Root Canal Therapy

Inside a tooth is a pulp chamber and root canal system containing nerves, blood vessels, and connective tissue. Deep decay, cracks, trauma, repeated procedures, or breakdown around a restoration can cause the dental pulp to become irreversibly inflamed, infected, or necrotic.

Root canal therapy—also called endodontic treatment—removes the affected tissue, cleans and shapes the canal system, disinfects the space, and fills and seals it. The tooth then needs a timely permanent restoration to protect the remaining structure and restore the access opening.

At Prestwicke Dental, we combine symptoms, clinical examination, pulp and bite testing, periodontal findings, diagnostic imaging, remaining tooth structure, and long-term restorability before recommending treatment. Complex anatomy, retreatment, trauma, resorption, or uncertain diagnosis may warrant referral to an endodontist.

Not every toothache or area of sensitivity needs root canal therapy. Reversible pulp irritation, cracks, high bite contacts, gum disease, sinus conditions, jaw-muscle pain, and other problems can resemble endodontic pain. Some teeth with necrotic pulp or chronic apical disease have few symptoms, so diagnosis relies on the full clinical picture rather than one symptom or X-ray alone.

During treatment, a dental dam isolates the tooth and an access opening is made through the biting surface or existing restoration. Small instruments and irrigating solutions are used to clean, shape, and disinfect the canal system before it is filled with a biocompatible material and sealed.

Some cases are completed in one visit, while others require medication inside the tooth and a second appointment. Curved or calcified canals, unusual anatomy, previously treated teeth, significant infection, resorption, fractures, or diagnostic uncertainty may require additional procedures or specialist referral.

After canal treatment, the access opening must be restored promptly. Many molars and premolars need cuspal coverage because decay, cracks, previous fillings, and the access opening can leave them vulnerable to fracture. Front teeth and teeth with more remaining structure may require a different restoration. A post may help retain a core when little structure remains, but it does not strengthen the root.

Mild biting tenderness can occur for several days as tissues around the root recover. Avoid chewing hard foods on a temporary or incompletely restored tooth. Contact the office for severe or increasing pain, visible swelling, an uneven bite, a lost temporary restoration, a medication reaction, or the return of previous symptoms.

Antibiotics are not a substitute for root canal treatment, drainage, or other definitive dental care in most localized pulpal and apical conditions. They are considered when findings such as systemic involvement, spreading infection, fever, malaise, or relevant immune compromise make them appropriate.

Seek emergency medical care for rapidly increasing facial or neck swelling, difficulty breathing, swallowing, or speaking, swelling near the eye or vision changes, or other signs of a potentially serious spreading infection. These symptoms should not wait for a routine dental visit.