Root Canal Therapy Explained

Root canal therapy is a common and effective treatment used to repair or preserve teeth that have damaged or infected pulp (nerve tissue, blood vessels and other cellular inside of the root canal). Root canal therapy is also known as root canal, root canal procedure, endodontic therapy, endodontic treatment, or root canal treatment.

In a root canal operation, the infected pulp is removed and the inside of the tooth is carefully cleaned and disinfected, then filled and sealed. Root canal treatments allow you to keep your natural tooth and protect it from future infections.

Diagram of a Healthy Tooth

The root canal is a hollow passageway at the center of a tooth that is inhabited by nerves, blood vessels, and other connective tissue.

Tooth anatomy
  • Enamel: A clear, very hard substance that makes up the outer shell of a tooth. Did you know that tooth enamel is considered the hardest substance in the body, even stronger than our bones?
  • Dentin: Calcified, hard substance between the enamel and the pulp.
  • Pulp chamber: Space in the center of the tooth above the gums that contains the pulp.
  • Gums (gingiva): The soft tissues that surround and provide support and hold the root of the tooth in place.
  • Root canal: Hollow passage at the center of a tooth that is inhabited by nerves, blood vessels, and other connective tissue.
  • Cementum: Hard tissue covering the root of the tooth. The cementum is thinner and more delicate than the enamel.
  • Periodontal ligament: Layer containing blood vessels and nerves that connects the cementum layer and the alveolar bones of the jaw.
  • Alveolar bone (jawbone): Part of the jaw that holds the teeth.
  • Crown: Visible top portion of the tooth.
  • Neck: Portion of the tooth between the crown and the root.
  • Root: The part of the tooth that is embedded below the gum line, inside the bone socket.

What Are the Signs that Root Canal Therapy is Needed?

  • Tooth pain. You should talk to your dentist about any pain in your mouth. However, tooth pain that is persistent, severe, or gets worse when eating, or biting down, may indicate an infection needing a root canal.
  • Sensitivity to heat and cold. Sensitivity to heat and cold, especially if the sensitivity lingers long after the hot or cold food or liquid is removed, may indicate the need for root canal therapy. This is because inflamed and infected tooth nerves become hypersensitive to cold or hot food or drink.
  • Sore / Swollen Gums. Inflamed, swollen, darkened gums or gums that are sore/tender to the touch indicate the presence of infected tooth nerves that require a root canal for relief. Also look for pimple-like spots on your gums (known as fistula) – they are also a sign of tooth infection.

How is a Root Canal Done?

Root canal therapy is a relatively straightforward tooth-saving procedure. Every year, over 15 million root canals get performed throughout the United States. Modern dental technology, training, and research has made huge leaps in making the root canal procedure effective and pain-free. A root canal procedure typically takes about 30-90 minutes. Your dentist may ask you to schedule more than one appointment if you need multiple root canals.

Major steps of a Root Canal Procedure:

  • Your dentist or endodontist uses local anesthesia to numb the area surrounding the tooth, then uses a specially designed drill to create a small opening through the crown of the tooth into the pulp chamber. A dental rubber dam is used over the area to protect it from bacteria and saliva during the procedure.
  • Small files are used to carefully remove dead/infected tissue from the pulp chamber and root canal, and shape the inner chamber.
  • A variety of solutions that may include antimicrobial medication is used to disinfect, wash away any remaining pulp, and eliminate any remaining bacteria from the area.
  • If the tooth lacks sufficient strength to hold the restoration in place, your dentist or endodontist may place a small rod inside the tooth to add structural strength.
  • A sealant made of biocompatible material – usually a rubber-like substance called gutta-percha – is used to fill the root canal and pulp chamber to prevent bacteria from re-entering. An adhesive cement is also used to ensure complete sealing.
  • A temporary filling is used to protect the tooth until a permanent filling or crown is placed.
Teeth Chart

Root Canal Therapy Myths, Facts, and Statistics

  • According to the American Association of Endodontists (AEE), 25 million root canals are performed every year (or an average of 41,000 each day).
  • Per the National Center for Biotechnology Information (NCBI), 97 percent of the root canal procedures endodontists perform are successful, and 85 percent of root canals last for a lifespan with proper home care and regular dental exams and cleanings. Source.
  • Myth – root canals are very painful: false. While that may have been true decades ago, with modern technology and anesthetics, aside from some minor discomfort, you shouldn’t experience any pain at all. If you are still feeling anxious about the procedure, you can ask your dentist for a sedative to help you relax.
  • Myth – a root canal kills the tooth: false. A root canal cleans and disinfects the inside of the tooth, allowing it to heal.
  • Myth – root canals require multiple visits: false. A root canal typically is done in a single visit and lasts between 30 to 90 minutes.

Does Dental Insurance Cover Root Canals?

Many dental insurance plans pay a portion (such as 50%) after your deductible for major or complex restorative treatments including root canals. Our practice will work with you and your insurers to maximize your benefits and coverage and minimize your out-of-pocket costs. We also partner with CareCredit, a healthcare financing program.

Schedule an Appointment

For more information about root canal treatment options, please call our practice at 703-454-5656 or 855-DIVADENT (855-3482-3368) or use our Appointment Request Form. Dr. Joon Coe (prosthodontist and endodontist), Dr. Julie Coe, and the rest of the DIVA team look forward to helping you achieve the highest possible dental health.


Dental Innovations of Virginia provides comprehensive dental services, and preventive dentistry for the whole family. In addition to our Lansdowne office serving the Leesburg, Lansdowne, Ashburn, Loudoun County areas, we also come to you via our DIVA Mobile Clinic service for patients living in long-term care facilities, and our DIVA Home Visit service for patients who prefer to receive treatments in the comfort of their own home.

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