The thought of root canal causes pain in some individuals. While it is one of the most common treatments, many people tend to avoid it because of the discomfort and pain. 

Interestingly, not many people know what exactly happens in the root canal. Also, some people believe that a root canal is the “only” treatment for cracked or infected tooth.

Well, that’s not the case because alternatives to root canal exist. In this post, we will explore the root canal treatment, when it becomes necessary, and the alternatives to this procedure. 

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What Is A Root Canal?

A root canal is a cavity or hollow section of your tooth which contains blood vessels, the nerve tissue, and cells – the pulp. A crown and roots constitute a human tooth. The crown is above the gum, and the roots are below. The latter helps attach your tooth to the jawbone.

The pulp that lies inside the root canal helps in tooth nourishment. It also moisturizes the surrounding area. The presence of a tooth nerve does not affect the health or functioning of a tooth. Once the tooth cuts through the gums, the nerve tooth performs sensory functions. It provides the sensation of hot or cold temperatures.

Why Root Canals Might Be Necessary

Before delving into the details of the root canal treatment, you have to understand when and why you need a procedure? Damaged, inflamed, or irritated nerve tissues and pulp are the main reasons for root canal treatment. Repeated dental procedures and large fillings also damage the pulp.

Cracked tooth and deep cavities allow bacteria to enter the nerve tissues or pulp. As the bacteria thrive in the pulp chamber, it causes an infection or abscess. 

Abscess –a pus-filled pocket – forms at the end of your tooth roots when the infection advances. Besides an abscess, the infection may lead to other problems, including

The weakening of the bone, leading to bone loss around the root’s tip. 

Swelling in the tooth ligaments causing tooth loosening 

Swelling spreading to the face area, neck, or head

Increased sensitivity

Throbbing pain when chewing

Root canal infection may extend outward from the root. It causes a hole to develop through the tooth side, draining into gums or through your cheeks with drainage into your skin. 

Symptoms of a Cracked Tooth

A cracked tooth, gum diseases, and traumatic injury cause serious damage to the root canal. When a crack in the tooth extends from the chewing surface towards the root of your tooth, root canal treatment becomes necessary. 

While cracked tooth does not always show symptoms, some of the common signs or warnings include sensitivity to extreme temperatures, swelling, and pain around the affected tooth. You may also experience pain when chewing or biting food. The pain is rarely continuous as it comes and goes. 

What Is Root Canal Treatment?

If the damaged pulp is left untreated, it leads to the formation of infection and abscesses around the affected tooth. Root canal treatment also referred to as endodontic therapy, is performed to control the damage and save an infected tooth. An endodontist performs the process. 

Who is an Endodontist?

Endodontists are dentists who have expertise in diagnosis, treatment, and prevention of dental pulp or nerve tissues. They specialize in treating root canals infected by diseases, tooth decay, trauma to the face, and repeated procedures. 

The Procedure

The procedure involves three stages, cleaning, filling, and then sealing the root canal. However, even before the procedure, the endodontist first takes an X-ray to determine the shape of the root canal. The X-ray also helps them to find any signs of infection in the bone surrounding the tooth. 

Cleaning of the Root Canal

Root canal treatment is performed under strong local anesthesia. Endodontists numb the affected area to prevent the patient from pain and discomfort. 

The dentist then installs a rubber dam around the tooth to keep the area dry and saliva-free during the process. 

The next step is to drill an access hole into the tooth. The endodontist removes the damaged pulp, the nerve tissue, bacteria, and other debris from the tooth. For the cleaning purpose, the dentists use small root canal files. 

The dentist places a series of files subsequently in the hollow space.

These files work down the full length of the tooth and scrape and scrub the sides of the affected root canal. 

Filling of the Root Canal

Next, the endodontist uses water or an irrigation solution, such as sodium hypochlorite, to flush away the bacteria and other debris.

After a thorough cleaning, the dentist fills the interior of the tooth with a rubber-like material called gutta percha.

For the exterior hole created for the procedure in the beginning, a filling is placed. 

Sealing of the Root Canal

Depending on the condition, the endodontist may either seal the root canal the same day or wait for a week. For instance, in case of an infection, the dentist may put a medication inside the treated tooth. 

The tooth is sealing with an adhesive cement or sealant. 

After a root canal, the tooth is more fragile. In the absence of the pulp, the ligaments provide nourishment to the tooth. While the supply is adequate, it makes the tooth more brittle. So, a crown or filling is used to restore the teeth. 

When Root Canal Is an Unnecessary Procedure

A root canal treatment is not always the only option for a cracked tooth, decay, or pulp damage. In fact, 75% of the root canal procedures are unnecessary. First, for an uninfected nerve tooth with root canal therapy is overtreatment. Your endodontist may save your tooth through alternative treatments. 

Due to the canal’s shape, it is impossible to remove bacteria or clean completely and fill the canal. Since your tooth is not dead yet, the bacteria still thrive within the tooth. Anaerobic bacteria hiding in the bone may cause condensing osteitis.

The root canal destroys the neurological and arterial anatomy of the tooth. It stops the healthy blood flow, thereby preventing the immune system from killing bacteria. The toxins penetrate the bloodstream destroying the important enzymes in your body. 

Root Canal Alternatives

During a root canal, the endodontist removes and irrigates bacteria from the main chamber of the tooth. Place the tooth under a microscope, and you will see thousands of microbes surviving without oxygen. 

So, root canal therapy only masks the root cause and does not provide an effective solution. Saving your natural tooth must be the priority as it allows you to eat and chew properly. Let’s have a look at the two main alternatives to root canal treatment.

Tooth Extraction

Nothing is better than saving the natural tooth as per the American Association of Endodontists (AAE). 

However, there is no point in saving a badly damaged or infected tooth. It will only lead to other serious diseases. So, tooth extraction is one of the most popular alternatives to a root canal.


Besides infection, you may get your tooth extracted in case of a traumatic injury, or pulp damage. 

During the process, the dentist injects local anesthesia into the affected tooth to numb the area. In some cases, dentists prefer using a strong general anesthetic. This prevents the patient from excruciating pain throughout the procedure. 

For the impacted tooth, the dentist cuts away gum and bone tissue covering the tooth. He then uses forceps to grasp the tooth and gently rocks it back and forth. Once the tooth loosens from the jawbone, the dentist pulls it out. However, the hard-to-pull tooth is removed in pieces.

After the tooth extraction, a blood clot is usually formed in the socket. Don’t worry as the dentist knows how to stop the bleeding. Your doctor will put a gauze pad into the socket, asking you to bite it down. In some cases, the dentist may place a few stitches for closing the gum edges over the extraction site. The stitches dissolve on their own. 

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