Basic dental hygiene is not difficult and can prevent all manner of difficult health problems from beginning if performed with daily regularity. When proper dental hygiene goes neglected for too long or old age or injury to mouth intervenes, however, more serious dental work becomes necessary. This severe dental work has become a cultural short hand for describing high amounts of pain in American comedy, and not without due cause. One of the quintessential expressions of pain in American wit is comparing a painful experience to a root canal.

A root canal becomes necessary when a tooth is considered so cracked or infected that a simple sealing or disinfecting will not prevent the tooth from becoming infected again. In this case, the process of endontic therapy, or a root canal, becomes necessary.

The process is essentially removing the pulp of the tooth, usually along with some measure of already existing inflammation or infection. To purge the infection and hopefully salvage the tooth, a dentist has to drill into the pulp chamber and remove the infected pulp, followed by the removal of the nerve out of the root canal where it is contained. Once the infected pulp is removed, the dentist then takes needle shaped instruments known as files to widen the root canal, starting out with small files and working their way up to larger files. This removes debris and infected tissue, as well facilitating a great penetration of the chemical irrigating solution.

When the nerve is finally removed from the root canal, the dentist then fills the root canals and pulp chamber with an inert material and seals the opening, normally with gutta-percha (a natural polymer prepared from the percha tree), usually topped by a crown to finish the job.

This process can be very painful to the patient and oftentimes requires an anesthetizing substance to make the process bearable, though when it’s over, the patient usually needs painkillers for some days afterwards.