Root canals can seem intimidating, especially if you’ve never had one before. But understanding the process can make it a lot less daunting. Root canal treatment is designed to save a tooth that might otherwise need to be removed due to infection or damage. This step-by-step guide walks you through each part of the procedure so you know how root canals are performed and what to expect and can feel confident about preserving your smile.

Why Do You Need a Root Canal?

Before we dive into the steps, let’s quickly look at why root canals are needed. Inside each tooth is a soft tissue called the pulp, which contains nerves and blood vessels. When the pulp becomes inflamed or infected—often due to decay, trauma, or a crack in the tooth—a root canal is often the best solution. Removing the infected pulp not only saves the tooth but also relieves pain and prevents further issues.

Step 1: Initial Consultation and Examination

The root canal process begins with a visit to your dentist or endodontist (a specialist in root canals). During this visit, the dentist will:

  • Examine your tooth to check for visible signs of infection or damage.
  • Take X-rays to get a closer look at the tooth’s root structure and the extent of the infection.

This examination helps the dentist confirm that a root canal is the right treatment for you.

Step 2: Administering Local Anesthesia

Once the dentist determines that a root canal is necessary, they will numb the area around the affected tooth with local anesthesia. You may feel a slight pinch, but after a few moments, the area will be numb, and you won’t feel any pain during the procedure. This step ensures that you remain comfortable throughout the treatment.

Note: For those with dental anxiety, some dentists offer options like nitrous oxide (laughing gas) to help you relax during the procedure.

Step 3: Placing a Dental Dam

To keep the area clean and free from saliva, your dentist will place a small rubber sheet called a dental dam around the affected tooth. This isolation ensures that the procedure is as sterile as possible and that the infected area is kept separate from the rest of your mouth.

Step 4: Creating an Access Opening

With the tooth isolated, the dentist will drill a small access hole into the top of the tooth. This opening allows the dentist to reach the pulp chamber and root canals where the infection or damage is located. The access hole is typically drilled through the chewing surface of the tooth for easy access to the inner canals.

Step 5: Removing the Infected Pulp

Using specialized tools, the dentist carefully removes the infected or damaged pulp from the tooth’s pulp chamber and root canals. This step is crucial for stopping the infection and preventing it from spreading. Since the area is numb, you won’t feel any pain during this part.

Fun Fact: The pulp is essential during a tooth’s growth and development, but once the tooth is fully mature, it can survive without the pulp, as it continues to receive nourishment from surrounding tissues.

Step 6: Cleaning and Shaping the Canals

After the infected pulp is removed, the dentist will thoroughly clean the inside of the tooth and shape the root canals. This involves using tiny, flexible files to clean out any remaining debris and to create a smooth, bacteria-free canal system. The dentist may also rinse the canals with an antibacterial solution to ensure they’re completely clean.

Step 7: Filling the Canals

Once the root canals are cleaned and shaped, they are filled with a biocompatible material called gutta-percha. This rubbery material seals the canals, preventing bacteria from re-entering and causing a new infection. The dentist carefully packs the gutta-percha into each canal to fill the entire space.

Step 8: Sealing the Access Opening

With the canals filled, the dentist seals the access hole created at the beginning of the procedure. Often, a temporary filling is placed to protect the tooth until a permanent restoration (usually a crown) can be applied. This temporary filling ensures that the tooth remains protected until your next visit.

Step 9: Placing a Crown (if Needed)

In many cases, the final step of a root canal treatment involves placing a crown over the treated tooth. This is because a tooth that has undergone a root canal is more fragile and needs added protection to handle normal biting and chewing forces. During a follow-up appointment, your dentist will:

  • Remove the temporary filling.
  • Fit a custom-made crown over your tooth to restore its shape, strength, and appearance.

A crown not only protects the tooth but also gives it a natural look, so you can feel confident in your smile.

Post-Treatment Care and Recovery

After the procedure, it’s normal to experience some sensitivity or mild discomfort, but this usually fades within a few days. Your dentist may recommend over-the-counter pain relievers and advise you to avoid chewing on the treated side of your mouth for a short period. Following good oral hygiene habits, like brushing and flossing daily, will help maintain your restored tooth.