next the dentist will disinfect the tooth using a water laser with a bleaching solution. A special type of heat gun is used to fill the canal with a latex material called gutta-percha that expands and seals the hollowed area in about 15 minutes. The dentist then fills the hole that was made to access the canal with a temporary filling, to provide time to monitor for complications.

The permanent filling or crown is performed within 10 days of the root canal procedure. During the interim, you may receive medication to manage the soreness and discomfort that comes after the procedure.

The cost of a root canal procedure can range from $500 to $1,000.

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