A root canal treatment removes the infected or damaged tissue from inside a tooth so the tooth can be kept instead of extracted. It has a reputation for being unpleasant, and much of that reputation comes from the toothache that sends people to the dentist in the first place. This article explains what the treatment involves, when it is needed, and what you can reasonably expect before, during and after.
What is inside a tooth, and what goes wrong
Under the hard outer enamel and the dentine beneath it, each tooth has a soft core called the pulp. The pulp holds nerves and blood vessels and runs down through narrow channels in the roots, which are the root canals. When deep decay, a crack, a leaking old filling or an injury lets bacteria reach the pulp, it becomes inflamed or infected. Left untreated, the infection can spread beyond the tip of the root and form an abscess in the surrounding bone.
Signs that a tooth may need root canal treatment
- A toothache that is persistent, throbbing or wakes you at night
- Pain or lingering sensitivity to hot or cold that does not fade quickly
- Pain when biting or pressing on the tooth
- Swelling of the gum or face near the tooth, or a small pimple-like bump on the gum
- A tooth that has darkened compared with its neighbours
These signs can also point to other problems, and sometimes an infected tooth gives no pain at all. Only an examination and an X-ray can tell which it is. If you have swelling or severe pain, do not wait; see our guidance on emergency dental care in Kompally.
The steps of a root canal treatment
- Examination and X-ray. The dentist checks the tooth and takes an X-ray to see the shape of the roots and the extent of any infection around them.
- Local anaesthetic. The tooth and the surrounding area are numbed. Tell the dentist if you can still feel anything; more anaesthetic can be given before work continues.
- Access. A small opening is made in the top of the tooth to reach the pulp chamber.
- Cleaning and shaping. The infected pulp is removed and the canals are cleaned and shaped using fine files, which can be hand-operated or motor-driven (rotary).
- Disinfection. The canals are flushed with antimicrobial solutions to remove bacteria that the files cannot reach.
- Filling. The cleaned canals are sealed with a biocompatible material called gutta-percha so bacteria cannot re-enter.
- Restoration. The tooth is closed with a filling and, in many cases, protected with a crown.
The number of visits depends on the tooth, the number of canals and whether an active infection needs time to settle. The dentist can tell you after looking at your X-ray.
Does it hurt?
The treatment is done under local anaesthetic, so you should feel pressure and vibration rather than sharp pain. The toothache people dread is usually caused by the infection, and removing the infected tissue is what relieves it. Some tenderness for a few days afterwards is common, especially when biting, and is usually managed with the pain relief your dentist recommends. Pain that is severe, that gets worse, or that comes with swelling should be reported to the clinic.
Why a crown is often advised afterwards
A tooth that has needed a root canal has usually lost a good deal of its structure to decay or to the treatment itself, and it no longer has a living pulp. Back teeth in particular take heavy chewing forces, and a crown helps protect them from cracking. Whether you need one depends on how much natural tooth remains, and your dentist will explain this at the end of treatment. Until the final restoration is done, avoid chewing hard food on that side.
Root canal or extraction?
Where a tooth can be saved and restored, keeping it is generally preferred, because your own tooth supports the surrounding bone and stops the neighbouring teeth from drifting into the gap. Extraction is the right answer when a tooth is too badly broken down, has a root fracture, or is too weakened by gum disease to be restored. That is a decision made after examination, not before. If a tooth is removed, options such as dental implants can replace it.
Looking after the tooth afterwards
- Do not chew hard or sticky food on the treated side until the permanent restoration is placed.
- Brush and floss as usual; the tooth can still decay or develop gum disease.
- Return for the final filling or crown. A temporary filling is not meant to last.
- Attend check-ups so the tooth and the bone around it can be reviewed on X-ray.
Questions worth asking your dentist
- Can the tooth be saved, and what is the outlook for it in my case?
- How many visits are likely, and what happens between them?
- Will I need a crown, and when should it be placed?
- What should I expect over the next few days, and when should I call?
- What is the full cost, including the restoration?
Who will see you
Dr. Jaya Lakshmi, a BDS general dentist, and the clinical team at Dr C Dental Clinic on Medchal Road, Kompally, opposite CinePlanet, assess and treat teeth that may need root canal treatment. You can read more about the treatment on our root canal service page, or book an appointment or call +91 96426 56568.
This article is general information and not a diagnosis. Whether a tooth needs root canal treatment can only be decided after an examination.
