The tooth is made mostly of dentin.  Covering the dentin in the mouth is a thin layer of enamel which protects the tooth and gives it insulation, strength and beauty.  Within the dentin lives the tissue of the tooth, the dental pulp (usually called the nerve of the tooth), which provides nutrients to help make and support the dentin.  In the crown of the tooth, the space is shaped like a bowl and is called the pulp chamber.  In the roots, the space is shaped like a tunnel and is called the root canal.

Around the tooth is a layer of cells lining the bone socket called the periodontal ligament which helps to support the tooth by absorbing shock and providing nutrients.  If the tooth undergoes a traumatic blow and the cells in the periodontal ligament were damaged, blood supply to the tooth would be compromised and the dental pulp would die.

A break in the dentin caused by decay, cracks, fractures, or tooth brush abrasion may cause symptoms of sensitivity to cold, heat, or sweets.  Caught early, this can be effectively restored with a filling.  If this goes untreated, the pulp may become damaged by inflammation or bacteria, this is often not painful, but it can produce severe symptoms such as intense, throbbing pain that radiates to the ear and head.  The inflammation usually starts near the source of the problem in the crown of the tooth and spreads down the roots.  Once the inflammation gets to the end of the root, the cells of the periodontal ligament (shock absorbers lining the bone socket) become inflamed.  If there are bacteria present, an abscess may form resulting in sensitivity to biting or chewing, or severe tooth ache and swelling.

 When a tooth becomes injured or diseased it often can be saved by a procedure called Root Canal Treatment.  The Root Canal Treatment may take one or two visits.  First, the endodontist (root canal specialist) will give some local anesthetic.  The tooth is then isolated from saliva.  An opening is made through the crown of the tooth and the decay is removed.  Next, she will locate the canals and remove all the dead or damaged pulp tissue.  The canals are then cleaned, disinfected, filled with a biocompatible material, and sealed.

At a later visit with your general dentist, a metal or plastic post may be placed to support the restoration.  A porcelain crown is then placed to strengthen and improve the appearance of the tooth. 

To help your tooth stay healthy, maintain good oral hygiene and get regular dental exams.