To understand root canal treatment, it helps to understand the anatomy of a tooth and its surroundings. Within the core of every tooth are hollow spaces and channels containing a soft tissue organ called the pulp. The pulp is sometimes referred to as "the nerve". Pulp tissue is largely comprised of blood vessels, nerve endings, and connective tissue. The blood vessels and nerves enter the pulp tissue through tiny openings at the tips of each root. A thin membrane called the "periodontal ligament" surrounds the entire root surface of the roots and connects the tooth to the surrounding jaw bone.


The pulp is a very vulnerable tissue and can easily become diseased for a variety of reasons. Symptoms can range from none to excruciating pain. In the early stages of pulpal disease, the pulp tissue is inflamed and sensitivity to cold or hot is often the hallmark symptom. The ligament around the tooth often also becomes inflamed causing the tooth to be painful when biting or chewing. Irreversible inflammation progresses to necrosis (death) and infection of the pulp. The process of necrosis often causes spontaneous pain and toothache. Infection spreads into the surrounding bone and gum tissues through the root openings, forming an "abscess". Since the blood supply no longer functions in a necrotic pulp, bacteria thrive within the confined space, safe from antibiotics or the immune system. For this reason, a tooth that has a diseased pulp should either be extracted or receive root canal treatment to eliminate this inevitable source of infection.


Root canal treatment involves the meticulous removal of diseased pulp tissue and debris. The canals are mechanically shaped and the remaining pulp spaces are chemically disinfected. This is achieved through an access opening at the top of the tooth allowing the endodontist to identify and treat the canals. Once the diseased tissue or infection is removed from within the tooth, the tissues around the the tooth can heal.


In order to prevent salivary bacteria from contaminating the disinfected root canal spaces, the canals are sealed off with a root canal filling material called gutta-percha. Gutta-percha is a rubber-like material that is solid at body temperature but is moldable when heated or compacted. This allows the material to form a custom seal in the root canals, and prevent the percolation of bacteria, contamination, and secondary infection.


A tooth that has received root canal treatment needs to receive a permanent restoration. This is typically done by your restorative dentist after several weeks of healing. During this time the tooth has a temporary restoration. The type of permanent restoration is determined by the the restorative dentist after considering of a variety of factors. With proper root canal treatment and restoration of the tooth, healing can occur and the health of the tooth can be maintained.