What is root canal treatment?
Root canal therapy refers to the process by which a dentist treats the inner aspects of a tooth, specifically that area inside a tooth that is occupied by its "pulp tissue." Most people would probably refer to a tooth's pulp tissue as its "nerve." While a tooth's pulp tissue does contain nerve fibers it is also composed of arteries, veins, lymph vessels, and connective tissue. For the purposes of this discussion, so to use terminology that people seem to be most familiar with, we will use the terms "nerve" and "nerve tissue" to refer to a tooth's pulp tissue.

Where precisely in a tooth is its nerve?
Teeth are hard calcified objects but their inner aspects are not completely solid. Inside every tooth there lies a hollow space which, when a tooth is healthy, contains the tooth's nerve tissue. Dentists use the following terms to refer to various portions of this nerve area:

(a) The pulp chamber.
This is a hollow space that lies more or less in the center of the tooth.

(b) The root canals.
Each tooth's nerve enters the tooth, in general, at the very tip of its root(s). From this entry point the nerve then runs through the center of the root in small "root canals" which subsequently join up with the tooth's pulp chamber.

What is the function of a tooth's nerve tissue?
You might think that a tooth's nerve tissue is vitally important to a tooth's health and function, but in reality it's not. A tooth's nerve tissue plays an important role in the growth and development of the tooth, but once the tooth has erupted through the gums and has finished maturing the nerve's only function is sensory (it provides the tooth with the ability to feel hot and cold).

In regards to our normal day to day oral functions the sensory information provided by a single tooth is really quite minimal. Dentists realize that on a practical level it is pretty much academic whether a tooth has a live nerve in it or not. If a tooth's nerve tissue is present and healthy, wonderful. But if a tooth has had its nerve tissue removed during root canal treatment that's fine too, you will never miss it.

What is the purpose of root canal treatment?
You could say that the purpose of root canal treatment is to create an end result where the tissues that surround a tooth's root will maintain a healthy status despite the fact that the tooth's nerve has undergone degenerative changes. Specifically, we mean that the tissues surrounding a tooth's root are not affected by bacterial infection and/or irritating substances leaking from those inner aspects of the tooth originally occupied by the tooth's nerve tissue.

Possibly in more scientific terms, our bodies, as a defense mechanism, will initiate an "inflammation reaction" when irritants (such as those that might seep out of a problematic tooth) have injured or destroyed body tissues. So if we choose to incorporate the term "inflammation" into our description we would say, root canal treatment is the treatment of the inner aspects of a tooth (whose nerve has undergone degenerative changes) so to provide an environment where the tissues surrounding a tooth's root are free of, and will likely to continue to be free of, the presence of inflammation.

How does root canal treatment accomplish this goal?
In a nutshell, the process of root canal treatment first removes (as thoroughly as possible) bacteria, nerve tissue, the organic debris left over from the breakdown of nerve tissue, and bacterial toxins from within the inner aspects of a tooth (the area originally occupied by the tooth's nerve tissue). Each of these items can produce tissue irritants that can cause your body to activate an inflammation reaction.

Subsequently, once this space has been cleansed the second half of root canal treatment involves filling in and sealing up the interior of the tooth. This aspect of the treatment is an attempt to minimize the possibility that bacteria will be able to recolonize the inner aspects of the tooth or that tissue fluids can seep inside the tooth, become stagnant, and subsequently break down. (Either of these situations could produce a state of persistent inflammation in the tissues surrounding the tooth's root.) The seal also contains and encapsulates any debris that could not be fully removed during the cleaning aspect of the root canal treatment process so that it can't leak out and trigger an inflammation reaction.

How do you know when your tooth needs root canal treatment?
It will take an examination by your dentist to determine if root canal treatment is indicated for your tooth. Not only must your dentist determine if the treatment can be an appropriate solution for your situation but also that the overall condition of the tooth in question warrants the time and expense involved.

Here are some situations where root canal therapy might be the proper solution:
- A tooth is currently causing you pain or else has a history of being painful.
- You have noticed the presence of tenderness and/or swelling in your gums near a tooth.