Root Canal Treatment: What Actually Happens, Step by Step

Say “root canal” to most people and they wince. The reputation comes from the time before modern anaesthetics, and from the fact that people usually arrive when the tooth is already badly infected and painful. The treatment itself is meant to take the pain away.

Why a tooth needs one

Each tooth has a soft centre called the pulp, which contains nerves and blood vessels. Deep decay, a crack or a knock can let bacteria in. The pulp becomes inflamed, then infected. If it is left, the infection can spread to the bone around the root and cause an abscess.

Signs to take seriously

• A throbbing toothache, sometimes worse at night
• Lingering pain after hot or cold drinks
• Pain when you bite
• Swelling in the gum or face, or a pimple-like bump on the gum

Swelling of the face, a fever or difficulty swallowing need urgent attention. Do not wait for those signs to go away.

The steps, one by one

1. Examination and X-ray. The dentist looks at the tooth and takes an X-ray to see the roots and any infection at their tips.
2. Local anaesthetic. The area is numbed. If a tooth is very inflamed, it can take slightly longer to numb, and the dentist can give more.
3. Opening the tooth. A small opening is made to reach the pulp chamber.
4. Cleaning the canals. Tiny instruments remove the infected tissue and shape the canals, with disinfecting solutions.
5. Filling and sealing. The cleaned canals are filled, and the opening is sealed.
6. Restoring the tooth. A tooth that has had a root canal is often weaker, so a crown is commonly advised to protect it.

Does it hurt?

With proper anaesthetic, most people feel pressure and vibration but not pain. Afterwards the tooth can feel tender for a few days, especially when biting, and this usually settles. Pain that is getting worse, or swelling, should be reported to your dentist.

How many visits?

It depends on the tooth. Front teeth with one canal can sometimes be finished in a single visit, while back teeth with several canals may need more than one. Infected teeth sometimes need a dressing placed first.

Is extraction easier?

Pulling a tooth is quicker, but a missing tooth needs replacing, which can cost more in the end, and the neighbouring teeth can drift. Saving your own tooth is usually preferred when it is possible.

Looking after the tooth afterwards

• Avoid chewing hard food on that side until the final restoration is in place
• Brush and clean between teeth as normal
• Return for the crown or filling as planned, because a temporary seal does not last

Book a visit

Dr. Touseef Khan treats patients at T-Dent Dental Clinic in North Nazimabad. See our page on root canal treatment, or book a visit if you have tooth pain.

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This article is general information and not a substitute for an examination.

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