What Is a Root Canal?

When many dental issues arise, endodontic treatment is required. This term refers to all procedures related to cleaning and sealing the tooth’s root canals. The ASTHETE dental clinic offers professional services for root canal treatment. A solid practical experience and high qualifications of the doctors allow them to address cases of any complexity.

What is a Root Canal?

The roots of teeth contain elongated spaces, which are known as root canals. They are filled with pulp – a soft, fibrous tissue. The pulp contains nerve endings, blood vessels, and lymphatic vessels.

The number of canals in a root can vary, from one to four, and they can branch out. Typically, these are very narrow and twisted spaces, which makes their treatment particularly challenging.

In modern dentistry, endodontic procedures are usually performed using a microscope. High magnification allows the dentist to observe each part of the canal in great detail, ensuring that nothing important is missed.

At the tip of the root, there is one or more apical openings. Through these openings, nerves and blood vessels pass, connecting the pulp to the periodontal tissues surrounding the tooth.

Types of Root Canals

The canal systems inside tooth roots vary in structure. Therefore, dentists distinguish nine types of such spaces:

• Type I – typical for central incisors. Usually, this is one canal starting at the bottom of the pulp chamber and continuing to the root tip, with one apical opening at the tip.
• Type II – commonly found in the roots of upper premolars and lower incisors. This involves two canals that merge at the root tip, with one apical opening.
• Type III – typically seen in lateral teeth. One canal divides, but as it nears the root tip, the independent passages merge again, ending in one apical opening.
• Type IV – often found in premolars, lower molars, and incisors. Two separate canals end with two apical openings.
• Type V – occurs in lower premolars. One canal turns into two independent passages.
• Type VI – two canals in the middle of the tooth merge but then split again. At the root tip, there are two apical openings. Dentists often consider this configuration one of the most complex for treatment.
• Type VII – a complex variety seen in lower jaw lateral teeth. One canal narrows, then splits into two independent passages, which later merge but branch out at the root tip, with two apical openings.
• Type VIII – rarely observed in various tooth units. It is characterized by three independent canals.
• Type IX – sometimes seen in third molars. Three independent canals merge near the root tip and exit through a single apical opening.

Why Do Problems with Root Canals Occur?

The cavities inside tooth roots are filled with soft pulp. Hard layers of enamel and dentin protect it from infection. However, if harmful microorganisms penetrate inside, inflammation called pulpitis begins. This can occur in the following cases:

• Cavities – the most common cause of pulp inflammation. Due to poor oral hygiene, excessive consumption of sugary foods and drinks, and other reasons, bacterial waste products erode enamel and dentin. The pulp becomes unprotected and susceptible to infection that enters the tooth.
• Periodontal diseases. Gum and bone diseases may allow infection to enter the tooth through the apical openings at the root tips.
• Dental trauma. Chips and cracks from impacts or other mechanical forces increase the risk of cavities or allow microorganisms to directly penetrate the root canals.
• Repeat dental treatments. Medical interventions can irritate and cause subsequent inflammation of the pulp. This may occur with multiple treatments, especially if the dentist lacks experience or does not follow the treatment protocol.

When Should You Treat Root Canals?

Endodontic treatment is a comprehensive set of procedures. The dentist cleans the canals of infected, inflamed pulp, enlarges them, further treats them with special medications to eliminate the infection, and then seals the canals with filling material.

Indications for such treatment:

• Pulpitis – inflammation of the pulp, usually caused by bacterial infection. The canals are treated when the pulpitis is irreversible, meaning that the affected tissue can no longer be healed.
• Pulp necrosis – the death of the soft inner tissue, which occurs when a patient fails to seek medical help in time, preventing successful treatment.
• Periodontitis – an inflammation of the ligaments around the root tip. Periodontitis is typically caused by infection spreading through the root canals or mechanical trauma.
• Cyst – a fluid-filled capsule that forms near the root tip. It can be the result of poor root canal treatment or a complication of periodontitis.
• Dental crowns and bridges – even if the tooth is healthy, there may be a need to seal its canals to serve as a stable support.
• Dental injuries and fractures, leading to infection entering the pulp.

In these cases, a thorough diagnosis is necessary. A tooth with sealed canals stops receiving nutrients, and its condition will gradually deteriorate. Therefore, endodontic treatment is performed only when there are serious medical indications.

Symptoms indicating problems with root canals:

• Severe tooth pain – it may be aching, pulsating, and become worse when chewing or pressing on the tooth;
• Increased sensitivity or discomfort triggered by cold or hot stimuli;
• Color change of the tooth, darkening of the enamel;
• Swelling and redness of the gums around the affected tooth;
• Formation of an abscess on the gums – small pus-filled sacs often appear during inflammation.

How is Root Canal Treatment Performed?

Treatment is carried out after a diagnosis. A regular examination is not enough, so dentists use radiographs or CT scans. These images allow for a detailed study of the root system, the number of canals in the tooth, and their type.

After diagnosis, the dentist determines the treatment strategy. The further steps generally follow this protocol:

1. Anesthesia – since the pulp contains nerve endings, effective anesthesia is essential. In the past, dentists used arsenic or similar substances to eliminate the nerve. This added extra strain on the body, and required another clinic visit. Modern dentistry uses more effective and safer methods.
2. Isolation of the tooth with a latex dam – this prevents saliva from entering the working area and keeps small tooth fragments out of the mouth.
3. Accessing the tooth cavity. The dentist uses a drill to create easy access to the root canals.
4. Cleaning and enlarging the canals. At this stage, the dentist may use a microscope to control the procedure. The pulp and dentin are removed from the root cavities, and the canals are shaped appropriately for sealing.
5. Flushing the canals. The dentist injects a solution into the cavities with a syringe, which kills microorganisms, washes away infected tissues, and removes small dentin chips left after mechanical treatment.
6. Filling – the final step. The dentist inserts a gutta-percha point into the canal and seals it with filling material. Depending on the clinical situation, a temporary or permanent filling may be placed afterward.

Full endodontic treatment is typically completed in at least two sessions. However, the exact number of visits and the duration of the procedures depend on the complexity of the issue and the patient's individual characteristics.

How to Care for a Tooth After Root Canal Treatment

The dentist aims to save the tooth, and endodontic treatment helps achieve this. Even if the tooth no longer receives nutrients, it remains strong for a long time, retains its chewing function, and plays a vital role in maintaining the jaw structure.

For a few days after the procedure, the tooth may ache slightly and be more sensitive to temperature and other irritants. These are normal residual sensations that gradually subside.

Initially, avoid chewing hard food on the treated side. It is also important to take prescribed medications, such as antibiotics, anti-inflammatory drugs, or painkillers.

Regularly brush your teeth using the right toothbrush and toothpaste. Dental floss can be a helpful addition to daily hygiene.

Visit the dentist for a preventive check-up about once every six months. Also, seek medical advice promptly if any symptoms arise that may indicate dental or gum issues.

Possible Complications

A side effect of treatment can be tooth darkening, as it no longer receives nutrients. A crown or veneer can be placed to solve this issue. The ASTHETE dental clinic installs veneers using the Magicneers technology, which does not require preliminary tooth shaping.

A recurring infection may develop if the canal is not sealed tightly. Therefore, dentists use X-rays not only for diagnosis but also to check the quality of the sealing. The canal must be fully filled with filling material, without gaps or excess outside the canal.

A rare complication, occurring in exceptional cases, is root perforation. This may happen when the dentist works with extremely narrow or complicatedly shaped canals.

How Long Does Recovery Take After Canal Treatment?

The dentist will provide recommendations to follow. Typically, the recovery process includes:

• no eating for 2 hours after the treatment;
• limiting chewing on the treated tooth;
• taking painkillers as prescribed by the dentist if pain occurs.

Swelling and discomfort are individual reactions. Some people may not experience any symptoms, while others may feel discomfort that gradually disappears. Pain usually goes away within 1-3 days, and discomfort may last up to two weeks.

If the pain does not subside or intensifies, if swelling does not decrease, or if there is a fever, you should seek medical help as soon as possible.

The ASTHETE Dental Clinic is located in Dubai (UAE), Bluewaters Island. We invite adults and children who need root canal treatment. Our experienced doctors will conduct a preliminary diagnosis, develop a treatment strategy, and perform necessary procedures to solve the problem successfully.

Frequently Asked Questions

Does root canal treatment hurt?

Endodontic treatment is always performed under local anesthesia, so the patient will not feel pain. General anesthesia or sedation – a harmless sleep induced by safe medications – can also be used if necessary.