The process of removing the pulp of a tooth. It is more properly termed endodontic treatment, or Root Canal Therapy (RCT). It may or may not be done in conjunction with the placement of a crown.

This procedure is performed on abscessed teeth, or any tooth with a substantial pulp exposure.

The pulp of a tooth is where the nerve lies. If this area should become infected, it is extremely painful. A pulp exposure allows bacteria access to your pulp, which can destroy the entire tooth. At that point, RCT is indicated.

The process consists of opening the pulp chamber, then inserting files of various diameters to completely remove the pulp and its nerves along their canal. The canals are then filled with a material such as gutta percha.

Simple RCT can be performed by a general dentist, but in cases where roots twist or canals have odd shapes, an endodontist should perform the RCT to ensure complete removal of pulp without perforation of the root.

So when do you need RCT? The basic answer overall is: When the pulp is infected to the point where it will not recover. Despite being one of the areas in the body with the highest blood flow, it cannot effectively deal with active infection. If you find yourself with lingering pain (say, more than a minute or two) on exposure to cold, or pain on exposure to heat, or spontaneous pain, it's probably time to go in.

But pain isn't always an indication. After all, that's where the nerve is ... but if the tooth is already dead, then the nerve is dead, and you won't feel anything. There are many cases where RCT is still indicated. After all, you can't feel diabetes, but that doesn't mean you don't have it.

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