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Root Canal Treatment – How Does It Work

A root canal, or commonly known as RCT is a procedure to treat dental infections by killing bacteria, removing the dead or dying nerve tissue inside a tooth and replacing the affected tooth with a new one. The goal of this procedure is not to cause you pain, rather save a severely infected tooth. According to the National Institutes of Health, the root canal is one of the commonest and most widely used procedures to remove trapped bacteria and clean dental infection. New York Total Dental refers to root canal treatment as “a method used to save a tooth with a damaged nerve” and explains in detail how the nerves become damaged. We skip that part in this article and go straight to the treatment.

Modern techniques are transforming root canal procedure into a relatively comfortable treatment option that often needs no more than one, or in some cases, two to three trips to the dentist.

The root canal treatment steps can be broken down as follows;


Your dentist will take an X-ray or series of X-rays of the affected tooth before starting root canal treatment. This helps him view a clear picture of the affected tooth, assess the extent of damage and design a treatment program accordingly.
The next usual step is the administration of local anesthesia – to help numb the specific area using a painkiller anesthetic medicine. It is not required in severely infected or dead tooth tissues as their nerve supply is already damaged and is no longer sensitive to touch or pain.

Removing The Dead Pulp

To keep the affected area dry during the whole procedure, your dentist will place a dam (a kind of rubber sheet) around the tooth. It is also helpful in reducing the chances of breathing in or swallowing any chemicals or medicines the dentist uses and the remnants of the dead pulp.

The dentist will use the flat part crown to open and access the soft tissue at the center of the tooth (pulp). The dead cells and tissues (blood vessels and nerves) of the pulp and root canal are removed with special instruments. Before proceeding to the next step, he will make sure that there is no abscess or pus-filled cavity is remaining and all the remnants of the dead pulp have been removed successfully.

Dental Filling

The dead pulp has been removed and the empty space is ready to be filled.

Normally, the root canal is quite narrow, which makes it challenging to fill. Your dentist will use a special drilling instrument to clean and enlarge the root canal so it can be easily filled. Now, the affected tooth will be filled with a temporary filling material.

This step may take several hours or even more than one visit to complete. The time duration also depends on the type of affected teeth, the extent of damage, and the skills of the dentist. Incisors and canine teeth have a single root with one root canal so they take less time to fill. While the chewing teeth such as premolars and molars usually have two roots (and root canals), so they will take more time to fill and heal.

If you are experiencing any symptoms of the infection such as a large swelling or raised temperature, you may be given antibiotics and anti-inflammatory medicines to subside these symptoms and prevent further infection. This will take additional time (days to weeks).

Sealing and Fixing The Tooth

At your next visit, the medication (if placed) and the temporary filling in the tooth are removed and the root canal is filled with a permanent filling material. Nowadays, the most common filling materials being used are resilon (resin-based cons), endorez cones, and ActiV GP. You should ask your dentist the type of filing material he is going to insert and if that’s the best option for you. Filling the root canal not only seals the tooth but also prevent reinfection.

Root-filled teeth are delicate compared to normal, healthy teeth. As they are more likely to break, your dentist may recommend placing a crown to protect your tooth.

Placement Of Crowns

A crown is a cap made up of synthetic materials that is designed to completely cover a real tooth. It is helpful in preventing tooth fracture and restoring the normal shape of the affected tooth. Crowns are usually made up of:

  • Metal or porcelain (or both)
  • Powdered glass
  • A ceramic material

Your dentist will first reduce the size of your tooth and then place the crown. A special type of cement is used to glue the crown to the tooth. Most dentists will take a mold of your tooth to make sure the crown is the right size and shape.

With this, your root canal treatment steps are completed. Now you have your tooth infection treated and the affected, trimmed-down tooth is replaced with a natural-looking crown.