Root Canal

A root canal removes infected or inflamed tissue from inside a tooth and seals it, treating the underlying problem while keeping the natural tooth in place — the alternative, when a tooth reaches this point, is usually extraction.

What’s actually infected

Inside every tooth, beneath the enamel and dentin, is the pulp — a soft tissue containing nerves and blood vessels that runs down into the roots. Deep decay, a crack, repeated dental procedures on the same tooth, or trauma can let bacteria reach the pulp, where it becomes infected or inflamed in a way the tooth can’t resolve on its own. That infection is the source of the pain associated with a tooth needing a root canal, and it’s also what a root canal is designed to eliminate.

What happens during treatment

After numbing the area with local anesthetic, the dentist or endodontist creates a small opening in the top of the tooth to access the pulp chamber, then removes the infected pulp tissue from the chamber and the canals that extend into the root or roots. The canals are cleaned and shaped, then filled with a biocompatible material (most commonly gutta-percha) and sealed to prevent bacteria from re-entering. A temporary filling closes the access opening until the tooth is ready for its permanent restoration.

Molars, which typically have two to four separate canals, take more time to treat thoroughly than front teeth, which usually have a single canal — this is one of the reasons a molar root canal sometimes takes longer or is split across two visits, while a front tooth is more often finished in one.

Why it usually isn’t the last step

Once the infected pulp is removed, the tooth no longer has its internal blood supply, which over time makes the remaining structure more brittle than a living tooth. For back teeth especially, which absorb significant force during chewing, this is why a crown is the standard follow-up — it protects the tooth from fracturing under that load. Front teeth, which see less bite force, sometimes need only a filling to close the access opening rather than a full crown, depending on how much of the tooth’s structure survived the original damage.

General dentist or endodontist

Many root canals are performed by a general dentist, particularly for front teeth or straightforward cases. An endodontist is a specialist with additional training specifically in root canal treatment and other procedures involving the tooth’s internal structure, and is often the referral of choice for molars, teeth with unusual canal anatomy, retreatment of a root canal that failed previously, or cases complicated by a narrow or calcified canal that’s harder to access.

What recovery typically looks like

Mild soreness at the tooth and surrounding gum for a few days after treatment is common and usually manageable with an over-the-counter pain reliever, since some inflammation from the procedure itself is normal even once the infection is resolved. This is different from the pain that brought the patient in to begin with, which stems from the infection rather than the treatment, and it typically fades as the area settles — persistent or worsening pain after treatment is worth reporting back to the dentist.