Your tooth consists of two main parts: the crown, which is that part of the tooth above the gum and visible in your mouth; and the root or roots, which is that part of the tooth that lies beneath the gum and is surrounded by bone. Inside each root is a channel that runs the length of the tooth. This channel is the root canal and contains the pulp (nerves, blood vessels, and soft tissue), which is often referred to as the nerve of the tooth. The pulp may be irreversibly damaged by bacteria associated with decay, very deep restorations, fractures, trauma, or periodontal disease.

In order to preserve a tooth in which this has occurred, it is necessary to remove the diseased pulp tissue. This procedure is known as endodontic therapy. Since endodontic therapy is concerned with removing only the pulp from the root canal, the root will continue to function normally because the supporting tissues remain intact. It is advisable to remove the injured pulp because it may become infected or act as an irritant to the tissues surrounding the tooth.

There are many misconceptions surrounding root canal (endodontic) treatment and whether patients experience root canal pain. The American Association of Endodontists wants you to have accurate information. As always, when considering any medical procedure, you should get as much information as you can about all of your options. Your dentist or endodontistcan answer many of your questions, and if you still have concerns, it is often wise to seek a second opinion.

The perception of root canals being painful began decades ago but with modern technologies and anesthetics, root canal treatment today is no more uncomfortable than having a filling placed. In fact, a recent survey showed that patients who have experienced root canal treatment are six times more likely to describe it as painless than patients who have not had root canal treatment.

Most patients see their dentist or endodontist when they have a severe toothache. The toothache can be caused by damaged tissues in the tooth.Root canal treatmentremoves this damaged tissue from the tooth, thereby relieving the pain you feel.

The myth: Patients searching the Internet for information on root canals may find sites claiming that teeth receiving root canal (endodontic) treatment contribute to the occurrence of illness and disease in the body. This false claim is based on long-debunked and poorly designed research performed nearly a century ago by Dr. Weston A. Price, at a time before medicine understood the causes of many diseases.

In the 1920s, Dr. Price advocated tooth extractionthe most traumatic dental procedureover endodontic treatment. This resulted in a frightening era of tooth extraction both for treatment of systemic disease and as a prophylactic measure against future illness.

The truth: There is no valid, scientific evidence linking root canal-treated teeth and disease elsewhere in the body.A root canal is a safe and effective procedure. When a severe infection in a tooth requiresendodontic treatment, that treatment is designed toeliminatebacteria from the infected root canal,preventreinfection of the tooth andsavethe natural tooth.

But what about Dr. Price?This is a good example of how the Internet can give new life to long-dispelled theories. Believe it or not, the misinformation about roots canals that is found on the Internet is still based on Dr. Prices century-old, discredited research. Dr. Prices research techniques were criticized at the time they were published, and by the early 1930s, a number of well-designed studies using more modern research techniques discredited his findings. In 1951, theJournal of the American Dental Associationtook the extraordinary step of publishing a special edition reviewing the scientific literature and shifted the standard of practice back to endodontic treatment for teeth with non-vital pulp in instances where the tooth could be saved. TheJADAreviewed Dr. Prices research techniques from the 1920s and noted that they lacked many aspects of modern scientific research, including absence of proper control groups and induction of excessive doses of bacteria.

Nothing can completely replace your natural tooth. An artificial tooth can sometimes cause you to avoid certain foods. Keeping your own teeth is important so that you can continue to enjoy the wide variety of foods necessary to maintain the proper nutrient balance in your diet. If your dentist recommends extraction, ask whetherroot canal treatmentis an option.

Endodontic treatment, along with appropriate restoration, is a cost-effective way to treat teeth with damaged pulp and is usually less expensive than extraction and placement of a bridge or an implant.

Millions of healthy endodontically treated teeth serve patients all over the world, years and years after treatment. Those healthy teeth are helping patients chew efficiently, maintain the natural appearance of their smiles and enhance their enjoyment of life. Through endodontic treatment, endodontists and dentists worldwide enable patients to keep their natural teeth for a lifetime.

Dr. Thomas Waldron received his D.D.S. degree at the University of Minnesota School of Dentistry in 1995. He continued graduate work there as a Dentist-Scientist Fellow during which time he completed post-graduate specialty training and earned his Certificate in Endodontics in 2000. Prior to dentistry, he was a mechanical engineer for three years after graduating from the University of Minnesota Institute of Technology. He and his family live in Inver Grove Heights.