It is important to have some knowledge of the anatomy of a tooth in order to understand endodontic treatment. The tooth is made up of an outer layer of white enamel and a hard layer of dentin. Under these two layers is the pulp. The pulp is a soft tissue and is made up of nerves, connective tissue, and blood vessels. During development of the tooth, the pulp creates the hard tissue that surrounds it.
The pulp is very important during the growth and development of the tooth, but is not really needed to sustain a fully mature tooth. The pulp starts at the crown of the tooth and continues to the roots tips, connecting the tissues around the root.
Root canal Therapy is needed when this pulp becomes damaged or diseased from a very deep cavity, a fracture in the crown, a deep filling, the placement of a porcelain or gold crown or from trauma. Unlike other tissues in the body the pulp is often unable to heal once damaged and will eventually deteriorate. While some patients will not experience any discomfort as the pulp begins to deteriorate many will experience cold or hot sensitivity and discomfort to biting. After the pulp completely degenerates bacteria will begin to inhabit the space that the pulp used to occupy. This bacteria then begins to drain out of the tooth causing loss of bone, abscess, pain and swelling.
To prevent or reverse these symptoms and to remove the infection, root canal therapy is needed. The process of a root canal is as follows. First the tooth and surrounding tissues are made profoundly numb. A small hole is then created to gain access to the root canal spaces. The diseased infected tissue is then removed with endodontic files and the entire root canal system is thoroughly irrigated and cleaned. Next a root canal filling material known as gutta percha is melted into the tooth to prevent bacteria from re-entering the tooth. Following root canal treatment a new filling and crown are usually necessary to prevent re-infection and fracture of the tooth.