Dental model showing tooth root canal

Your Complete Guide To Root Canal Treatments

Root canal treatment is one of the last resources the dentist can use to save a tooth, especially after a large fracture that involves the pulp or an extensive cavity.

Although a dental filling is mostly enough to restore the tooth, sometimes a root canal treatment is necessary.

This is the best treatment option available for cases where dental caries have reached the tooth pulp and created irreversible damage. Furthermore, it does not only cure the pain but allows you to maintain your teeth in the mouth.

However, there are many things you should know before getting a root canal treatment. Luckily, our Seattle dentists can give you all the in-depth information you need to understand how your treatment is done.

Visit us at Smile Dental Clinic as soon as possible to save your tooth. Our dentists are trained to provide the best care and perform root canal treatments.

We will explain in this article what root canal treatments are and why you should get one.

What is root canal treatment?

An endodontic therapy, also known as just root canal, is a dental procedure that consists of removing the dental pulp inside the tooth and filling the space left behind with a special material.

This treatment is necessary when the dental pulp, the soft tissue inside the teeth, has suffered irreversible damage and become inflamed or infected.

Furthermore, its primary goal is to eliminate infections caused by bacteria and prevents their spread to the nearby tissue and entire body. Nonetheless, any toothache that you might be experiencing also disappears after a root canal treatment. However, the tooth’s sensitivity is lost during the procedure since the pulp contains the tooth nerves.

A root canal treatment is the only way to save a tooth and prevent its extraction after it has been irreversible damaged to the nerve. However, root canal treatment alone is not enough. Performing a filling or placing a dental crown on top of the tooth after the treatment is vital to maintain the results.

What is dental pulp?

Dentist shows on dental model how caries destroys tooth enamel
Dentist shows on dental model how untreated caries leads to dental pulp infection

The dental pulp is a soft tissue found inside each tooth. It resides in a space in the middle of every tooth called the pulp chamber. Furthermore, it extends inside the tooth’s roots through canals, hence the name: root canal treatment.

The pulp contains nerves and tiny blood vessels and is responsible for the tooth’s vitality. It supplies nutrients to the tooth through the blood vessels to keep it healthy and alive.

The nerves inside your teeth allows you to feel different stimuli, such as heat or cold. However, it is also responsible for toothache.

Why must the dentist remove the pulp?

The dental pulp is a highly sensitive tissue that reacts to every external stimulus. When the tooth suffers trauma or develops a cavity near the pulp, this tissue reacts in the form of inflammation, discomfort, and eventually, pain.

Usually, the inflammation disappears when the stimulus is removed if the trigger is not strong enough, such as in the case of a small cavity. However, the inflammation can become irreversible if the stimulus is too powerful or the pulp has been affected for a prolonged time. Moreover, the only solution available in this case is the removal of the affected nerve along with all bacteria from the space. This condition then the pulp is inflamed is characterized by severe pain, which is usually the main reason people visit an emergency dentist.

After reaching this stage, the pulp condition can only progress and worsen over time. The reason is that the pulp cannot go back to a healthy state, even if the stimulus that caused its inflammation is removed or treated.

Furthermore, the pulp eventually dies and becomes infected if it is not removed. A necrotic or dead pulp releases bacteria that travel to the bone through the apical foramen. This is a small opening at the end of the root. Once bacteria reach the bone, an infection develops nearby in the form of an abscess.

For this reason, removing the pulp after it reaches these stages is essential, as it is the only way to prevent the spread of the infection. Moreover, this infection won’t subside until the pulp is removed if an abscess has already formed. 

When do you need a root canal?

Root Canal Procedure Rubber Dam
Dentist performing root canal treatment

A root canal treatment is necessary when the dental pulp dies or when the inflammation is irreversible.

Your dentist can make a thorough clinical and radiographic evaluation to identify the state of your tooth. Furthermore, they perform a few simple tests to determine the pulp vitality and its condition.

However, some symptoms can help you figure out if you might need a root canal treatment, such as:

  • Severe and prolonged pain that makes the patient take painkillers. Usually triggered while chewing.
  • Hypersensitivity after the tooth contacts a cold or hot beverage or food. This pain doesn’t fade away after the stimulus is removed.
  • Appearing spontaneous pain without an apparent cause or stimulus.
  • Tooth fracture with pulp exposure and damage.
  • An extensive cavity that reaches the pulp.
  • Tooth abscess. Can have a drainage pathway through the gums.
  • Intra-oral or extra-oral edema caused primarily by an infected tooth’s nerve.
  • Fever due to a dental infection which is spreading.

Although these symptoms can help you identify if you might need a root canal treatment, only the dentist can determine it after a thorough examination. 

How is a root canal done?

The procedure takes several steps:

1. Examination

Dental Exam
Dentist Performing a Dental Examination

The dentist must examine the oral cavity and the teeth to determine which is the affected tooth and its condition.

In many cases, it is obvious which tooth requires a root canal treatment. However, on some occasions, there might be multiple affected teeth by cavities that look similar but only one that requires a root canal treatment.

Furthermore, the pain might be diffused and not located. This makes it hard for the patient to identify where it comes from precisely and what tooth hurts.

Therefore, the dentist needs to properly evaluate the oral cavity to determine the affected tooth.

2. Anesthesia

Dentist provides dental anesthesia
Dentist provides dental anesthesia

The procedure is done under local anesthesia since it involves removing the nerve from the tooth. 

If necessary, the dentist can use a numbing cream on the area before injecting the anesthesia. This helps ease the discomfort caused by the anesthesia needle.

The anesthesia prevents you from feeling any pain or discomfort throughout the treatment. Furthermore, it can offer some relief, especially if you visit the dentist’s office with a toothache.

Also, for patients with severe dental anxiety sedative options can be discussed. Sedation can be done with different medications and the doctor will discuss with you which option would be appropriate for you based on your medical and dental history along with the level of sedation desired to be achieved and other information. 

3. Pulp removal

Root Canal
Removal of dental pulp

After you are anesthetized appropriately, the dentist begins the root canal treatment. The dentist will place a rubber dam around the affected tooth.

This isolates it from the oral cavity and prevents saliva and bacteria from reaching inside the tooth. Although it might seem simple, this is an essential step to prevent infections and can determine the success of the treatment.

Once the tooth is isolated, the dentist can safely access the pulp chamber using the dental handpiece. This allows him to remove the pulp using specialized tools capable of penetrating inside the root canals. 

4. Disinfection, canal prepping, and medication

Collection of endodontic files
Collection of endodontic files

After the dentist removes the pulp, the following step is to disinfect and prep the inside of the tooth canal/s.

The dentist uses disinfectant solutions to clean inside the tooth. Simultaneously, s/he prepares the canals using tools called endodontic files. These tools are used to enlarge the root canals to clean it thoroughly and prepare it for the filling materials. This process also removes any pulp leftover that could remain inside the root canals.

Occasionally, the dentist requires leaving medication inside the canals for a few days. This helps control the infection and is done before filling them. If medication is not necessary, the dentist proceeds to fill the canals immediately.

5. Root canals filling

Dental model showing tooth root canal
Dental model showing tooth root canal

The dentist can fill the inside of the tooth after it has been properly prepared and disinfected. This is one of the last steps of a root canal treatment and is done using a material called gutta-percha along with a paste. 

Gutta-percha material is similar to rubber. Furthermore, filling the root canals with it allows preventing bacteria from traveling to the bone and causing infections.

An aspect to consider about root canal treatments is that the dentist takes multiple X-rays throughout the procedure. This is done to verify there are no issues and everything is going as planned. This is essential since there is no direct visibility inside the tooth, and the dentist doesn’t have any other verification method.

6. Temporary filling

Model Showing Dental Fillings
Model Showing Dental Fillings

The last step is a temporary restoration. This is done after the root canals have been filled and sealed. Sometime the dentist may place a permanent filling on top right away.

Before you get a temporary filling you need to understand that this restoration is done with a temporary (wick) material. It is not meant to be permanent, and its primary goal is to restore the tooth functionality while waiting for a definitive restoration. The root canal treatment itself is considered finished after the temporary filling is placed. But it is essential to understand the treatment for this tooth is not completed and you must finish it as soon as possible. We will go in more details and reasons bellow.

Does it hurt?

Patient taking pain killers with a glass of water
Patient taking pain-killers with a glass of water

People tend to think about root canal treatment as a painful procedure. However, it is not necessarily true.

This procedure offers quick pain relief and doesn’t cause any discomfort. The treatment is always done under local anesthesia to prevent any pain. Moreover, dentists nowadays possess many types of anesthesia and a wide variety of anesthetic techniques. This prevents pain in any situation, regardless of the case.

Nonetheless, it is normal for some people to feel slightly sore after the treatment. However, this sensation disappears on its own usually after a few days.


There are a few considerations and special care to have with a tooth that underwent root canal treatment.

Oral hygiene

Although these teeth are no longer vital, they can still develop cavities, and plaque can build up around them. As a result, it is still necessary to keep them clean and have good oral hygiene. 

Definitive restoration

The most essential aftercare recommendation is to replace the temporary filling with a definitive one as soon as possible.

These temporary fillings are made with materials that don’t have the best physical or esthetical properties. Therefore, they can break or dislodge after a while. This allows bacteria to penetrate the tooth and contaminate the canals. If this happens, the treatment can fail, and it would be necessary to repeat it to disinfect the tooth once again.

Furthermore, root canal treatment can affect the tooth’s integrity. Therefore, the tooth can fracture or chip while eating without a proper restoration done with the correct material.

The type of definitive restoration to be used depends on the tooth type and the integrity after the root canal treatment. All back teeth in our mouth must have a dental crown after a root canal treatment. For the front teeth – a composite resin restoration can be used if enough tooth structure is left . However, a dental crown might be mandatory for anterior teeth which are severely damaged and compromised teeth.

Careful with what you eat

Since teeth with root canal treatments are generally weaker than the other teeth, we recommend you avoid chewing hard food with them. This helps prevent fracture and prolongs the tooth’s lifetime.

The takeaway

Root canal treatment is a procedure used to prevent or treat dental infections and save a severely damaged tooth.

The procedure consists of removing the pulp inside the tooth and the roots. Afterward, the tooth is disinfected and filled with a material called gutta-percha plus paste. This treatment is necessary when the dental pulp is damaged or compromised beyond repair.

Root canals are almost always done under local anesthesia to ensure the patient’s comfort throughout the treatment. 

Multiple symptoms, such as severe or spontaneous pain, can indicate the need for a root canal treatment. However, only your dentist with a detailed examination can determine if a root canal treatment is necessary or if the tooth can be treated with other methods.

If you are experiencing a severe toothache, make an appointment at Smile Dental Clinic in Seattle. The Smile Dental Clinic team will treat you as soon as possible and restore your oral health. Moreover, our dentist’s office is equipped with all the tools necessary to ensure your treatment success and well-being.


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  3. Duran, R. (2021, November 13). Tooth abscess: Symptoms, causes, and treatment. WebMD. Retrieved July 29, 2022
  4. Frisbee, E. (2020, November 17). Toothaches: Causes, symptoms, diagnosis, treatment, remedies. WebMD. Retrieved July 29, 2022
  5. Rokaya, D., Srimaneepong, V., Hiran-us, S., & Khurshid, Z. (2022). Alloys for endodontic files and Hand Instruments. Biomaterials in Endodontics, 131–168
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