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It's the most feared dental treatment of all. Patients avoid going to the dentist because they don't want to hear that they need a root canal. They would rather have the tooth extracted, removed forever, with a permanent space, than go through the agony of a root canal. In reality, a root canal usually isn't painful and, in most instances, the pain associated with the tooth infection subsides in a matter of days after the treatment is complete.
Root canal treatment is required when the nerve tissue of the tooth, or pulp, becomes infected or dies. The only way to remove the infection is to remove the source of the infection, the infected or dead pulp tissue. There are two ways to remove pulp tissue. The first way is to remove the entire tooth, and the pulp tissue comes with it. The second better way to remove infected pulp tissue is to perform root canal treatment. In this procedure your dentist removes the infected pulp tissue while leaving the rest of the tooth intact.
A root canal is what a dentist does to clean out and remove only the pulp tissue of the tooth. Your dentist will first give you anesthetic to numb the tooth, so you should be comfortable during the entire procedure. To maintain a dry field and ensure the pulp does not become further contaminated with saliva and other bacteria, your dentist will place a protective barrier around the tooth, known as a rubber dam, to isolate it and keep it clean. Once the tooth is isolated, your dentist will create an opening in the top of the tooth to access the pulp tissue. Then, using tiny files, your dentist will scrape the inside of the tooth and the walls of the pulp canal space to remove any infected or dead nerve tissue. Your dentist will repeat this part of the procedure several times with files of varying sizes and shapes to remove a sufficient amount of pulp tissue and adequately clean the nerve canal space. To determine how deep to go with each set of files, your dentist may use a device called an apex locator. This machine tells your dentist how far to go with each file and when the file reaches the end of the canal.
Now that the canal spaces are cleansed and dry, the empty spaces need to be filled. A rubber material, called gutta percha, is placed in each canal to fill the void left by the pulp tissue. The access area your dentist made through the top of the tooth also needs to be filled. A silver amalgam or white composite restoration fills in the rest of the tooth. Finally, a permanent restoration needs to be made to protect the brittle tooth from splitting. Your dentist will make a crown for the tooth, a restoration made from metal alloys and rigid porcelain, to surround the tooth and protect it from breaking. A couple days after the root canal treatment, your toothache should be eliminated, and you still have your tooth!