What is a Root Canal? Put simply, a root canal is a treatment that is used to prevent or resolve infection of the jaws caused by a necrotic (“dead”) tooth. So, what’s a dead / necrotic tooth?

The formative tissue of a tooth is the dental pulp. It is composed of specialized cells that make tooth structure and it contains blood vessels and nerves to maintain these cells. As the tooth develops the amount hard tooth structure increases and the size of this tissue diminishes. Even in a very mature adult tooth, a small portion of dental pulp remains vital in the middle of the crown and roots of each tooth. It’s job of building the tooth is essentially done but it continues very slowly to make additional tooth structure.

It is this tissue that senses the cold when you bite into your favorite ice cream. Like all tissues, it is at risk of injury. Common culprits for injuring a dental pulp are decay, trauma, and cracks. Many insults to the pulp are minor and result only in minimal pulpal inflammation. An example of this is the short term mild sensitivity that often occurs following a new filling. A more severe injury to the pulp may result in inflammation it cannot survive. The pulp tissue becomes necrotic (dies) and the tooth becomes a “dead” tooth. This process of an injured/inflamed pulp turning into a necrotic pulp can to a variable degree, be uncomfortable.

Does it matter if the tooth is dead? It is already fully formed and it looks and can function as it did before it died. There’s just no feedback about your ice cream. Unfortunately, this newly necrotic tissue and space it occupied typically become immediately infected. The infection inside your tooth causes inflammation and infection of the surrounding bone which then results in bite sensitivity. As the infection spreads, there may even be swelling of the gums and face. Acute infections of the head and neck can have serious ramifications.

What to do? The infected tooth could be extracted which allows the adjacent bone and soft tissue infection to resolve. Or, often, we can maintain the tooth and just remove the dead and infected tissue from inside the tooth. This too results in resolution of the surrounding infection while allowing the tooth to return to normal function. The procedure of removing the infected tissue from the inside of a tooth then sealing that space to prevent reinfection of the tooth is commonly (and rather inappropriately) called “having a root canal done”.

A ‘root canal” is a technical, often time-consuming procedure that is as much art as it is science. It is also a procedure that is generally very easily tolerated and typically feels similar to having a standard filling done. Most patients are comfortable and able to go directly back to their daily activities. Except in Seattle when the sun is shining, then, we often jest a recommendation of taking the rest of day off!


This blog is intended to provide very general background information on a variety of dental and endodontic topics. It is not intended to be scientifically or clinically precise and should not be used as advice related to any particular situation.