A Detailed Guide on the Root Canal Treatment Procedure Step-by-Step

What Is a Root Canal Treatment?

A root canal therapy is an endodontic method performed on an outpatient basis. Dentists perform the RCT procedure when bacteria infect the tooth pulp. The human oral cavity harbors around 700 microbial species.^[1] Microbial invasion or the entry of bacteria into the interior parts of the tooth through breaches. Dental caries, followed by cracks and trauma, are the common causes of root pulp infection. ^[2] The central agenda of your dentist to perform RCT is to remove the bacteria, cure infection and preserve the tooth.^[3] 

Root Canal Inside the Tooth: Understand in Detail

Natural teeth appear hard and white, bearing a clear anatomy from the inside. Below the external white-colored enamel is the hard dentin layer covering the soft tooth pulp. The tooth pulp contains blood vessels, connective tissue, and nerves. It is the sensitive portion of the hard tooth structure and plays a significant role during tooth structure development. 

The number of root canals a tooth has depends on the type and anatomy of the tooth. Typically, the molars or the back teeth have 2-4 root canals, while the premolars have 1-2 root canals. The incisors or the front teeth have a single root canal.  Having known what a root canal is, aren’t you interested in knowing more about the causes of it being infected? We have covered this for you. 

Causes of Root Canal Infection

Typically, enamel is the hardest substance in the human body that protects the tooth interior. Thanks to the brittle minerals arranged in a tough microstructure within the enamel, these add strength and toughness to this outermost layer of the tooth.^[4] With great resilience, tooth enamel acts as a protective barrier, preventing the entry of oral microbiome inside the tooth interior. However, tooth decay can sometimes cause deep cavities. Cavities are minute holes in the enamel caused by eroded enamel due to poor oral hygiene. In these cases, oral bacteria reach the interior tooth pulp, causing inflammation or pulpitis. In other cases, a broken or cracked tooth can expose the tooth pulp, making it accessible to oral bacteria. Irrespective of the cause, an infected root canal leads to severe symptoms.

Signs of Infected Root Canals That Need Rct Procedure Step-by-Step

An infected root canal requires an RCT treatment and is associated with the following symptoms.

• Severe pain deep inside the tooth that does not go away. It may also spread over the jaws or other teeth. Inflammation and swelling inside the pulp chamber pressurizes the tooth walls, causing deep pain inside the tooth.
• Small pimples, boils, or bumps on the gums near the infected tooth. These may ooze smelly pus.
• Sharp pain on touching the tooth or applying pressure on it.
• Tender, swollen, and painful gums and jaws. In severe cases, pus accumulates inside the jaws and does not drain out. 
• Loosened tooth structure, where the accumulated pus softens the bones holding the tooth, resulting in loosening from the socket.
• Discolored or darkened teeth and gums where the infected pulp prevents blood from entering inside the tooth, resulting in darkening.
• Prolonged tooth sensitivity to cold or hot foods. It can be sharp and still lingers around the tooth even when the causative has been removed. Occasional sensitivity to sweets also indicates the presence of tooth decay.

Does Root Canal Therapy Treat All Types of Teeth?

Root canal procedures can treat most of the tooth decay. Dentists perform the treatment for all types of teeth (incisors, canines, premolars, and molars). However, dentists would not recommend RCT for a fractured tooth that is left with an inadequate jawbone. Note that the affected tooth will be saved in most of the cases. However, RCT cannot save the tooth in cases of severe tooth decay. Suppose you are wondering why you should get a root canal treatment, we have briefly explained it in the upcoming section.

Should I Get Root Canal Treatment?

Root canal procedure aim to treat infection and preserve the tooth. Natural teeth cannot heal or fight an infection by themselves. The infected and inflamed pulp can probably disturb the health of surrounding tissues. The only alternative to a root canal is tooth extraction, which can have other side effects. Some cases of severe pulp infection can cause loss of a tooth or an entire jaw, dental abscesses, or sepsis.  

How Long Can You Wait for Root Canal Treatment?

The waiting period for root canal treatment varies with the severity of the infection. In most cases, it's recommended to get the RCT procedure within a week or two. The longer a patient waits, the greater the risk of complications. The infection can spread to adjacent tissues, cause abscesses, or lead to further deterioration of the tooth. Let’s first understand who performs the procedure.

Who Will Perform the Step-by-Step Procedure for Rct? 

General dentists are qualified to carry out the root canal procedures. It's worth mentioning that RCT is considered an endodontic procedure. Some dental specialists are specifically trained to treat the health of interior tooth structures or those parts that are not visible externally. Root canals and tooth pulps lie inside the tooth. In some cases, general dentists refer the root canal to endodontists. These dental specialists perform the endodontic procedure step by step and preserve the natural tooth structure.

After knowing who performs the treatment, let's find an answer to a simple question that most patients ask.

How Long Does a Root Canal Procedure Last?

The time required for rct treatment step by step ranges between 30-90 minutes with 1-2 dental appointments. The first appointment is to remove the infected root pulp, and the second one is to clean the root canal and fill it or cover it with a dental crown. We break the root canal procedure into three stages: before, during, and after the treatment. Now, let’s dive deeper into the procedure.

What Are the Steps for Root Canal Treatment? A Brief on Pre-Procedure Steps

You will see the dentist once you start experiencing symptoms like tooth pain or sensitivity. The dentist will physically examine the affected tooth and surrounding tissues, noticing visual signs of swelling, pus, or discoloration. Further, they will gently tap the tooth and check for pain or sensitivity. In case of physical damage like cracks or broken teeth, the dentist will perform diagnostic tests like X-rays to help them understand the extent of the damage.  

How Is Root Canal Treatment Done?

Dentists will follow the below-mentioned steps to perform the root canal treatment. 

• Step 1: Numbing the gums: The dentist will inject local anesthesia into the gums so that you will not feel any pain during the RCT procedure. Some patients with anxiety will require oral or IV sedation to feel relaxed during the procedure.
• Step 2: Accessing the root pulp: The dentist covers the infected tooth with a thin rubber sheet. Using a small drill, the dentist makes a cavity on the infected tooth surface, which helps them reach the root pulp.
• Step 3: Cleaning of root pulp: Dentists use tiny, specialized tools to remove the infected pulp and clean the tooth structure. They also disinfect the root canals and pulp chamber.  
• Step 4: Sealing the cavity: The dentist covers the drilled cavity and root canals using biocompatible dental material. 
• Step 5: Restoration: This step restores tooth function. Dentists place a dental adhesive or gutta-percha over the treated tooth structure to ensure complete sealing. This sealing acts as a barrier and protects the tooth interior against external bacteria. In some cases, patients with lost tooth structure are placed with a temporary filling until the permanent restorations are ready. Following this, the tooth impressions are collected for customized dental crown preparation. Once the crowns are ready, your dentist will schedule a second appointment to fix them using an adhesive.  

Note that the root canal treatment step by step dental filling procedure follows the same protocol as getting crown restorations. However, getting crowns requires an extra step of tooth reshaping, collecting impressions, and getting customized crowns. Dental crowns are either made from materials like porcelain, porcelain-fused-with-metal, or zirconia. These mimic the teeth' structure and restore the lost functions due to misshapen physical appearance. Read the article for detailed crown procedure step by step. 

What Happens After Root Canal Treatment?

After the root canal procedure, you can rest for a short period or resume work as the anesthesia wears off. Root canal recovery time is ideally less than a week. Because the dentist removes the infected pulp, the pain and discomfort prior to RCT slowly fade away. It's worth mentioning that root canal treatment does not kill the tooth or make it non-functional. While the dentists remove the nerves along with the infected pulp, the tooth remains functional as these nerves hold minimal function. However, in case your tooth has broken off or lost its structure, you will need a crown to maintain its functionality.  

Use the prescribed antibiotics to prevent infection. Some dentists recommend over-the-counter medicines like ibuprofen or topical gels to deal with discomfort. You may also rely on salt water rinsing or sleeping with your head in an elevated position to deal with discomfort. Rely on soft foods for a couple of days so that you will not apply pressure for biting or chewing. Prefer foods like hummus, applesauce, smoothies, or mashed potatoes. Care for the affected tooth like you care for the rest of the teeth. Follow basic oral hygiene, such as brushing your teeth two times a day and flossing on a regular basis. Never skip the routine dental check-ups and cleaning sessions recommended by the dentist.

Root Canal Treatment Side Effects

Root canal therapy is highly successful, provided you get it done by a good dentist and follow the right aftercare. However, every dental treatment carries a negative side. Here are a few complications associated with root canal treatment. 

• Allergic reaction: Some candidates may be allergic to the filling material, antibiotics, or the materials used for dental crowns. This causes redness and soreness in the gums.
• Sinus infection: The upper jaws and sinuses lie closely located, and in some cases, fluids in the jaw can leak into the sinuses, causing infection. Patients will experience constant headaches and congestion, with a salty tinge in the mouth.

How Often Do Root Canals Need To Be Redone?

A root canal requiring retreatment is rare. Typically, well-performed root canal treatment can last for a lifetime when the dentist clears off the infection properly and seals the cavities effectively.  Qualified dentists will perform the cleaning and infected pulp meticulously to prevent further infection. However, when performed incorrectly or with compromised oral hygiene, a root canal fails and catches reinfection. This can take several weeks, months, or, in some cases, a few years as well. Here are a few possible instances of root canal infection that require retreatment.  

• Infection: When the tooth interior is not cleaned properly, or the empty canals are not disinfected before adding the filling material. 
• Crown breaks: The dental crown might break due to physical pressure or strong bite force. 
• Failed sealant: Dentists fix the sealants or fillers over the cleaned canals to prevent food accumulation or bacteria buildup. In rare cases, the sealants develop cracks or gaps, leading to reinfection. This can happen when the patients do not follow proper aftercare and the sealant wears off.

Are you wondering how it feels to find out that you need one? Below are the symptoms of an infected root canal.

Symptoms of Failed Root Canal

A failed root canal re-launches the original symptoms of tooth decay. Your treated tooth can show any one or a combination of the following symptoms:

• Severe tooth pain or sensitivity when you bite or apply pressure.
• Small pimples on the jaw, out of which pus oozes out.
• Swelling gums associated with soreness.
• Discolored structure. 
• Facial swelling or the neck swelling. 

A root canal treatment procedure step by step is successful when performed with precision and care. With the right dentist, the process can be seamless and stress-free. At Envoy Health, we understand how dental anxiety can hold you back, which is why we’re committed to guiding you every step of the way. Whether you’re seeking care abroad or closer to home, we connect you with top-rated dentists and provide the support you need for a smooth and confident dental journey. We also believe in the power of informed decisions, and that is why we offer free second opinions to help you make the right choice for your dental health. 

Sign up with Envoy Health today and find your trusted smile partner to turn dental care into a comfortable, worry-free experience. Your smile deserves nothing less!

References 

1. Mouth Microbes: The Helpful and the Harmful
2. Microbiological Aspects of Root Canal Infections and Disinfection Strategies: An Update Review on the Current Knowledge and Challenges
3. Expert Consensus On Difficulty Assessment Of Endodontic Therapy
4. Nature’s Design Solutions In Dental Enamel: Uniting High Strength And Extreme Damage Resistance