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The Dental Pulp

To understand root canal or endodontic treatment, it helps to first understand the anatomy of the tooth. The part of the tooth visible in your mouth is called the crown and the part covered by the bone and gum is the root.

The crown of the tooth is made up of the hard white enamel layer and a thicker dentine layer. Both these hard layers protect the innermost soft tissues of the tooth called the pulp. The dental pulp contains blood vessels and nerves within and extends from the crown to the tips of the root or roots.

Rubber dam isolation and access cavity

• Removal of the infected or inflammed pulp is the first step in saving the tooth. Under local anaesthetic, an opening is made in the crown of the tooth to get across to the infected or inflammed pulp within. 

X-ray showing files in root canal

• Using small, specially designed hard or rotary files, the root canals are cleaned and shaped to a form that can be sealed. Debris within the canals is removed by flushing with an anti-bacterial solution.

X-ray of a root filled tooth

• The canals are finally filled or sealed with an inert material called gutta-percha. The tooth should be restored to full shape and function by either a permanent filling or a crown, depending on how much of the tooth is left. This should be done as soon as possible as there could be a risk of tooth fracture due to biting forces.

All root canal treatment procedures are done by isolating the tooth with a rubber dam to provide a clean and saliva-free environment. Root canal treatment may be done in single or multiple visits depending on tooth complexity. In between treatment appointments, medicaments may be placed within the canals and the tooth is covered with a temporary filling.

Often, X-rays are taken to determine the length of the root and to monitor various treatment stages.