To fully appreciate the root canal procedure it helps to be familiar with the basic anatomy of the tooth.
A tooth is composed of a number of different types of tissues. Perhaps the most familiar of these parts of a tooth is enamel. Enamel is the hard mineralized material that covers the outside of a tooth. Beneath this enamel layer lies the dentin. Like enamel, dentin is also mineralized however it is somewhat softer than the enamel layer on the exterior. Inside the dentin we find the dental pulp (commonly referred to as “nerve”). The dental pulp, in contrast to the other parts of a tooth, is a soft tissue. This soft tissue is composed of nerves, blood vessels, & other types of tissues. The dental pulp plays an important role in the formation of teeth early in life however when teeth are fully formed its purpose is greatly diminished.
Endodontics (Endo=inside dontic=teeth), is the dental specialty that involves the study and treatment of the tissue inside of a tooth, the dental pulp. Endodontic treatment is often required when the pulp becomes either infected or irreversibly inflamed. This infection or inflammation of the dental pulp can occur in a number of ways: decay, dental procedures, trauma, diet, etc. . The pulp is different from most other tissues in the body; it is encased within a confined space and lacks a large blood supply that is found throughout the body. These characteristics contribute to the body’s inability to respond to the inflammation or infection present within the pulp. Therefore, whenever the pulp becomes inflamed or infected it must be removed. If left untreated, this can lead to pain or an abscess. The pulp can be removed in one of two ways – either removal of the entire tooth (tooth extraction) or removal of the pulp only (root canal therapy).
The root canal procedure involves a number of steps. Local anesthetics are used to anesthetize the tooth. Next, a rubber sheet is used to isolate the tooth, this helps to keep the tooth clean and dry throughout the procedure. The pulp is then located by making an access cavity through the tooth. Once the pulp has been located the nerve tissue within the root(s) is removed using small metal instruments (files) and irrigating solutions. When the canal(s) have been properly cleaned and disinfected they are filled with gutta-percha, a rubber filling material. Finally, the access cavity is filled with either a temporary or permanent filling.