Each tooth is made up of three types of tissue - the enamel, the dentin and the pulp. Endodontics is a dental specialty that focuses on the pulp, or the inner most layer of the tooth. If it becomes infected or injured, an endodontist has the specialized training to treat the pulp, and hopefully save the tooth.
The root canal is a cavity within the tooth that holds the tooth pulp and the tooth nerve. Root canal therapy, or treatment of the pulp, has commonly become known as "a root canal." A root canal is necessary when the pulp of a tooth is infected or injured. This causes the sensation of pain in the nerve. The nerve serves no vital function to the tooth once it has come through the gum, so in the case where there is an infection in the pulp, the pulp and the nerve can be removed. The tooth is then sealed to prevent bacteria from infiltrating it. After the interior of the tooth is treated, it is generally fitted with a cap to protect the tooth from future damage.
What Causes the Pulp to Get Infected/Injured in the First Place?
Some possible causes of infection or injury to the pulp are deep decay, repeated dental procedures in the same tooth, large fillings, a chip or crack in the tooth, a chip or crack in a filling in the tooth, or facial injury.
What Happens if I Don't Get a Root Canal?
When there is damage or an infection in the pulp, the tissue begins to break down and bacteria multiply. When that happens, it may lead to an abscess (or pus-filled pocket), swelling, spread of the infection, bone loss or further damage to the tooth.
Surgical Root Canal Therapy
There are a variety of reasons non-surgical root canals are not possible, or are not enough. For example, the root canals may not be accessible from the crown (top) of the tooth, previous root canals may not have healed properly, a crack in the tooth may not be visible above the gum surface, or additional treatment of the bone or root surface may be needed. In these cases, a surgical root canal is necessary. This is a procedure that requires the doctor cut into the gum and access the tooth from below the surface. It is done under local anesthesia.
Sometimes a tooth is damaged to the point that there is no hard surface of the tooth left that can be used to properly anchor a cap after endodontic treatment. In that case, and endodontist will perform a series of procedures that include cleaning out the root canal and filling it, then drilling out some of the filling material to make way for a metal post. This post will be inserted where the roots used to be, and then be used to anchor a restorative cap. This is known as a post and core procedure. or post prep.