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Root canal care

Inside each tooth is the pulp (the soft center of the tooth), a core of nerves and blood vessels that runs down through thin channels in the roots. Deep decay, a crack, or an injury can let germs reach it. Once the pulp is badly inflamed or infected, it usually can’t heal on its own.

Root canal therapy removes the damaged pulp, cleans the channels, and seals them, so you can keep your own tooth. Many people expect it to be an ordeal. With numbing, most people say it feels much like getting a filling.

You might need this kind of care if you have:

  • A toothache that throbs or keeps coming back
  • Pain that lingers after something hot or cold
  • Pain when you bite down
  • A tooth that has turned darker
  • Swelling or a pimple-like bump on the gum near a tooth

Sometimes there are no signs at all, and the problem shows up on an X-ray at a routine visit. These signs can also point to other problems, which is why an exam comes first.

If you have trouble breathing or swallowing, swelling that spreads toward your eye or neck, or a high fever, go to an emergency room or call 911. For other urgent problems, see emergency dental care for what to do until you’re seen.

Below, you’ll find what happens during a root canal, and what can be done if a treated tooth has trouble later.

Care is provided byDr. James Minici, general dentist.

Treatments

  • Root canal therapy

    A root canal cleans out the soft center of a tooth when it’s inflamed or infected, so you can keep the tooth. With numbing, it often feels like a filling.

A lower molar, cut in half to show its layersLine drawing of a lower back tooth cut from front to back through both of its roots. It shows the hard enamel cap, the dentin under it, the pulp in the center (shaded), the root canals inside the roots, and the gum and bone that hold the tooth.
  • Enamel
  • Dentin
  • Pulp
  • Gum
  • Root canals
  • Bone
A molar, cut through the middle. Enamel covers the crown and dentin forms the body of the tooth. The pulp, its soft center, holds nerves and blood vessels that run down the root canals.

Root canal retreatment

Most teeth heal well after a root canal. Sometimes, though, a treated tooth doesn’t heal, or it becomes infected again months or years later. New decay, a crack, or a loose filling or crown can let germs back in. Germs can also hide in a narrow or curved canal.

Signs include pain or swelling near the tooth, tenderness when you bite, or a small bump on the gum. Some problems show up only on an X-ray.

In retreatment, the tooth is reopened, the old filling material is taken out of the canals, and the canals are cleaned and sealed again. The tooth then needs a new filling or crown.

Retreatment is usually more involved than a first root canal, so it’s often done by an endodontist, a dentist who focuses on root canals. Dr. Minici will tell you whether he recommends a referral. Other choices can include surgery at the tip of the root or removing the tooth. Learn more about root canal therapy.

An exam is how we find out what’s right for you.

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