Root canal fillings have an undeserved bad name. They do, however, remain the only alternative to the extraction of an abscessed tooth. Inside any vital tooth is a remnant of embryonic tissue that formed the dentin and enamel. We call this the pulp of the tooth and it is composed of blood vessels, nerves, and connective tissue. A small opening is at the end of the root through which the pulp is connected to the rest of the body and receives what it needs to remain vital. However, if this vitality cannot be maintained, the pulp and the bony area around the tooth can become inflamed, infected, necrotic, and very painful. Generally, this is referred to as an abscessed tooth. Extracting the tooth removes the offending tissue but creates a new problem, that of a now missing tooth. A root canal filling keeps the tooth intact by removing the diseased pulp and allowing healing to happen around the tooth.

A tooth can have one, two, three, and sometimes four or more canals (channels) leading from the tip of the roots to a central chamber where they come together. These canals can be as small as a human hair or many times larger. In all cases the entire canal structure needs to be cleaned thoroughly and shaped from the chamber to the root tip in order to fill it with bio-compatible inert filling material. This completely seals the inner part of the tooth enabling it to heal. A tooth with a root canal filling can remain in full function for a very long time; often as long as a vital tooth.

The need for a root canal filling can be determined by symptoms of pain in various forms, change in the bone around the root of a tooth as identified in an x-ray, or by the response to various tests. Teeth that have a history of deep decay, large fillings, heavy wear, or other forms of trauma are more likely to develop the need for a root canal filling. Maintaining a healthy mouth with a program of Dental Wellness reduces the probability of needing a root canal filling.

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