If your dentist has just let you know that you need a root canal, you may be feeling a little nervous. That’s totally understandable, my friend. I’ve been there! If you are wondering, “What is a root canal, anyway?” I’m here to answer your question, and let you know what to expect, so that you can feel confident and informed going into the procedure.
Let’s Start with a Tour of Your Tooth
When you smile, the part of your teeth that you’re seeing is called the crown. Under the surface of your gums is a part of your tooth called the root. 
All of the exterior surfaces of your teeth are designed to protect the more delicate inside. Underneath the hard enamel and softer dentin layers is the pulp chamber, which leads into the root canals. This is where all the nerves and blood vessels live inside your teeth.
When bacteria sneaks inside the pulp chamber or roots, it can cause an infection. Sometimes, these infections are painful, and sometimes you have no idea they’re even happening. But bacteria are microscopic, so they’re able to slip inside through vulnerabilities in your tooth, like cracks or cavities. You can also get an infection after hurting your tooth, like getting hit in the mouth.
If your dentist lets you know there’s an infection inside your pulp chamber, don’t delay getting it treated. While the pain might go away as your body fights off the initial infection, you’ll still need treatment. The good news is that a root canal is a natural, safe, and nearly painless way of restoring your mouth to health, all while saving your natural tooth and potentially even regrowing your bone.
Just What Is a Root Canal?
Root canals are actually a form of biohacking. They allow you to naturally change the microbiome of your tooth in a way that helps your overall health. By removing the infected pulp and replacing it, your root canal is a natural, safe, and easy way to save a tooth that would otherwise need to be pulled (otherwise known as an extraction).
On the high level, here’s what a root canal is: Your provider will create a small hole in your tooth so they can access the pulp chamber inside. From there, they will clean out the bad bacteria, fill the tooth up so it should not have another infection, and then seal it to give your tooth protection.
Step-by-step, here’s what you can expect from your procedure:
1. Your provider will bring you in for an examination or consultation. At my office, I like to call these appointments an “orientation,” because I need to get oriented to you, your symptoms, and your tooth’s anatomy. Did you know that no two teeth on the planet are the same? Your dentist may refer you to an endodontist, otherwise known as a root canal specialist, for treatment.
During your initial consultation, your provider will ask you questions about your health and tooth, and they will take x-rays and sometimes 3-D images called cone beam images, so they can see your tooth from every angle. Most likely, unless you are in a lot of pain, they will schedule you to come back for your treatment on another date. This gives you time to digest the information, and get answers to any questions you may have before the procedure.
2. When you arrive for your treatment, the first thing the doctor will do is use local anesthesia to make sure you are numb. This will help make sure you’re comfortable for the procedure. If you’re experiencing pain, this will already make you start to feel better! If you’re feeling pain during your root canal procedure even after anesthesia, don’t hesitate to let your doctor know. They will usually use a little more anesthesia to ensure your comfort (and chances are you won’t even feel the injection the next time around)! Always let your provider know if you are uncomfortable.
3. Next up is the rubber dam. This is a large, thin piece of rubber that will have a hole cut in it for your tooth. This protects you and your provider from any bacteria that may be present during your procedure. For example, it helps keep the bad bacteria in your infected tooth from going into the rest of your mouth, and it also prevents any disinfectants used from entering your throat. Most importantly, it keeps saliva (which is full of bacteria) out of the tooth while we are disinfecting it. Rubber dams make safe, clean root canals possible! You will be able to breathe normally through your nose during the procedure.
4. Now, your provider is ready to enter the tooth to begin the procedure. This part of the process is called “access.” They will make a little opening in your tooth so their instruments and disinfectant can get inside. You should not feel any pain or anything sharp from the procedure, just some vibrations. Remember, say something if you are uncomfortable!
5. Next, your doctor will go on a treasure hunt. Their mission is to find every single canal and get to the end of every single canal. This is trickier than it sounds, because some canals are microscopic and can be tough to find. Fortunately, modern day endodontic technology is a huge help, between high-tech imaging, magnification, rotary files, and irrigation.
6. Once your doctor has found all of the canals, they will clean and shape each canal, all the way from the top to the bottom. They will brush and rinse the walls. This is how we dentists make sure that the bad bacteria is gone, so your infection can heal up on its own.
7. Next, your endodontist or dentist will dry the canals. That way, they’ll be ready to fill them. In the meantime, they’ll take some more imaging, to make sure everything is going well, that our filling material is set to the right length, and that there aren’t any final canals that were missed during the previous steps.
8. After your canals dry, your provider will fill the canals to prevent future infection in a process known as “obturation.” This creates a “seal” in the canal to keep further bacterial penetration from happening.
9. Your provider will put on a temporary restoration to protect your freshly-filled canals.
10. The last step of your procedure will be to get a permanent restoration (like a crown) on your tooth, to keep it safe from future infections within a few weeks of treatment. This is extremely important, and even though it may require an additional appointment, don’t skip it! The reason you may have to wait a few weeks is that your provider may want to make sure everything is healing properly before a permanent crown is placed. 11. Your provider will ask you to return for a follow-up appointment months or even a year later to check on the progress of your tooth’s healing. Remarkably, your doctor should be able to see that the bone that was lost due to the infection is growing back. Our bodies are truly amazing!
What Is a Root Canal? A Safe, Effective Procedure to Save Your Tooth
When you might otherwise lose a tooth due to extraction, a root canal can often help you restore your natural tooth to health. This is important for maintaining your smile, bite, and bone. Mother Nature gave us our teeth for a reason, and a root canal gives your teeth a chance, whereas extractions are a one-way street.
Modern technology and science has made root canals a routine, safe, and effective procedure. Endodontists like me perform dozens every single week, making us experts in the procedure. We are pros at diagnosing your pain and providing treatments that work and keep you safe.
If you’d like to be a better-informed and more empowered patient regarding your oral health, I think that’s a kickass goal! That’s why I create resources for patients just like you, to make sure you can feel confident asking your dentist questions, saying yes to the right treatment plans, and taking your health into your own hands.
– Sonia