Each tooth consist of two parts, the crown which is what is visible in the mouth and the root which is part of the tooth that extends into the jaw bone anchoring the tooth in position. The crown of the tooth is made of three layer, enamel, dentine and pulp (Fig 1).
The enamel and dentine protect the innermost soft tissue of the tooth called the pulp. This soft tissue includes the nerve and blood vessels which extend from the crown down to the root tip.
The pulp can get inflamed or infected with bacteria and will begin to die. This can happen due to either deep decay, deep fillings, crack or fractures to tooth structure caused by trauma, excessive tooth wear, and sometimes as a result of severe gum disease.
Signs of pulp damage may include pain, prolonged sensitivity to heat or cold, discolouration of the tooth, swelling, tenderness of the overlying gums, pus discharge in overlying gum or a bad taste in the mouth. Sometimes there are no symptoms at all. If an inflamed or infected pulp is left untreated, it will eventually result in pain, swelling and loss of supporting bone.
To treat a pulp damaged tooth the inflamed or infected pulp needs to be removed. This can be done by removing the tooth or attempting to save the tooth by removing the pulp.
In root canal treatment, the dentist removes the damaged or infected pulp and replaces it with a special filler. The tooth is sealed with a filling or crown which helps protect the rest of the tooth.
Root canal treatment should not be painful because a local anaesthetic is given, it should be no more unpleasant than having a filling. After treatment, the tooth may be sensitive or tender for a few days due to inflammation of the surrounding tissues. This discomfort can be relieved by taking painkillers available over the counter at the pharmacy. However, if the pain persists and is severe, or a swelling occurs, you should contact your dentist.
