A root canal, officially known as endodontic treatment, is a procedure designed to save a severely infected or damaged tooth. This treatment becomes necessary when decay or trauma allows bacteria to reach the pulp—the soft tissue containing nerves and blood vessels—inside the tooth’s root canals. When the pulp becomes inflamed or infected, it causes significant pain and can lead to a dental abscess. By removing the diseased pulp and sealing the inner structure, a root canal preserves the tooth, preventing the need for extraction and subsequent issues like shifting teeth or bone loss.
General Dentist vs. Endodontist: Who Performs the Treatment?
Both general dentists and specialists known as endodontists are trained to perform root canal therapy. A general dentist, or Doctor of Dental Surgery (DDS) or Doctor of Dental Medicine (DMD), provides a full range of preventive and restorative dental care, including routine root canals. They are equipped to handle straightforward cases, especially those involving front teeth that typically have simpler root anatomy.
An endodontist, however, is a dentist who has completed an additional two to three years of specialized training focused exclusively on the dental pulp, root canal system, and surrounding tissues. The prefix “endo” means “inside,” reflecting their expertise in the inner workings of the tooth. This extensive focus means an endodontist may perform dozens of root canal procedures weekly, giving them a high level of experience and technical proficiency.
General dentists often refer patients to an endodontist for complex cases, such as molars with multiple or curved canals, retreatment after a previous root canal failed, or cases involving significant infection or internal trauma. Endodontists use advanced equipment like operating microscopes and specialized instruments, which contribute to higher success rates, especially in challenging anatomical situations. Consulting a specialist is recommended for complicated anatomy or prior treatment failure to ensure the highest probability of saving the tooth.
Selecting a Qualified Practitioner
Choosing a practitioner requires careful consideration of their qualifications and experience. For a specialist, verify board certification and documentation of their post-doctoral training in endodontics. Inquire about the frequency with which a provider performs root canals, as procedural volume often correlates with technical skill.
The technology used in the office can significantly affect the treatment outcome. An operating microscope allows for enhanced visualization of the intricate root canal system, aiding in the complete removal of infected tissue.
Advanced imaging like Cone-Beam Computed Tomography (CBCT) provides a three-dimensional view of the tooth, invaluable for diagnosing complex anatomy or hidden infections. Patient reviews and a preliminary consultation offer insight into the practitioner’s approach to pain management and patient comfort.
What Happens During the Root Canal Procedure?
The procedure begins with a detailed examination, including X-rays, to confirm the diagnosis and visualize the root canal system. Local anesthesia is administered to numb the tooth and surrounding tissue. A small, protective sheet called a dental dam is then placed around the affected tooth to isolate it from saliva and maintain a sterile environment.
The practitioner creates a small access opening through the crown to reach the pulp chamber. Fine, specialized instruments are used to remove the infected pulp tissue from the chamber and the root canals. The canals are then thoroughly cleaned, disinfected, and shaped to prepare the space for filling.
Once the canals are completely disinfected, they are filled with gutta-percha, a biocompatible, rubber-like material compressed and sealed in place with adhesive cement. This material occupies the space where the pulp once was, preventing bacterial re-entry. Finally, the access opening is sealed with a temporary or permanent filling to protect the tooth until the final restoration can be placed.
Essential Post-Treatment Care and Follow-Up
Following the procedure, it is common to experience mild tenderness or discomfort in the treated area for a few days, which can typically be managed with over-the-counter pain relievers like ibuprofen. If a temporary filling was placed, a person should avoid chewing hard or sticky foods on that side of the mouth until the tooth receives its permanent restoration, as temporary material is not designed for long-term function. Maintaining excellent oral hygiene, including gentle brushing and flossing, is important to keep the area clean during the healing phase.
The most important follow-up step is the placement of a permanent restoration, usually a crown, by the general dentist. A tooth that has undergone root canal therapy becomes brittle over time because it is no longer nourished by the pulp, making it susceptible to fracture. The permanent crown provides the necessary structural protection and seals the tooth completely, which is necessary to prevent reinfection and ensure the long-term success of the treatment.