Introduction

Endodontics is the branch of dentistry that deals with diseases of the tooth’s pulp. The pulp is found in the center of the tooth and in canals (called root canals) inside the root of each tooth. Pulp includes connective tissue, nerves and blood vessels. Pulp nourishes the tooth when it first emerges through the gum. Once the tooth matures, the pulp can be removed without destroying the tooth. That’s because each tooth also is nourished by a blood supply in the gums.

Removing the pulp is called endodontic treatment, but it is often referred to as root canal treatment or root canal therapy. Many people refer to pulp removal as “having a root canal.” Root canal treatments are quite common. In the United States, they save about 24 million teeth each year.

Why Would You Need Root Canal Treatment?

Root canal treatment is needed for two main reasons. The first is infection. An untreated cavity is a common cause of pulp infection. The decay destroys the enamel and dentin of the tooth until it reaches the pulp. Bacteria then infect the pulp. Antibiotics can’t get to infections inside teeth. The inflammation caused by the infection reduces the blood supply to the tooth. The reduced blood supply also keeps the pulp from healing.

The second reason for a root canal is damage to the pulp that can’t be fixed. A fracture in a tooth can damage the pulp. So can a less severe blow to the tooth (trauma), even if there’s no visible damage. Multiple fillings or other restorations on the same tooth also can damage the pulp.

Sometimes, common dental procedures can hurt the pulp. One example would be if a tooth is cut too close to the pulp while it’s being prepared for a crown. Then the tooth might need a root canal.

When the pulp is inflamed but not infected, it may heal on its own. Your dentist may want to see if this will happen before doing root canal treatment. If the pulp remains inflamed, it can be painful and may lead to infection.

An infection in the pulp can affect the bone around the tooth. This can cause an abscess to form. The goal of root canal treatment is to save the tooth by removing the infected or damaged pulp, treating any infection, and filling the empty root canals with a material called gutta percha.

If root canal treatment is not done, an infected tooth may have to be extracted. It is better to keep your natural teeth if you can. If a tooth is missing, neighboring teeth can drift out of line. Keeping your natural teeth also helps you to avoid other treatments, such as implants or bridges. Also, if you ignore an infected or injured tooth the infection can spread to other parts of your body.