Root canal treatment is needed in moderate to severe cases of tooth decay. While mild tooth decay can be managed by preventive measures, when the inner pulp of the tooth becomes infected, root canal treatment is indicated.
Outer enamel or hard covering
A softer material called dentine underneath the enamel
Inside the dentine is the dental pulp where blood vessels and nerves supplying the tooth are contained. The pulp extends through the root canal. While the front incisors and canines contain a single root canal, the premolars and molars contain two to three root canals.
Indications or need for root canal treatment
Tooth decay: Food particles, saliva and bacteria present in the mouth form a colourless biofilm across the teeth called plaque. The bacterial colonies in plaque break down sugar present in food to form simple sugars and acid and this acid erodes the enamel.
As this process continues, the enamel and then the dentine are eventually damaged. In the case of severe tooth decay, the dental pulp at the centre of the tooth is also affected. This leads to symptoms such as toothache, sensitivity to eating food or drinking hot or cold drinks, pain on biting or chewing and loosening of the tooth.
If the tooth pulp becomes damaged or dies, the infection then spreads via the root canal into the blood vessels and nerves that supply the tooth. This can lead to severe infection of the jaw and gums as well as the formation of dental abscesses. This condition needs to be treated urgently with antibiotics and any abscesses may be drained of pus. Root canal treatment can then be performed.
Severe injury to the tooth and damaged enamel and dentine can sometimes lead to exposure of the dental pulp and the root canal. This may lead to pain and sensitivity on eating or chewing and may require a root canal treatment, especially to prevent infections from affecting the injured tooth.
Leakage of a dental filling may also necessitate root canal treatment.
Reviewed by Sally Robertson, BSc