Anatomy of the tooth

To understand why you need root canal treatment, it helps to know something about the anatomy of teeth. Teeth are composed of three layers: the outer enamel, the inner dentin and the innermost layer, the pulp. The enamel is the outer insulating layer of the tooth that is devoid of nerve supply. The next layer, the dentin is innervated and is the sensitive tooth structure. The pulp contains blood vessels, nerves, and connective tissue and creates the surrounding hard tissues of the tooth during development. The pulp is housed in the canal system within the tooth, which comprises of the pulp chamber in the crown and the root canals in the roots. The pulp connects to the tissues surrounding the root through the apex or the tip of the roots.

Root canal treatment is necessary when the pulp becomes inflamed or infected. The inflammation or infection can be due to a variety of causes: deep decay, repeated dental procedures on the tooth, a crack in the tooth or traumatic injury to the tooth. If the pulp inflammation or infection is left untreated, it can cause pain and lead to an abscess.

Signs of pulp damage include throbbing pain, prolonged sensitivity to heat or cold, discoloration of the tooth, swelling and tenderness in the nearby gums. Sometimes, there are no symptoms.

Click here to watch educational videos on root canal therapy

Root Canal Procedure

Root canal treatment can often be performed in one or two visits depending on the complexity of the canal system and the severity of the infection. It involves the following steps:

	1) Our doctors perform several tests to determine the health of the pulp within your tooth. An x-ray is always taken. Then profound local anesthesia is achieved. After the tooth is numb, we place a small protective sheet called a "dental dam" over the area to isolate the tooth and keep it clean and free of saliva during the procedure.
	2) The dentist makes an opening in the crown of the tooth to access the pulp chamber and locate the root canals. Anterior teeth and lower bicuspids usually have one canal, upper bicuspids usually have two canals and the molars have 3-5 canals. Very small instruments called files are used sequentially to clean and shape the canal system to receive the canal filling.
	3) After the space is cleaned and shaped, the dentist fills the root canals with a biocompatible material, usually a rubber-like material called "gutta-percha". The gutta-percha is placed with an adhesive cement to ensure complete sealing of the root canals.
	4) After the root canal treatment is finished, you will likely need to return to our office to have a crown or other restoration placed on the tooth to protect and restore it to full function. Failure to do so will increase the risk of a fracture of the tooth and ultimate loss of the tooth.
	5) If the tooth lacks sufficient structure to hold the core build up in place, we may place a post inside the tooth. Ask us for more details about the specific restoration planned for your tooth.