If a tooth feels painful or sensitive or you have other signs of a tooth infection, your dentist may recommend a root canal treatment. This is often the only way to remove an infection and restore a tooth.
Root canal therapy (also called endodontic treatment) is a common dental procedure that has a very high success rate when it's performed by an experienced dentist, but it's important to know what to expect.
Your dentist or endodontist will make sure you know what the procedure involves so you can make an informed decision about whether root canal treatment is right for you.
What is a root canal?
A root canal procedure treats an infection or damage to the dental pulp. The pulp is the soft tissues at the centre of a tooth containing nerves and blood vessels that keeps the tooth alive and sensitive. If this becomes infected or damaged, the entire pulp needs to be removed.
The pulp extends down into the root canals. These are the spaces inside the tooth roots, the part of the tooth inside the gum where it attaches in the jaw. Root canal therapy involves carefully cleaning, disinfecting and shaping the root canals, then filling and sealing them to protect the tooth.
How long root canal treatment takes depends on how many root canals the tooth has. Teeth towards the front of the mouth (incisors and canines) usually only have one root, while teeth towards the back of the mouth (molars and premolars) can have two or three. Each root may have multiple canals.
When is a root canal recommended?
The dental pulp can be damaged or infected when the outer layers of the tooth (enamel and dentine) are damaged. This can happen due to:
- severe tooth decay or decay under a filling
- advanced gum disease
- injury or trauma to the tooth
- cracked filling or crown
- damage from dental treatment
- tooth grinding or clenching (bruxism)
- wear and tear
You may need a root canal treatment if you have some of these common symptoms:
- sudden toothache
- tooth pain when biting or chewing
- sensitivity to temperature, especially if this continues afterwards
- swelling of the gums, face or neck
- discharge from around the tooth
- your tooth has darkened
- your tooth feels loose
If your tooth is painful or sensitive or you have any other unusual symptoms, make an appointment with your dentist so they can examine your mouth and discuss treatments or home remedies to ease the pain.
A tooth may be infected without showing obvious signs, so it's important to keep up with your regular check-ups so your dentist will be able to catch an infection before it causes permanent damage.
What happens if a tooth infection isn't treated?
If a tooth pulp infection is left untreated, bacteria will multiply and the infection can spread. This may lead to more serious problems or permanent damage, including:
- Dental abscess – a pocket of pus that forms around tooth roots and can be extremely painful
- Bone loss – if an infection spreads beyond the tooth, it may damage the surrounding jaw bone
- Tooth loss – if a tooth is too badly damaged to save, it will need to be extracted to stop the infection from spreading. Missing teeth can lead to other issues such as the surrounding teeth going crooked, so your dentist will recommend replacing it.
Treating a dental abscess and replacing a tooth can be more complex than a root canal treatment, so you should avoid delaying the treatment you need.
Stages of the root canal procedure
Endodontic treatment can involve several appointments at the dental clinic, depending on the size of the tooth and the root canals being treated. The 5 stages of the root canal treatment are:
- Consultation and treatment planning
- Removing the damaged pulp
- Cleaning and shaping the root canals
- Filling the root canals
- Sealing the tooth
Read more about each of these stages below.
1. Consultation and treatment planning
On your first visit, your dentist will ask about your symptoms and take an x-ray of your mouth. They can then determine whether an infection is present and whether it has also spread to the surrounding bone.
If your tooth pulp is infected or damaged and needs to be removed, they will use the x-ray of your mouth to begin planning your treatment.
2. Removing the damaged pulp
Your dentist will isolate the tooth being treated with a rubber dam and administer local anaesthetic or other sedation so you won't feel pain during the treatment.
They will then open the infected tooth by drilling into it, then carefully remove all traces of the dental pulp and other tissues from inside the root canals.
3. Cleaning and shaping the root canals
The longest part of the procedure is disinfecting the root canals and shaping them so the sides are smooth and ready to be filled.
This can sometimes take several visits over a number of days or weeks. This depends on the number, size and shape of the root canals and how difficult it is to remove bacteria.
If you need to have multiple appointments, your dentist can place a temporary filling in the tooth to protect it from damage between visits.
4. Filling the root canals
Once all bacteria has been removed and the root canals have been shaped, a barrier material is placed inside and attached using dental cement. This fills and seals the tooth to prevent further damage or infection.
Dentists most commonly use gutta-percha to fill root canals, but other natural or synthetic materials may be used to ensure long-lasting protection for the tooth.
If a tooth is more severely damaged, a small support may be placed inside with the filling to give it extra strength.
5. Sealing the tooth
When the root canals have been filled, the treated tooth is covered by a custom restoration to restore its function and appearance.
This may be a large filling for smaller teeth or a dental crown for chewing teeth or teeth that need extra support or have less structure remaining. Crowns may be made from porcelain, metal or a combination of the two.
Traditional crowns may require more than one appointment, as they need to be custom made, but your dentist may be able to design and manufacture your crown on the same visit if their clinic uses CEREC technology.
Is a root canal painful?
It's a common misconception that root canal treatments are painful. Like most dental treatments, root canal therapy is carried out under local anaesthetic, which numbs the mouth during the procedure.
The time involved can make root canal therapy more uncomfortable than a filling, so if you have anxiety about dental treatments, your dentist can discuss other sedation options to help you feel more relaxed.
Your mouth may feel sore after the treatment, but this can be managed by taking over-the-counter pain relief medication and following your dentist's advice about foods and activities to avoid.
What to expect after root canal treatment
Root canal procedures have a high success rate, with 90% to 95% of treated teeth continuing to function normally after the treatment. Without the pulp, teeth will no longer feel sensitivity and may sometimes darken over time, but they can last as long as healthy teeth when you follow good oral hygiene.
You should avoid putting too much pressure on the tooth for at least a few days after your treatment. Your dentist will advise that you eat soft foods while your mouth is healing and your crown bonds fully with the tooth.
What are the alternatives to a root canal?
Root canal therapy is the only effective treatment for infected or damaged dental pulp. The alternative is to have the tooth extracted.
Extraction may be necessary if the tooth is more severely damaged and not likely to be functional, but dentists will always recommend a root canal if there's a chance to save the tooth.
How to prevent a tooth infection
If you want to avoid further infections and root canal treatments in the future, you can lower your risks by taking good care of your teeth. This means:
- Brushing your teeth twice a day using a soft toothbrush and fluoride toothpaste
- Cleaning between your teeth once a day using floss or other interdental cleaners
- Eating a balanced diet rich in vitamins and minerals to support healthy teeth and gums
- Cutting down on sugar and carbs that contribute to tooth decay
- Wearing a mouthguard to help prevent dental injuries during sports
- Talking to a dentist about teeth grinding treatments
- Visiting your dentist once or twice a year for a check-up and preventive care
Find out more about root canals in the Gold Coast
Do you think you have symptoms of a root canal infection? Talk to our friendly team at Robina Town Dental to make an appointment with our Gold Coast dentists. We'll examine your mouth and discuss your treatment options.
Better Health Channel. Root canal treatment [Online] 2019 [Accessed September 2021] Available from: https://www.betterhealth.vic.gov.au/health/ConditionsAndTreatments/root-canal-treatment
Healthdirect. Root canal treatment [Online] 2021 [Accessed September 2021] Available from: https://www.healthdirect.gov.au/root-canal-treatment