Root canal treatment comes under the branch of restorative dentistry called endodontics. It is a treatment option for badly decayed teeth which cannot be restored by a simple filling. Root canal treatment is an alternative option for extraction. It involves the removal of the pulp and infection and filling the canal with an inert filling material.

When caries in a tooth spreads deep and infects the pulp, the tooth has to be extracted or endodontically treated, because the infection in the pulp has to be removed or else it will progress further.

The pulp chamber is that part of the tooth, which contains nerves, connective tissue and blood vessels. It is the vital structure in teeth, through which it receives nutrition and is present at the centre of teeth.

If a badly decayed tooth is not endodontically restored it eventually  leads to need for extraction as the bacterial infection in the pulp may spread causing an abscess and bone loss around the root tip. The infection can prove fatal if it spreads to the face and neck region
Why has my pulp been infected?
It may happen due to many reasons:

• Undetected tooth decay that involves the pulp
• Large fillings
• Secondary caries under a filling involving the pulp
• Trauma during blows or accidents
• Spread of infection from periodontal pockets to the pulp

RCT procedure

• The first step is to take an x-ray of the symptomatic tooth and assess the problem.
• A local anesthetic is given to numb the area and tooth to avoid any pain.
• A rubber dam is used to isolate the tooth.
• Using a drill an access cavity is prepared into the pulp chamber and the remnant Pulpal debris and tissues are removed, cleaned and disinfected.
• If the root canal treatment is planned in multiple visits then the chamber if filled with a disinfectant filling and sealed and the patient is sent home.
• At the next visit the pulp chamber is filled with an inert material usually gutta-percha along with zinc oxide eugenol acting as a sealer, provided the tooth remains asymptomatic on that visit.
• A permanent filling is then used to fill up the access cavity and a crown should be provided over the tooth as a tooth with a root canal restoration becomes brittle with time.
• If in case of multiple visits, the patient is advised to minimize chewing on the affected tooth till the endodontic treatment is completed. This will reduce risk of fracture or recontamination to the tooth.

Failed root canals

• Some teeth may present with an extra canal which may be missed by the dentist, thus failure to remove the pulp from this canal leads to failure.
• Irregularly shaped canals make cleaning and shaping difficult.
• Any infected pulp left behind leads to failure.
• Any allergies to the filling materials used in the root canal therapy may lead to failure in the procedure.
• Any inadequacies in the restoration may lead to leaching in of bacteria in to the tooth causing reinfection.
• Broken instruments left in the canal are difficult to retrieve and leads to failure in the treatment.