Whenever someone talks of going to the dentist and how terrible it is going to be, the term root canal is usually mentioned. Although this is a fairly common and highly feared procedure, most patients do not really understand what a root canal is or why it is necessary. A root canal is the common name for the practice of endodontic therapy. Originating from Greek words "endo" which means inside and "odont" which means tooth, endodontics is literally dentistry that takes place inside of a tooth.

In the middle of the root of a tooth is a soft tissue called pulp. Because this pulp has blood vessels and is living material it can become infected or inflamed. A tooth can function fine without the pulp, so sometimes the best course of action is to simply remove all of the pulp and fill the tooth with a replacement material and then seal it. Just like with everything else, new advances in root canal treatments are making it easier, less painful, and more successful.

• Instruments - Traditionally the root of a tooth was cleaned out using a very small stainless steel file which the dentist would move by hand to clean the pulp from the canal. New advances in file technology include nickel-titanium files which can be rotary driven to allow for easier and more complete clearing of the pulp. Even newer files use a reciprocating action to file the canal and allow even more precision. When combined with ultrasound imaging, endodontists like George J Mendel DMD are able to very accurately and completely clear the inside canal of a tooth.

• Irrigation - Even in the cases of most complete clearing of pulp from the tooth there are at least trace amounts left behind. For this reason it is critical to irrigate the inside of the tooth with the chemical sodium hypochlorite (NaOCl). This irrigant actually dissolves the remaining living tissue. Sodium hypochlorite however cannot dissolve inorganic material that may be present so it is combined with other chemicals.  Chlorhexidine (CHX) is the newest chemical used for this purpose as it has antimicrobial properties and is non-toxic.  When these substances are combined the dentist can have a completely clean canal to work with.

• Obturation - The process of filling the canal after cleaning it out is known as obturation. The substance used for this is typically a rubber-like compound called gutta-percha. Traditionally this substance has been used cold and forced into the root canal from above. New techniques use a warmed gutta-percha which can be injected into the canal and the warm compound can fill all of the space within the canal.

When a person understands the benefits of a root canal and how technology and science have improved to make it less painful and easier to perform, maybe it will no longer be such a dreaded procedure.