Root canal treatment (Endodontic therapy)| Types and steps

Root canal treatment

Some people are afraid of visiting the dentist, especially if they find out that they require root canal treatment.

Toothache is one of the most acute pains, however, that one cannot ignore.

But is all that fear really necessary for this procedure?

This article will explain endodontic therapy, its requirements, steps, and advantages for adults and children.


What is root canal treatment  (Endodontic Therapy)?

A tooth consists of a crown- mainly above the gum- and roots.

The pulp exists inside the crown and the roots, which is known as the tooth nerve.

The pulp consists of blood vessels, nerves, and connective tissues. 

It is responsible for pain perception and sensing the hotness and coolness of food.

The pulp may be damaged or infected, necessitating its removal, cleaning, and obturation.

Endodontic therapy, or root canal treatment, is the term for this procedure.


Root canal treatment (Endodontic Therapy) benefits

This procedure aims to eliminate the bacteria that cause nerve inflammation or infection. 

Also, to save the tooth from reinfection.

Some complications may arise if a proper root canal is not performed, such as:

  • Apical Periodontitis.
  • Abscess.
  • An abscess may lead to cellulitis.
  • Osteomyelitis.
  • Bone resorption.
  • The injured upper teeth may cause sinusitis.
  • The injured lower teeth may cause infection in the floor of the mouth, known as Ludwig’s Angina.


Root canal treatment helps prevent tooth loss, allows the patient to chew properly, and maintains the natural appearance of teeth.

As a result, endodontic therapy is a must to save the natural tooth in the following cases:


Irreversible pulpitis

Irreversible pulpitis causes the following symptoms:

  • Pain that lasts longer than 30 seconds after eating or drinking something hot or cold.
  • The pain may be spontaneous.
  • Sometimes, the pain increases when lying down, which may cause the patient to wake up.
  • A patient may not have the ability to locate the pain; it may spread to the adjacent or opposite teeth.


Pulp necrosis

Pulp necrosis is a condition that occurs when the soft pulp inside the tooth dies; it stops transmitting signals necessary to feel pain when exposed to cold or hot stimuli.


Neglecting treatment may lead to abscess or bone resorption.


Causes of nerve damage in teeth

  • Advanced tooth decay.
  • Cracked or chipped tooth.
  • Dental trauma; may cause nerve damage even without a crack or a fracture in the tooth.
  • Nerve irritation due to repeated procedures in the same tooth.


Root canal treatment steps

The endodontist or the general dentist performs this procedure. 

It takes one session or more, depending on the nerve condition.

The first step is to take an X-ray to assess the tooth condition, then proceed with the following steps:



The patient receives local anesthesia to numb the area near the tooth to avoid feeling pain. 

Then the dentist isolates the tooth from the rest of the mouth by using a (Rubber Dam).


Cleaning and shaping

The dentist removes the decay and drills an access cavity to the tooth pulp.

The dentist uses fine tools to remove the pulp. 

Also, to clean, debride, and shape the canals.

He also uses a sterilizing solution for root canal irrigation.

The dentist may coat the area with a topical antibiotic in case of severe infection and end the session using a temporary filling to continue the treatment on another day.

Some cases need antibiotics to treat infections spread outside the tooth.



If there are no more symptoms and the tooth doesn’t have any signs of infection.

The dentist places the filling inside the roots and crown cavity. 

He seals the tooth tightly to protect the roots from contamination with saliva.

After the decay removal and root canal treatment, the tooth becomes more vulnerable to fracture. 

So, it is vital to protect it with an artificial crown.


Root canal treatment in pediatric patients

root canal treatment in pediatric patients

Some parents fear root canal treatment for their children because they believe they won’t be able to handle it.

Furthermore, some parents believe the deciduous teeth are unimportant as they are not permanent and will eventually fall out.

However, this assumption is incorrect; as it is a simple procedure designed for preventing children from losing their teeth too early, which can cause several issues, including:

  • Chewing difficulty, which has an impact on children’s nutrition.
  • Jaw growth impairment, and misaligned teeth.
  • Appearance and pronunciation are affected, resulting in a negative psychological state of the child.


Root canal treatment types for deciduous teeth include

There are two options:


This procedure aims to remove the pulp of the deciduous tooth’s crown- the pulp of the part above the gum- in the following cases:

  • Pulp exposed due to the eradication of caries.
  • Pulp exposed as a result of dental trauma.

Keeping some restrictions in mind:

  • The pulp is intact or injured with reversible pulpitis.
  • No signs of tooth infection.


It aims to remove the pulp and the roots in the following cases:

  • Irreversible pulpitis.
  • Pulpal necrosis.

The filling of a deciduous tooth root is not the same as the permanent; it must be resorbable to allow normal root resorption during teeth replacement.


Root canal treatment pain

Feeling pain after root canal therapy is typical; most people experience sensitivity or discomfort for the following reasons:

  • Inflammation of the tissues around the tooth is typical after the procedure.
  • Sometimes, the precise tools used to clean the root canal cause damage to the surrounding tissues.
  • The temporary filling surface may be higher than the neighboring tooth, which would cause the tooth to be sore on chewing.

Although the pain is typical after the treatment, the severe, persistent, and unbearable pain may be due to other reasons, such as:

  • The existence of another canal the dentist couldn’t find easily.
  • Cracks in the root.
  • A filling leak.
  • Improper bacterial removal from root canals.
  • The filling is not suited to the canal size adequately.


Root canal treatment price

Permanent teeth cost between 1200 and 1800 Egyptian pounds.

But deciduous teeth cost between 500 and 1000 Egyptian pounds.


When should you visit the dentist?

If you experience any of the following symptoms after root canal treatment:

  • Persistent severe pain.
  • Filling leak.
  • Tooth decay.
  • Crack or chip in the tooth.
  • Swelling or pain of gum.
  • Pain with cold or hot stimuli persists even when it is no longer exists.
  • Swelling of the face.


Finally, do not hesitate to visit the dentist if you experience pain.

And remember, root canal therapy is a simple procedure that aims to save your teeth and keep you safe from complications.

Translated by
د. مي نادرDr. shrouk osama
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