Anatomy of a Root Canal


The words themselves are enough to send a shudder down the spines of musclebound men and mothers tough enough to have children less than two years apart. Root. Canal. That wasn’t so bad was it? The truth is, whatever stigmatized fear, anxiety and pain is associated with the aforementioned procedure pale in comparison to what would happen to you if you didn’t get one.


Why does one require a Root Canal?


Endodatic therapy, more commonly referred to as a root canal becomes necessary when the pulp of a tooth is damaged, diseased or dead. The pulp of a tooth is the living connective tissue comprised of blood vessels and nerves that is found directly in the center of each tooth within a pulp chamber. The pulp is responsible for nourishing the tooth itself allowing it to exist as a living thing. Although well protected, the pulp of a tooth can become damaged or dead due to severe trauma or cracking as well as infections that are the result of cavities deep into the pulp chamber. If affected pulp is left untreated, it can lead to severe infection at the root of the tooth known as an abscess. Beyond being extremely painful, abscesses can damage the bone surrounding the tooth.


Unlike root canals, abscesses are nothing new. Treatment in simpler times (and places) involved the extraction of affected tooth as there was no other way of saving the tooth or relieving discomfort. Although an effective short term solution, missing teeth causes other surrounding teeth to drift out of line, which in and of itself can lead to a plethora of oral complications.


How does the root canal happen?


Determining whether you need a root canal is a decision best left to a dentist. Whether you were driven to come in due to pain and trauma or are simply in for a routine appointment your dental professional will advise you on your best course of action. The full treatment can take one to two appointments and may be done in full or in part by your dentist themselves. Those who have not trained in the specialization will refer you to an Endodontist, a dental pulp specialist.


As for the actual procedure, it is comprised of the following steps:


  1. The dentist performing the procedure will give you either a local or general anesthetic depending on whether they do sedation dentistry.

  2. As your saliva has bacteria in it, a rubber dam is placed around the tooth being operated on so as to protect it from possible infection.

  3. With a drill, the dentist makes a small opening in the tooth in order to gain access to the pulp chamber and damaged pulp. Holes are made in the back of pre-molars and in the crown (top) of molars.

  4. The dentist then removes all the pulp in the affected tooth, a process known as a pulpectomy. Once all of the pulp is removed, the spaces the pulp once occupied at the base of the teeth leading into the pulp chamber known as root canals are cleaned, enlarged and shaped in order to be optimally filled.

  5. At this point a permanent or temporary filling material is used in the tooth to fill the root canals and pulp chamber. Temporary fillings may be used by an Endodontist who is sending a patient back to their regular dentist for a permanent filling or by your own dentist if the root canal is split over the course of two appointments.

  6. Permanent fillings for root canals are done using a plant based bio compatible material known as gutta-percha (pronounced gutta perk-ah). The temporary filling material is removed and gutta-percha is inserted into the root canals and pulp chamber and sealed in place with cement.

  7. The tooth must now be restored to an acceptable level of functionality. Plastic or metal posts may be placed within heavily damaged teeth to provide structural integrity and crowns are placed over top of the treated teeth to look and act like the original tooth. Bridges and dental implants may also be used to replace the affected tooth.


    Life after a root canal


    It is very common for the tooth and surrounding area and tissue to be sore and tender for the first two weeks following a root canal. Severe pain and swelling however are not common occurrences and should be reported to your dentist.


    Once a root canal has been performed, that tooth is not immune to cavities and gum disease. The actual tooth itself, devoid of the nourishment the pulp provided will grow brittle and discolored over time, making a crown a popular long-term replacement for the tooth.


    With regular brushing, flossing and dental visits, treated teeth and crowns can be expected to last as long as other teeth. Regular x-rays will aid your dentist in determining whether the root canal was a success or not based on bone being regenerated or lost near the procedure. If it is deemed unsuccessful, a root canal re treatment, where the filling is removed and replaced may be done.


    For the visual learners, the diagram below details the steps involved in a standard root canal.




    Sources: CDA, Colgate

    Photos: esthetiquedental, River Dentistry

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