What Is Root Canal?

Many people have misleading information about root canal treatment or root canal therapy, sometimes simply called a "root canal." Root canal is the inner aspect of the tooth that contains nerve fibers and blood vessels in a system of canal spaces, together they provide normal sensation, vitality, support, and nourishment for that tooth. Root canal treatment is the treatment of the canal spaces, with the goal to alleviate pain, infection, and preserve and protect the tooth. What does it mean when you need a root canal? When do you need a root canal? Does it hurt? Is it a myth that root canals don't work? Is it better to take the tooth out instead of trying to save it with a root canal? These are the questions that you should ask your dentist.


A tooth usually needs a root canal when it is broken with nerve exposure (think trauma to the front tooth), extensive decay that goes into the nerve or pulp (too sensitive?), an abscess and/or swelling, toothache that doesn't go away with lingering pain and keeps you up at night, or sometimes a dead nerve that doesn't present with any symptom at all. A recent large and deep filling on a tooth close to the nerve that was sensitive to cold prior to the work and has gotten worse usually indicates the need for root canal therapy. On occasion, the new filling must be evaluated for other problems and root canal may be avoided. 

A parulus on a chronically infected tooth which

has had root canal treatment. 

One sign of a dead nerve may be a pimple on your gum (dentally known as a parulus, also known as gumboil). A parulus may indicate a need for root canal therapy, but it may also be caused by a periodontally abscessed tooth, which may not need root canal therapy. Sometimes you may notice a bad taste, or a bleeding point along your gum that doesn't quite heal. A parulus is the drainage point of pus buildup of an abscessed tooth. Drainage may or may not be present. This is a serious condition and should be addressed as soon as possible to prevent severe flare up and swelling all of a sudden without any warning. Further, chronic swelling and resolution (recurrence of drainage and healing) can cause further damage to the bone support and result in tooth loss.

A deep cavity causing a lot of pain which 

needed root canal therapy to save it. 

This tooth had recurrent decay or cavity under the existing filling which was done by another dentist many years ago (black arrow). The decay was very advanced and had already reached the nerve (white arrow), and was painful to the patient. The nerve had died over a period of time. In order to save the tooth, root canal therapy was needed and we could keep the tooth root. You can compare how deep the cavity on this tooth with the other one, which could be treated simply with a new filling.

Dr. Vuong corrected a faulty filling that caused food trap, sensitivity, and gum bleeding. 

Each tooth is different, and the complexity of the canal systems may make the treatment of infected nerve a challenge. Some teeth should best treated by a root canal specialist called an endodontist. 

"Does it hurt?" You will be numbed before the procedure is started. It should not hurt. On contrary, root canal is one of the treatments for a toothache (besides pulling that tooth out) and it should resolve the pain that you have presented. Pain can be managed by adequate anesthesia, pain medication, and/or antibiotics. Each person as well as each situation is different. It should not hurt (didn't I just say that?). Dr. Vuong will discuss with you and provide appropriate recommendations. 

"I've heard that root canals don't work." There could be many reasons for failures of teeth that have been treated. Some canals may not have been adequately cleaned out, located, or the infection has recurred. The tooth may be fractured making it not savable. Some patients may fail to return for the follow up appointment to complete the procedure, rendering the re-infection too severe to treat. The good news is that many of these previously treated teeth can be re-treated by a well trained dentist or specialist. Dr. Vuong can discuss with you the prognosis, benefit, and risk of the procedure. 

Dr. Vuong uses specialized root canal instrumentation, such as digital x-ray, apex locator (an electronic instrument to determine appropriate lengths of the canals), magnification, and rotary files to clean and shape the canals. Dr. Vuong also uses a rubber dam to cover your mouth opening for safety and to keep the tooth away from bacteria in your saliva contaminating the canals. The purpose of the root canal is to kill off and clean out the bacteria inside your canal system, so you don't want them to be contaminated. That is why it is important for you to return to the dentist to have the tooth built up and crowned as soon as possible. Root canal treated tooth can become more brittle and prone to fracture. A crown helps protecting it and increases the longevity of the tooth.

Dr. Vuong treated this tooth with root canal therapy because it was hurting, and made a crown to protect it. 

"Is it better to take the tooth out?" Once the tooth is gone, it is gone forever, there's no second chance. Root canal therapy is the best way to save the tooth which may otherwise cost more to replace later on. You can keep the roots of the teeth; the infected inside contents of the root is removed and cleaned out. Root canals have over 90% of success when done properly, when the tooth is restored to its original function. In cases where the tooth is severely broken, or despite all efforts, the tooth is not savable, then it should be removed. That missing tooth can be replaced with a bridge, implant, or removable partial.