The Cure, Not the Cause: Root Canals Explained

A root canal does not cause tooth pain. Infection does. When bacteria reach the soft pulp inside a tooth, the result is often a severe, lingering toothache, and root canal therapy is the treatment that removes the cause of that pain, clears the infection from inside the tooth and lets you keep the tooth instead of losing it. That is why a root canal is best thought of as the cure, not the cause.

This guide from the Timonium office of Dr. Steven W. Haywood, DDS explains what a root canal actually is, how a tooth gets to the point of needing one, the signs to watch for, what happens if an infected tooth is left untreated, and how root canal therapy compares with removing the tooth. For the service overview, see root canals in Timonium.

Where the bad reputation comes from

Root canals have a reputation that makes many people uneasy just hearing the words. Part of the reason is timing. People usually need a root canal when a tooth is already badly infected, so the pain they remember is often the pain of the infection that came before treatment. The treatment and the toothache get linked together in memory, even though the treatment is what brought relief.

Stories passed from friend to friend add to it, and so does a general dread of anything that sounds like surgery. Understanding what the procedure does is the best way to see it for what it is.

What a root canal actually is

Every tooth has a pulp chamber at its center, filled with soft connective tissue. Root canals are the tiny passages inside the roots that lead up to that chamber, and nerves run through them. When decay, a crack or an injury lets bacteria reach the pulp, the tissue becomes infected, and that infection can cause serious pain.

Root canal therapy is the procedure used to save a tooth with that level of infection. Infection is removed from inside the tooth to stop it spreading, and the tooth is then protected with a porcelain crown. The name refers to those canals inside the root, not to anything done to the gum or jaw.

How a tooth gets to the point of needing one

A tooth usually needs a root canal because something has let bacteria in. Common reasons include:

• Deep decay that has worked its way through the outer layers of the tooth toward the pulp
• A cracked or chipped tooth that opens a path for bacteria
• An injury to the mouth, which can damage the nerve even when the tooth looks intact
• A tooth that has had repeated dental work over the years

Regular checkups, good daily brushing and flossing, and a mouthguard for contact sports all help reduce the chances of a tooth reaching that point.

Signs you might need a root canal

Patients who need a root canal often have a chronic, severe toothache. Other signs that a tooth deserves a prompt look include:

• Pain that comes and goes when you chew, or throbs constantly
• Swelling in the gum near a tooth, or in the jaw or face
• Lingering sensitivity to hot or cold after the source is gone
• A tooth that has darkened compared with its neighbors
• A small bump on the gum, or a bad taste around one tooth

Not every infected tooth hurts. An abscess can be visible on an X-ray before it causes any pain, which is why an exam and digital X-rays matter. Equally, not every sensitive tooth needs a root canal; sensitivity has many causes. Read sensitive teeth: causes and treatment to learn more, and let an exam tell you what is really going on.

What happens if an infected tooth is not treated

An infection inside a tooth does not usually resolve on its own. Left alone, it can spread to your other teeth or to your bloodstream, where it can cause serious health problems. Bacteria from a dental abscess can spread through the jaw and cause swelling, which can become life threatening. If your face is swelling, call the office right away, and if swelling affects your breathing or swallowing, go to the emergency room. Read more in oral infection signs, causes and when to call.

Root canal or tooth extraction?

Before root canal therapy was available, an infected pulp meant the tooth had to be extracted. Today a root canal lets you keep your natural tooth even after a serious infection and preserves your remaining tooth structure.

Extraction is still an option when a tooth cannot be saved, and all available options are discussed before an extraction is recommended. If a tooth does need to come out, Dr. Haywood talks with you afterward about ways to fill the gap, such as a dental implant, a bridge or dentures. See tooth extractions in Timonium.

Root canal therapy in Timonium

At the practice, treatment follows three broad stages:

1. Find the source of the pain. Dr. Haywood examines the tooth, and digital X-rays help reveal infection, which does not always hurt right away.
2. Clear out the infection. The tooth is numbed and may be isolated with a rubber dam. Infection is removed from inside the tooth. Depending on how severe it is, treatment can take two or more appointments, with a temporary filling in between.
3. Protect the tooth with a crown. Once treatment is complete, the tooth is capped with a porcelain crown.

For a detailed, step-by-step account of the appointments and recovery, read calming root canal fears: what to expect.

Why every root canal is finished with a crown

A tooth is fragile after root canal treatment. A porcelain crown protects it from breaking and helps keep it from being re-infected or damaged. Until the permanent crown is placed, avoid sticky and hard foods and do not chew on that side. Learn more about dental crowns.

A holistic perspective on root canals

Dr. Haywood also practices holistic dentistry, choosing materials and treatments with your whole body in mind. For patients who already have root canals, cone beam CT scanning gives a full three-dimensional view of the teeth and jaw, so existing root canals can be assessed in far more detail than a flat X-ray shows, and options can be weighed with your overall health in mind. Learn more about holistic dentistry at the practice.

Paying for root canal therapy

The practice is out of network with all dental insurance companies. You pay at the time of your visit, and the office files the claim on your behalf so your plan can reimburse you for what it covers. Health savings and flex plans are welcome. Financing is available through CareCredit, with no-interest options for up to 12 months, and Cherry, with payment plans from 3 to 24 months. See financing options.

Frequently asked questions

Will a root canal relieve my toothache?

Treatment removes the cause of the pain and relieves infection symptoms. Some discomfort for several days afterward is normal, especially when chewing.

Can a tooth infection go away on its own?

It is not something to wait out. An infection can spread to other teeth or the bloodstream, and an abscess does not always hurt even while it remains. Have the tooth examined.

How many visits does a root canal take?

Root canal therapy often takes two or more appointments, depending on how severe the infection is, with a temporary filling or crown protecting the tooth between visits.

Is it better to just pull the tooth?

A root canal lets you keep your natural tooth and its remaining structure. Extraction is an option when a tooth cannot be saved, and your options are discussed before anything is recommended.

Get tooth pain checked in Timonium

If a tooth is aching, swollen or sensitive, do not wait for it to get worse. Request an appointment or call (410) 453-9399, as early in the day as you can if you are in serious pain. The office of Dr. Steven W. Haywood, DDS is at 108 W Timonium Rd, Ste 200, Timonium, MD 21093, serving Timonium, Towson, Pikesville and Baltimore. For urgent problems, see emergency dental care.