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A Breakdown of the Root Canal Procedure

Everything you need to know about a root canal before your appointment.

What to Expect with Root Canal Treatment

A root canal procedure can feel and sound like there's construction going on in the mouth: rumbling, scraping, and drilling. That's because there is! The dentist uses several different drills and hand instruments to ensure the tooth is restored to last several more years, like:

  • High and slow speed drills
  • Mini files
  • Apex (root tip) measuring device
  • Mouth mirror and explorer

When tooth decay is left untreated, the bacteria can get into the pulp chamber and cause an infection. Symptoms of tooth infection include throbbing pain and sensitivity. If tooth decay is not addressed it can result in a dead nerve. Thus, a root canal and filling or crown may be the best option to restore the tooth's strength and function. These are the signs of a dying nerve in the tooth:

  • Discoloration- usually gray or darker
  • A "Zing" (lingering pain) reaction to hot or cold
  • Gingiva (gum) inflammation and infection

A Step-by-Step Guide of the Root Canal Procedure

Dental technology has come a long way. Nowadays, the most painful part of a root canal procedure might be having to listen to whichever elevator music the dental office is playing for an hour; otherwise, the procedure is pain free. Root canal treatment can usually be completed in one or two office visits. Expect the following to occur once you're checked-in and seated:

  • X-ray- the dentist will review your most recent x-ray to determine the number of roots present, shape of root(s), and for infection. Under certain circumstances, your dentist may recommend a cone beam computed tomography (CBCT) scan to obtain more information regarding the anatomy of your tooth. If you originally went in for a toothache with infection present and were placed on an antibiotic, the dentist may order a new x-ray to confirm if the infection has cleared.
  • Topical and local anesthetic- the topical anesthetic numbs the gum and prepares it for the local anesthetic (Novocain or lidocaine) injection.
  • Isolation of the tooth- a rubber dam (thin sheet of rubber) is used to isolate the tooth from saliva and to keep debris out of the mouth.
  • Creation of an access hole- a high speed drill is used to create a hole in the tooth that is receiving the root canal treatment. This hole provides access to the root(s) and pulp.
  • Removal of the pulp- the pulp is removed with a broach (tiny barbed wire like pin).
  • Shape and clean the roots- the dentist will use special root canal files and instruments to shape and clean the roots. This process begins with a slim file, which causes a "scraping" sound in the mouth. The diameter slowly increases to ensure the full length of the root is reached, then a disinfectant solution is used to clean the roots.
  • Fill and seal the roots- a thermo-plastic material called gutta-percha is used to fill the prepared roots and protects them from bacteria and reinfection.
  • Fill the tooth- the rubber dam is removed and the access hole is filled with either temporary filling or permanent filling. If there is not enough tooth structure to support the filling, your dentist may recommend a crown.

It may be intimidating to hear that a root canal treatment is needed to restore a tooth, but rest assured, the procedure is pain-free. This step-by-step breakdown will hopefully relieve any apprehension about root canal treatment!

Who Can Perform a Root Canal?

Root canal treatment can be performed by a general dentist or an Endodontist. An Endodontist is a root canal specialist who possesses the tools and additional training of two or more years of education to diagnose and treat teeth needing a root canal. Your general dentist will review your x-ray to identify how complex the root canal treatment would be. Once this is determined, your dentist may provide a referral to an Endodontist if they feel one is needed to complete the procedure.

Be sure to review your dental benefit booklet for Endodontic Services and coverage.