A Root Canal Treatment (RCT) is a dental procedure to remove inflamed or infected pulp inside the tooth. The canal is carefully cleaned, disinfected, filled, and sealed. RCT eliminates bacteria, prevents reinfection, and saves the natural tooth.
Traditionally, RCT has been divided into two or more appointments to disinfect the canal, improve patient comfort, and observe healing before permanent filling. However, one-visit endodontic treatment is faster, well accepted by patients, and prevents recontamination of root canals between appointments.
This method is faster, more convenient for patients, and may be less expensive. It also prevents the root canal from becoming recontaminated between appointments.
This method involves placing a short-term medicament, like calcium hydroxide, between appointments. It may be better for certain complex cases because it allows for interim microbial control.
Many chipped and cracked teeth result from accidents or biting something hard. Even a tiny chip or hairline crack can allow harmful bacteria into the inner tooth, gradually causing decay and infection. Prompt treatment can help avoid a full-blown infection and the need for root canal therapy.
Not all types of tooth pain indicate a need for RCT, so early stages can be difficult to assess. Strong, persistent pain—especially if it worsens when eating, biting, or disturbing the tooth—is a major sign you may need a root canal. Tooth pain rarely goes away on its own, so see a dentist promptly.
Painful sensitivity to hot or cold that does not dissipate quickly may indicate nerve damage within the tooth and can be a sign that root canal treatment is needed.
If a tooth suddenly turns grey or black, it may indicate severe decay or breakdown of internal tissue. While some discoloration can be treated with teeth whitening, severe discoloration often signals the need for root canal therapy.
Swelling does not always indicate RCT is required, but swelling of the face, jaw, or gums—especially with pain—is a common sign of infection. This may indicate a dental abscess, which requires root canal treatment and antibiotics.
A pimple-like bump on the gum is a dental abscess, indicating severe infection near the tooth’s nerve and blood vessels. This can form deep pus pockets around the tooth root. Symptoms may include facial swelling, swollen lymph nodes, and fever. Immediate treatment with antibiotics and a root canal is required.
A root canal procedure may sound scary, but with today’s technology, it’s typically not much different from having a deep filling. There’s little to no pain because the dentist uses local anesthesia to numb your tooth and gums, keeping you comfortable during the procedure.
If you need a root canal and have facial swelling or a fever, the dentist may give you antibiotics beforehand to kill the infection. This can also help reduce your pain.
The root canal procedure itself is similar to getting a large filling, but it takes longer. Your mouth will be numb while the dentist cleans out decay, disinfects the roots, and then fills them in.
The dentist will use a rubber dam around the root canal tooth to prevent any infected material from spreading to the rest of your mouth.
Your mouth may feel sore or tender after the root canal. The dentist may suggest over-the-counter pain medications such as acetaminophen (Tylenol) or ibuprofen (Advil).
To prevent a root canal, it’s important to follow dental hygiene habits that help prevent cavities and other tooth problems. Keep your teeth healthy by following these steps:
Yes, it’s possible to have pain in a tooth that has had a prior root canal.
Some causes of this pain may include:
According to the AAE, re-treatment — meaning another root canal — is the best option to treat the pain and any other symptoms. Even though root canals have a very high success rate, when a root canal fails to heal or there is a recurrent infection, a Re-RCT (root canal re-treatment) may be necessary.
A Re-RCT usually occurs due to a particularly virulent infection or inflammation despite your dentist’s best efforts. Other reasons include a fractured crown or tooth, missed root canals, or leftover pulp tissue.
Common signs of a failed root canal treatment include:
A root canal re-treatment is very similar to a standard root canal treatment. However, a Re-RCT requires a few extra steps and normally two visits to the dentist. To complete the final restoration for the tooth, it may require 2 additional visits. Most root canal-treated teeth are restored with crowns.
During the first visit, the dentist removes all previous root canal filling materials and fills the void with an antibacterial paste. The tooth is closed with a temporary filling. The paste is left in place to kill as much bacteria as possible.
During the second visit, the calcium hydroxide antibacterial paste is removed, the canal area is cleaned and shaped, and a new root canal is performed.