Root canal therapy conjures bad thoughts and fears. However, most root canal procedures are painless and routine. Most root canal procedures are instituted to remove the pulp which contains nerves, blood vessels and other living cells in a normal situation. The abnormal pulp has pain or quiet inflammation that needs removal. The pain can be mild or acute and pulps are sometimes hyperemic and contain living tissue or necrotic cells, dead and abscessed cells.
Anatomically the root canal is within the tooth and must be accessed through the crown or top of the tooth. An access hole is prepared and small diameter files are introduced into the canal to remove the offending soft tissue. We use mostly rotary files in dentistry now and the procedures progress well and efficiently. This relieves the pain and usually we make it a two visit procedure in our office. We place a medicated or dry cotton in the top of the root canal and place a temporary filling. The tooth settles down and at the succeeding visit a week or so later we complete the root canal. This involves placement of a material called gutta percha which we heat in most cases to adapt to the inner aspect of the root canals anatomy.
Broken vital teeth can be completed in one visit usually because infection is not an issue. Appearance is an issue in those cases if the tooth is in the front of the mouth. We follow the root canal in such cases with a build-up post and place a temporary crown that first day.
Some root canals we send out to an endodontist because of intense calcification that makes access difficult. We may also do this if we have doubts as to the source of the pain to get their opinion.
We perform hundreds of root canals each year and have excellent up to date equipment for the purpose. We only use the rotary file on one patient and then discard them which should be done in every office.