Do I Need a Root Canal? What Is a Root Canal?

When it comes to dental anxiety, the term “root canal” has likely made more than a few people nervous.

Modern dental techniques have made this procedure nothing to fear, and, in fact, having a root canal done can actually alleviate the pain a patient may experience.

But what is a root canal, and when would you need to have this procedure performed?

We got the answer directly from the dentists themselves:

Root canals, or endodontic therapy, are typically indicated when tooth decay has progressed deep enough into the tooth to infect the delicate tissues of the pulp. The pulp is the “live” portion of the tooth that contains nerve endings that sense pain upon stimulation by temperature or changes in the pressure of the fluid within the small tubes that travel through the dentin of the tooth from the outside of the tooth to the pulp; this hydraulic pressure can be changed by sugar, salt, and temperature.

When the pulp becomes infected, the tooth becomes progressively more painful until the pulp dies, and then an abscess will likely form at the tip of the root, because the body sees the dead pulp tissue as a foreign material and sends defense cells through blood, leading to increased blood volume that eventually turns to necrotic fluid or pus. It is a form of gangrene.

Root canal therapy removes the diseased pulp to allow for healing to occur and to stop the pain.

Root canals may also be indicated in severely broken down teeth that require retention from an internal post placed down into the pulp chamber.

So, root canal therapy may be needed when the pulp of the tooth is dying or is dead and infected or when it is needed for reconstructive purposes. However, there must be enough tooth structure to allow for the appropriate restoration of the tooth after root canal therapy; if the tooth cannot be properly restored with a durable restoration, then extraction of the tooth may be more appropriate than root canal therapy.

Kevin D. Huff, DDS – Dover, OH

A root canal is when you clean and sterilize the inside of the tooth and roots in the effort to save the tooth; you then place a filling in the roots that seals them from further bacteria.

You need one when the tooth dies and the nerve inside the tooth and roots gets infected or unhealthy. You usually will have pain when the tooth is dying but this can vary. Sometimes it will not bother you and we don’t know anything is wrong until we take an x-ray of the whole tooth. In this case, even though it is not painful, the bacteria from the dying tooth can do a lot of damage to the bone surrounding the tooth.

Other times, they can be very sensitive to cold or hot and then get really painful. But sometimes it can be sensitive and it goes away for a while and then gets bad again. Sometimes it can be really painful and then suddenly gets better. This is usually because the infection has found a pathway out so that it is draining. It does not mean it is better; it is still infected it just doesn’t hurt anymore.

Therefore, if a tooth is sensitive or it hurts to bite on, your dentist should take a look.

Although implants are really great at replacing teeth, there are areas of the mouth that cannot have an implant. Especially in these cases, you would want to save a bad tooth with a root canal. Unfortunately, as we live longer the root canal may not save the tooth forever but I still feel they are very useful in many cases.

Cynthia M. Sachs, DDS – Rockford, IL

In short: a root canal can save a tooth that has become damaged to the point where the interior has become infected. It’s important to have this done, as the infected tooth can cause real problems if it’s left untreated. If you have any kind of tooth sensitivity or pain, make sure to have your tooth checked out by a dentist to discover the cause as early treatment is always best for whatever problem you may have.

If you’re still nervous about having a root canal done, watch for our follow-up article where we ask dentists if root canals are painful.