Root Canal Therapy

Root canal treatment becomes necessary when the integrity of the internal portion of the tooth (pulp) that houses the blood supply and nerve becomes violated either by tooth decay or some other means. An infected pulp is usually, but not always, painful. As the infected structures become more and more infected, pus and gasses created by bacteria tend to collect and build up both inside the tooth and in the bone below the tip of the root. This area of swelling is known as an abscess.

As the body's defenses try to keep the growing infection in check, abscessed areas often become cystic and destroy the healthy bone around them as they grow. An abscess or cyst that has broken out of the bone's outer shell creates swelling in the soft tissues of the mouth and begins to spread more quickly. Sometimes a fistula ( a periodically draining wound in the gums) near the tooth is the first symptom noticed by a patient.

The object of a root canal is to remove the original source of the infection by taking all of the infected pulpal material out of the core of the tooth while leaving the rest of the solid tooth structure intact. Once the infection has cleared, the space previously occupied by the pulp is filled in with a biologically inert material (a material that does not irritate or otherwise react with body tissues). Many materials have been used for this purpose but the most widely used material for this purpose is called gutta percha, a naturally occurring resin.

The diagrams below show how a root canal procedure is accomplished:

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1. Tooth decay has infected the pulp and underlying bony

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2. Surface decay is removed and an access opening is made so that the pulp and root canals are accessible.

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3. Small tools called files and reamers are used to remove all of the infected contents from inside the tooth root canals.

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4. After the infection has healed (but not always) the internal canals are filled with a biologically inert substance.

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5. The original access opening is then filled in with a rigid material for strength. If there is a need for further stability sometimes a post will be inserted into one of the canals as well.