Steps of root canal treatments

Root Canal Treatment
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The root canal procedure steps include removing dead pulp tissue from inside the tooth crown and roots, cleaning root canals, shaping them, and filling them with gutta-percha – natural rubber material. The final step of endodontic treatment is sealing the opening of the tooth with a temporary or permanent restoration. Ideally, a root canal-treated tooth requires an artificial crown to prevent future cracking of the tooth.

What is a root canal?

The anatomy of the human teeth consists of the crown portion, the exterior part of the tooth that you can see, and the roots, hidden beneath the gums firmly sitting in the jawbone. The root canals go inside the roots and contain soft dental pulp consisting of connective tissue and blood vessels. The upper part of the pulp starts in the crown (pulp chamber) and another part extends all the way down to the end of the root (apex). Posterior teeth – molars, have 3 – 4 root canals. The front teeth typically have one root canal, and premolars typically have 2 root canals.

What is root canal treatment?

Root canal treatment, also called endodontic treatment, is when the nerve and pulp inside the tooth are removed. When the pulp of the tooth has become infected, inflamed, or dead then a root canal procedure is performed by dentists or endodontists.

Root Canal Procedure Steps

Basically, root canal treatment steps are as follows:

Step 1
Local anesthesia is administrated to numb the tooth and surrounding gum before the procedure. If you are nervous/anxious about having a dental procedure done, our clinic offers nitrous oxide, known as laughing gas, oral sedation, or a combination of nitrous oxide and oral sedation.

Step 2
Isolation of the tooth.
A dental dam, which is a sheet of thin rubber or vinyl, will be applied to the affected tooth and surrounding area. The treated tooth will protrude through a hole in the dental dam, separating it from the surrounding tissues. This ensures that root canal treatment is performed in a hygienic environment free of bacteria from saliva or the surrounding tissues.

Step 3 Accessing the infected pulp and shaping root canals.
The dentist will make a hole in the tooth’s crown to access the pulp chamber and root canals. The dentist will use tiny instruments to remove the infected pulp from the pulp chamber and the root canals, and then will clean canals, shape, and disinfect them using special instruments (dental files) and an antibacterial solution to fit the filling material.

Step 4 Filling root canals and access a hole.
The dried and cleaned root canals will be finally filled with a special rubber-like material known as gutta-percha. The material is inserted into the canals, heated, and compressed into and against the walls of the canal. The canals will then be sealed with adhesive cement to eliminate the possibility of bacteria entering and contaminating the canals in the future.
The access hole will be closed with a permanent or temporary filling. A plastic or metal post may be placed in one of the root canals to help retain the restoration.

It is very common to experience some mild discomfort after endodontic treatment lasting usually from a couple of days to a week, which can typically be treated with non-prescription medications (e.g., aspirin, Ibuprofen, or acetaminophen). During the follow-up appointment, in a week or two, your dentist will evaluate the healing progress.

Remember to follow post-operative instructions to protect the tooth from damage and aid in healing:

  • Immediately after the endodontic treatment eat only soft food on the affected side.
  • Use a saltwater rinse to reduce symptoms of discomfort or possible swelling.
  • Use over-the-counter medications to manage pain and discomfort.
  • Brush gently until the area is no longer tender.
  • If you are prescribed antibiotics, complete the course even if you feel better before you have finished the course.

Why Do You Need a Root Canal Treatment?

There are multiple reasons why root canal treatment is needed such as an infection causing an infected pulp. The infection could be due to an unrestored tooth resulting in an infected tooth. Sometimes this infected pulp can be addressed by the dentist giving prescription medications such as oral antibiotics, however, if that pulp is continuously reinfected, then root canal treatment will be performed. This will help minimize future infections.

Discomfort when drinking/eating cold or hot food can slowly develop into long-lasting tooth pain or severe pain. If over-the-counter pain medications are no longer effective and the symptoms are increasing in severity, then it is recommended to book an appointment with your regular dentist as soon as possible or seek emergency dentistry.

Teeth that have cavities typically referred to as tooth decay and are not addressed in a timely manner can get bigger and deeper resulting in deep decay. This deep decay can reach the pulp where the nerve resides and cause pulp damage, or infection. Sometimes a simple restoration of the tooth by removing the decayed parts may be sufficient. However, if increasing sensitivity or discomfort were to develop, a root canal would be recommended.


There is a risk of infection when completing root canal therapy and this could be because a canal was missed leaving the infected pulp in the root, an undetected crack allowing bacteria to seep in, or an improper restoration allowing bacteria to enter the root canals. This can be fixed by performing a root canal re-treatment.

Here are some frequently asked questions

What does it cost?

There are many factors that affect the cost of a root canal procedure:

  • Number of root canals the tooth has.
  • Whether the roots have calcified or curved canals or have difficult access.
  • Whether the dentist needs to insert posts and build the core of the tooth because there are insufficient tooth structures left.

Book an appointment or consultation with your dentist today to get a more accurate estimate for your tooth needs.

You can resume your normal activities. If you are planning to eat or drink it is best to wait until the local anesthesia has worn off, especially if it is a lower tooth to prevent injury to the cheek and tongue.
It is recommended to avoid hard food to prevent fracturing the tooth. If you are eating anything that is hard to bite or chew on the other side.
You can eat before a root canal. The dentist will be using local anesthesia to freeze the tooth the dentist’s focus will be on. Local anesthesia does not affect your stomach.

Root canal treatment may no longer be an option if the periapical abscess causes a large inflammation around the tooth, or when the bone is infected/destroyed. If the bone around the tooth is destroyed by periodontal disease resulting in a decrease of bone greater than half of the normal length.

It is always recommended to book an appointment with your dentist to see if it is too late for a root canal and if there is sufficient structure.

To date there has been no association or evidence found that indicate root canal causes cancer.
If the infection is allowed to fester, then it may result in tooth loss. If a root canal is not in your budget the next option is to have an extraction if antibiotics are no longer helping.
Crowns are always strongly recommended to help maintain the integrity and functions of the root-canaled tooth. The dentist will cement a permanent crown onto the tooth. The crown is made to look like your natural tooth and is made to match the shade of your adjacent teeth allowing it to blend in naturally with its neighboring teeth.
Yes, you can drive after a root canal procedure. Your general dentist or endodontist will typically use local anesthesia, freezing only the area that is being operated on.
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