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Health Story: The Dentist Who Changed My Life

After a long history of unpleasant experiences, Jonathan finally found the right dentist. Read his story.
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Root Canal

By

Megan Freedman

What is a root canal?

A root canal is an outpatient dental procedure that treats decay and infection deep inside your tooth. The roots of your teeth contain a tissue called pulp. The pulp contains nerves, blood vessels and other tissues. If your tooth is cracked, injured or decayed, the pulp can become infected. A root canal saves the tooth by cleaning out infected pulp and sealing the tooth to prevent further problems.

A root canal is generally safe, but there are risks and potential complications. It is only one method used to treat tooth decay and infection. Discuss all of your treatment options with your dentist to understand which options are right for you.  

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Other procedures that may be performed

Your dentist may use a few different methods to assess the extent of the damage to your tooth before a root canal. The tests and devices used include:

  • Apex locators are devices used to measure the length of root canals.

  • Electric pulp testing helps determine the extent of disease and if pulp within your tooth is alive or not.

  • X-rays are imaging tests that use radiation to make pictures of the inside of your mouth and teeth.

Why is a root canal performed? 

Your dentist may recommend a root canal to treat tooth decay. Tooth decay (also called cavities or dental caries) occurs when bacteria in your mouth produce an acid that damages the teeth. Your dentist may perform a root canal if decay in your tooth is deep enough to affect the pulp inside your tooth. The pulp contains nerves, blood vessels and other tissues. Injury or cracks in your teeth can also damage tooth pulp.

Your tooth may need to be removed and replaced with a dental bridge, dental implant, or a denture if infection in the pulp is not treated. A root canal removes infection in your tooth and saves the natural tooth.

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Who performs a root canal?

The following dental providers perform root canals: 

  • Endodontists specialize in treating diseases of the deep parts of your teeth including the pulp and root canal.

  • General dentists prevent, diagnose and treat diseases and conditions of the teeth, gums, mouth, and associated structures of the jaw and face.

  • Pediatric dentists specialize in caring for the dental needs of children and teens.

How is a root canal performed?

Your root canal will be performed in a dental office or clinic. A root canal includes placement of a filling or crown that covers your natural tooth. The process typically requires two or more separate procedures spaced over a few weeks.

A root canal generally includes these steps:

  1. You will sit in a reclining position in the dentist chair and wear a clear shield over your eyes. The shield protects your eyes from spraying liquids and dental instruments.

  2. Your dentist will inject a local anesthetic into the gums near your tooth. The anesthetic numbs the pain during the procedure. Your dentist may apply a painless topical anesthetic to numb the gums partially before the injection.

  3. Your dentist will place a dental dam over the tooth. A dental dam is a thin sheet of latex. Latex-free options are also available. The dental dam keeps your tooth dry while your dentist repairs it.

  4. Your dentist will drill a hole in the top of your tooth to access the pulp deep inside your tooth in the root canals.

  5. Your dentist will clean out the pulp using small instruments. Your dentist will smooth out the surface of the root canals and scrape the inside of the roots to make them a little larger.

  6. If your tooth needs extra support, your dentist may insert a small post into one of your root canals.

  7. If there is an active infection in your tooth’s root, your dentist may want you to go home for a few days while the inside of your tooth heals. In this case, your dentist will put a temporary filling over the hole in your tooth. This protects your tooth from filling with debris and saliva, which may cause further infection.

  8. When your tooth is ready, your dentist fills your root canals with a rubber-like material. Your dentist will cover the rubber material with a type of cement near the top of your tooth. This seals the inside of your tooth and prevents further infection.

  9. Your dentist will make a mold (impression) of your tooth and the surrounding teeth to make a customized crown. A dental crown is a tooth-shaped cap that covers your tooth and restores the strength and function of your tooth.

  10. Your dentist will place your crown using cement that permanently attaches it to your tooth. This may occur at the same visit or at a later appointment. In this case, your dentist will place a temporary crown on your tooth until your permanent crown is ready.

  11. Your dentist will examine and test the crown for proper fit before placing it with permanent cement. This may involve grinding the crown to ensure a proper bite. You may need to return for painless adjustments of the crown to ensure a comfortable bite.

Will I feel pain?

Your comfort and relaxation are important to you and your care team. You may feel brief sharp pinches when your dentist injects your gums with local anesthetic. Ask your dentist if your gums can be partially numbed with a painless topical anesthetic before the injections. 

You may also feel pressure as your dentist performs your root canal and prepares your tooth to receive a crown. Take a few long, deep breaths to help yourself relax. Tell your dentist if any discomfort does not pass quickly.

What are the risks and potential complications of a root canal?  

Any dental procedure involves risks and potential complications. Complications may become serious in some cases. Complications can develop during the procedure or your recovery. Risks and potential complications of a root canal include:

  • Allergic reaction to the materials used in your root canal or crown

  • Anesthetic complications, such as allergic reaction and nerve or blood vessel injury

  • Crack and/or perforation in the tooth root

  • Mouth or tooth injury

  • Possible breakdown of root canal cement/sealer overtime

  • Possible unfilled canal

  • Return of tooth infection requiring retreatment

  • Sensitivity to heat and cold in the affected tooth

Reducing your risk of complications

You can reduce the risk of certain complications by:

  • Ensuring that the tooth is covered until the permanent restoration is placed

  • Following activity, dietary and lifestyle restrictions and recommendations before your root canal procedure and during recovery

  • Informing your dentist if you are nursing or if there is any possibility of pregnancy

  • Notifying your dentist immediately of any concerns after the procedure such as pain, fever, and difficulty chewing

  • Taking your medications exactly as directed

  • Telling all members of your care team if you have any allergies, especially any metal allergies if your dentist is using metal crown material

How do I prepare for my root canal? 

You are an important member of your own  dental care team. The steps you take before your procedure can improve your comfort and outcome. You can prepare for a root canal by:

  • Answering all questions about your medical history and medications. This includes prescriptions, medications, over-the-counter drugs, herbal treatments, and vitamins. It is a good idea to carry a current list of your medical conditions, medications, and allergies at all times.

  • Taking or stopping medications exactly as directed

  • Telling your dentist if there is any possibility of pregnancy

Questions to ask your dentist

Having a root canal procedure can be stressful. It is common for patients to forget some of their questions during a dentist’s office visit. You may also think of other questions after your appointment. Contact your dentist with concerns and questions before your procedure and between appointments.

It is also a good idea to bring a list of questions to your appointment. Questions can include:

  • How many procedures will I need as part of the root canal process?

  • Which dentists will be involved in my root canal process and how?

  • How long will each procedure take? When will I go home?

  • What restrictions will I have after the procedure? When can I return to eating, work, and other activities?

  • How should I take my medications?

  • How will you treat my pain?

  • When should I follow up with you?

  • How should I contact you? Ask for numbers to call during and after regular hours.

What can I expect after my root canal?

Knowing what to expect can help you get back to your everyday life as soon as possible.

How will I feel after the root canal?

Your mouth, gums and tongue may feel numb for a few hours after your root canal procedure. This is because the local anesthetic will take time to wear off. 

You may also feel some tenderness, and your tooth may be sensitive due to inflammation in the surrounding tissues. Tell your dentist if these symptoms worsen or last longer than a couple weeks because they can be a sign of a complication.

When can I go home?

You will probably go home and resume most of your normal activities right after a root canal procedure. Your dentist may tell you to wait to eat and drink until after your anesthetic has worn off and you can feel your mouth and tongue again. This will help prevent you from accidentally biting your mouth or tongue. 

Your dentist may also ask you not to chew or bite with your treated tooth until it has a permanent restoration, such as a permanent crown. This will prevent the cement from cracking, return of infection, and other problems. 

When should I call my dentist?

You should keep your follow-up appointments after a root canal. Call your dentist if you have any concerns between appointments. Call your dentist right away if you have:

  • Bleeding

  • Fever

  • Pain in your gums or teeth

  • Problems chewing or biting

Seek immediate medical care if you have itching, hives, mouth or tongue swelling, or breathing problems, such as shortness of breath, difficulty breathing, labored breathing, or wheezing. This may be due to a rare reaction to anesthetic.
How might a root canal affect my everyday life?

A root canal can save a severely damaged or diseased tooth and protect your tooth from further damage. It can also relieve pain that you felt in your tooth because it was infected. 

A tooth that has received a root canal requires daily care just like a normal tooth. You should continue to brush your teeth twice a day and floss every day. You should also visit your dentist as advised for regular cleanings and checkups. 

If you have a crown, your dentist will ensure that your crown still fits well and is intact at your checkups. Your dentist will also make sure that the tooth underneath your crown is free of decay.

Teeth treated with a root canal should last as long as normal teeth with proper care. Crowns, however, experience wear and tear. Your crown may need replacement after 10 to 15 years. Ask your dentist how long your dental crown should last. 

Medical Reviewers: William C. Lloyd III, MD, FACS Last Review Date: Sep 4, 2016

© 2017 Healthgrades Operating Company, Inc. All rights reserved. May not be reproduced or reprinted without permission from Healthgrades Operating Company, Inc. Use of this information is governed by the Healthgrades User Agreement.

View Sources

Medical References

  1. Crowns. Colgate Oral Health and Dental Resource Center. http://www.colgate.com/app/CP/US/EN/OC/Information/Articles/Oral-and-Dental-Health-Basics/Checkups-a....
  2. Crowns. Mouth Healthy by the American Dental Association. http://www.mouthhealthy.org/en/az-topics/c/Crowns.aspx.
  3. Dental Crowns. The Cleveland Clinic. http://my.clevelandclinic.org/services/cosmetic_dentistry/hic_dental_crowns.aspx.
  4. Myths about Root Canals and Root Canal Pain. American Association of Endodontists. http://www.aae.org/Patients/Myths_About_Root_Canals_and_Root_Canal_Pain.aspx.
  5. Root Canal Treatment. Colgate Oral Health and Dental Resource Center. http://www.colgate.com/app/CP/US/EN/OC/Information/Articles/Oral-and-Dental-Health-Basics/Checkups-a....
  6. Root Canals. American Association of Endodontists. http://www.aae.org/Patients/Root_Canals.aspx.
  7. Root Canals. Mouth Healthy by the American Dental Association. http://www.mouthhealthy.org/en/az-topics/r/root-canals.aspx.
  8. Tell Me More About Dental Crowns. Colgate Oral Health and Dental Resource Center. http://www.colgate.com/app/CP/US/EN/OC/Information/Articles/Oral-and-Dental-Health-Basics/Checkups-a....
  9. What is Root Canal Treatment? Colgate Oral Health and Dental Resource Center. http://www.colgate.com/app/CP/US/EN/OC/Information/Articles/Oral-and-Dental-Health-Basics/Checkups-a....

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