Biological Root Canal: What Happens During The Procedure

Key Takeaways:

    Nature of a Biological Root Canal: A Biological Root Canal is a specialized dental procedure performed by an endodontist to address infections in the tooth’s pulp and nerve. It focuses on using natural and biocompatible materials, such as bioceramics and advanced irrigation, to promote healing and reduce the risk of infection recurrence.

    Procedure and Benefits: The procedure involves several steps, including cleaning, disinfecting, filling, and sealing the root canal. It utilizes advanced tools and techniques, such as GentleWave and laser technology, which use sophisticated irrigation technology to clean and disinfect the root canal system effectively.

Are you familiar with the concept of a Biological Root Canal? Have you ever wondered how it differs from a traditional root canal?

We will explore the ins and outs of a Biological Root Canal, including the reasons for needing one, the steps involved in the procedure, the benefits it offers, and the potential risks and side effects.

Stay tuned to learn more about what to expect before, during, and after this specialized procedure.

What Exactly Is A Biological Root Canal?

A Biological Root Canal is a dental procedure performed by an endodontist to treat infections in the tooth’s pulp and nerve.

During the treatment, the endodontist carefully removes the infected pulp and nerve tissue from the inner chamber of the tooth. By cleaning, disinfecting, and sealing the root canal, they ensure the tooth remains functional and free from bacteria. 

Endodontists are highly skilled dental specialists who are trained in performing endodontic procedures and injuries to the dental pulp. Their experience in performing precise and delicate procedures like Biological Root Canals is necessary for maintaining dental health and restoring smiles.

How A Biological Root Canal Differs From A Traditional Root Canal

A Biological Root Canal is an enhancement of a traditional root canal by its emphasis on natural and biocompatible materials that protect the tooth’s structure, including dentin and the crown, and align with the body’s natural processes.

By utilizing these advanced irrigation technologies and materials, such as bioceramics, a Biological Root Canal aims to promote healing and reduce the risk of infection, potentially leading to improved overall outcomes and longevity of the treated tooth.

When Is Root Canal Therapy Necessary

Typically, this procedure is required when the pulp tissue inside the tooth becomes infected or inflamed owing to a variety of factors such as extensive decay, or a broken or fractured tooth.

Severe Tooth Decay

Severe tooth decay is a primary reason for considering a biological root canal, as it requires comprehensive treatment and restoration to preserve the tooth.

When left untreated, severe decay can lead to excruciating pain, infection, and even tooth loss. A biological root canal treatment focuses on removing the infected pulp, disinfecting the canal, and sealing it to prevent further deterioration. This specialized procedure not only alleviates discomfort but also helps maintain the integrity of the tooth structure.

Following the treatment, restoration is crucial to ensure the tooth’s strength and functionality. Neglecting decay can result in more invasive procedures, so addressing it promptly with a root canal is vital for optimal dental health.

Infected Tooth Pulp

Infected tooth pulp can lead to severe pain and discomfort, requiring the need for a biological root canal for effective disinfection and treatment.

When the tooth pulp becomes infected, it can cause throbbing pain, sensitivity to hot or cold, and even difficulty biting or chewing. Ignoring these symptoms can result in the infection spreading to the surrounding bone and tissues, leading to more serious complications.

Cracked Tooth

A cracked tooth resulting from trauma can allow bacteria to enter the dental pulp making a biological root canal necessary.

When a tooth is cracked due to trauma, it can lead to significant discomfort and potential complications if left untreated. In such cases, an endodontist can provide the necessary expertise to assess the extent of the damage.

The following symptoms can signal the need for a biological root canal procedure:

Intermittent and/or spontaneous pain – This includes pain that fluctuates or manifests without a clear cause, varying from slight discomfort to intense throbbing feelings.

  • A dull ache – This type of pain is often persistent and may feel like a dull, continuous discomfort in the affected tooth or surrounding area.
  • Sharp, shooting pain – Usually brought on by biting or chewing, this is characterized by abrupt, excruciating pain that may radiate through the jaw and teeth.
  • Bite pressure pain/sensitivity – This includes pain or sensitivity experienced when biting down or applying pressure to the tooth. This can indicate an issue with the tooth’s nerve or pulp.
  • Pain/sensitivity to heat and/or cold – Discomfort or sharp pain when consuming hot or cold foods, beverages, or even breathing in cold air. This sensitivity can be a sign of nerve involvement.
  • Gum swelling around the tooth – This includes inflammation and swelling of the gums near the affected tooth, which can be tender to the touch and may appear red or irritated.
  • A white bump near the tooth (pimple) – This can indicate an infection at the tip of the tooth’s root, leading to the formation of a pimple-like bump on the gums.
  • Facial swelling – This includes swelling of the face, particularly in the area around the affected tooth. This swelling may be accompanied by pain and tenderness.
  • Fever/Malaise – Systemic symptoms such as fever, fatigue, and overall feeling of illness can occur when a dental infection spreads beyond the tooth.

The Steps Involved In A Biological Root Canal Procedure

A biological root canal procedure encompasses several essential steps, including cleaning, disinfecting, filling, and sealing the root canal, often assisted by advanced tools. Below is a step-by-step breakdown of what it looks like:

1. Cleaning And Disinfecting The Tooth

    The initial step in a biological root canal involves thorough cleaning and disinfection of the tooth, targeting the removal of microorganisms through specialized irrigation techniques.

    This crucial process plays a pivotal role in ensuring the success of the root canal treatment. By effectively reducing the bacterial load and other microorganisms, irrigation not only cleans the root canal system but also helps in preventing potential reinfection. 

    The thorough cleaning and disinfection create an optimal environment for subsequent procedures, such as shaping and filling the canal. Without this initial step, the risk of complications and treatment failure significantly increases, underscoring the importance of careful attention to detail in the irrigation process.

    2. Filling The Root Canal

      After cleaning, the root canal is filled with materials to ensure proper sealing and restoration:

      Gutta-percha, a rubber-like material derived from the sap of certain trees, is commonly used in root canal procedures due to its biocompatibility and ability to fill the root canal space. The bioceramic sealer, used in conjunction with the gutta-percha, acts as a cement to fill any gaps and seal the root canal system. 

      These filling materials help maintain the structural integrity of the tooth and prevent reinfection, ensuring the lasting success of the biological root canal treatment. Once the root canal is filled, it is essential to proceed with the restoration of the tooth to prevent any future complications. 

      3. Placing A Temporary Filling

        Temporary fillings may be placed to allow time for the dentist to properly and permanently restore the tooth. Root canals are 6 times more successful after being permanently restored with a full coverage crown. 

        These fillings serve as a protective barrier to prevent bacteria from entering the root canal and causing further damage. 

        Postoperative care, including regular dental check-ups and proper oral hygiene, plays a crucial role in ensuring the success of the procedure and overall dental health. Patients are advised to follow their dentist’s instructions diligently to prevent complications and maintain the longevity of the tooth.

        4. Placing A Permanent Filling

          The final step in a biological root canal involves placing a permanent filling to restore the tooth’s function. 

          The Benefits Of A Biological Root Canal

          A biological root canal offers numerous benefits, such as promoting natural healing, supporting tissue regeneration, and showcasing a high success rate:

          Preservation of The Tooth’s Natural Structure

          One key benefit of a biological root canal is the preservation of the tooth’s natural structure. The advanced irrigation technology allows the endodontist to be more conservative with dentin removal during the root canal. 

          This preservation ensures that the tooth maintains its original integrity and strength, allowing for proper function. 

          Elimination Of Infection

          Another benefit of a biological root canal is the effective removal of infections, which addresses inflammation and eliminates bacteria.

          By focusing on the source of the infection within the tooth, the procedure targets the inflamed tissues, allowing for proper management of inflammation. 

          This method not only relieves pain and discomfort but also promotes the natural healing process of the teeth. The emphasis on disinfection is critical in eliminating any leftover bacteria, ensuring that the tooth is effectively cleaned, and reducing the risk of future infections.

          Risk Reduction Of Future Infections

          By cleaning and sealing the root canal effectively, a biological root canal reduces the risk of future infections, promoting long-term dental health.

          This meticulous cleaning and sealing process plays a vital role in preventing bacteria from re-entering the treated tooth. This proactive approach not only addresses immediate concerns but also contributes to the overall well-being of your dental health.

          GentleWave Root Canal: Comfortable and Holistic Procedure

          As a part of our biological root canal procedure, we at Ballantyne Endodontics utilize the GentleWave system to provide patients with a holistic and painless treatment option. This system uses advanced irrigation technology to clean and disinfect the microscopic spaces within the root canal system. Let’s look at its benefits below:

          Advanced Irrigation Technology

          The GentleWave procedure utilizes a sophisticated irrigation system to deliver specially designed irrigating solutions deep into the root canal system. The irrigating solutions are activated using low-energy light and sound waves, which help the solutions penetrate areas of the root canal that are difficult to access using traditional irrigation methods alone.

          The activated solutions help break up bacteria, pulp tissue, and dentin debris, which are then easily flushed away. This advanced irrigation process helps ensure the root canal system is thoroughly cleaned and disinfected.

          Reduced Pain and Discomfort

          The GentleWave root canal procedure is designed to be comfortable for patients and help reduce post-operative pain. The use of low-energy light and sound waves allows for effective cleaning and disinfection of the root canal system while avoiding damage to the healthy tooth structure. 

          With GentleWave, patients typically experience little to no pain during or after the biological root canal procedure. The risk of pain or flare-ups is greatly reduced compared to traditional root canal treatment.

          Successful and Predictable Results

          The GentleWave system achieves an exceptional level of cleaning and disinfection within the root canal system, which supports tooth restoration and long-term tooth retention. The advanced irrigation technology and disinfection capabilities of the GentleWave system provide patients with a root canal treatment that is designed to be successful and predictable and support long-term tooth health.

          The GentleWave root canal procedure utilizes sophisticated technology to provide a comfortable, holistic, and highly effective treatment. Ballantyne Endodontics is pleased to offer this advanced solution for root canal therapy. Feel free to contact our office today to request an appointment. 

          The Fotona Laser Technology 

          This innovative tool is changing the root canal technique by providing a precise and gentle method for removing bacteria and debris from the root canals while reducing post-operative discomfort.

          The Fotona Laser operates without physical contact, ensuring a thorough and hygienic cleansing process. It successfully eliminates microscopic particles that may accumulate throughout the operation, creating optimal treatment outcomes.

          What sets the Fotona Laser apart is its ability to maximize patient comfort. Prolonged hours with an open mouth can cause exhaustion, but the laser’s slight activation of jaw muscles can help reduce these concerns, resulting in a more calm and enjoyable experience.

          The Risks And Side Effects Of A Biological Root Canal

          While effective, a Biological Root Canal may carry small risks such as pain or recurring infections as potential side effects of the procedure:

          Pain And Discomfort

          Pain and discomfort may arise during or after a Biological Root Canal procedure, typically managed with over-the-counter analgesics and guidance from the endodontist to address any swelling.

          Anesthetics play a crucial role in numbing the area and minimizing discomfort during the root canal process. A skilled dentist ensures that the anesthetics are administered effectively to alleviate any pain.

          Following the procedure, it is important to be vigilant about taking anti-inflammatories, such as Advil, which will help post-operative discomfort. Swelling can occur as well and may require a post-op antibiotic. Consulting a dentist promptly in case of persistent or severe swelling post-root canal can help alleviate this. 


          Infections may recur post-biological root canal, even though it is rare. In general, the root canal success rate is in the 90th percentile. If infection recurs this could indicate another problem which may require endodontic microsurgery or worst case extraction

          Bioactive materials play a key role in inhibiting reinfection by promoting better sealing and helping prevent bacteria from re-entering the treated area. These materials actively support the healing process and contribute to the long-term success of the root canal treatment.

          How To Prepare For A Biological Root Canal

          Preparing for a Biological Root Canal involves discussing any health issues with your endodontist. The following advice will aid you in developing a comprehensive diagnosis and treatment plan, laying the groundwork for a successful treatment:

          Discuss Any Health Concerns With The Endodontist 

          Before the procedure, it is crucial to discuss any health concerns with your endodontist, to ensure comprehensive care.

          This proactive communication is essential, as the endodontist needs to assess the overall health condition to determine the most suitable approach for treatment. For example, vital pulp therapy may be necessary in children, to preserve the vitality of the tooth and allow the full growth of the root.

          By addressing these aspects beforehand, the endodontist can personalize the treatment plan to optimize outcomes and promote long-term oral health.

          Discuss Medication

          Before undergoing the procedure, individuals must communicate openly with their dental providers about any medications they are currently taking, such as anticoagulants or antibiotics. Medications can change the dentist’s approach and treatment plan. 

          By discussing your medications, your endodontist can ensure a smoother and more successful outcome for the procedure. 

          What To Expect After A Biological Root Canal

          Following a Biological Root Canal, patients may experience temporary discomfort and may need to schedule follow-up appointments with their general dentist.


          Discomfort is a common occurrence post-biological root canal, potentially accompanied by mild swelling.

          To address these reactions and promote healing, dentists may recommend over-the-counter anti-inflammatories and/or an antibiotic. These interventions help with post-op recovery of the area.

          Temporary Filling

          Temporary fillings post-biological root canals aid in tooth restoration, providing short-term protection to the newly completed root canal. 

          These fillings act as a barrier, sealing the area where the root canal procedure was performed, and safeguarding the underlying structures while allowing time for the tooth to heal. 

          Follow-Up Appointments

          Scheduled follow-up appointments are essential after a Biological Root Canal to monitor tooth healing and ensure that no further treatment is needed. Also, follow-up care with the general dentist right after treatment is essential to make sure the tooth is properly restored.  

          During these follow-up visits, the dentist evaluates the tooth’s response to the initial treatment, ensuring that any sensitivity is diminishing as expected. In cases where sensitivity persists, surgical endodontic intervention might be necessary to address underlying issues effectively. 

          These appointments are crucial for managing the success of the root canal procedure. By closely monitoring the healing process and addressing any concerns promptly, patients can maintain the health and functionality of their treated tooth in the long run.

          Discover the remarkable difference of a biological root canal with GentleWave, exclusively available to patients in the Charlotte, NC area. We invite you to witness its exceptional benefits firsthand and experience a new standard of dental care – schedule your appointment today and discover why GentleWave is the preferred choice for gentle, effective biological root canal therapy.

          Frequently Asked Questions

          What is a biological root canal?

          A biological root canal is a procedure done by a dentist to remove infected or damaged tissue from the root of a tooth to save it from extraction. It focuses on preserving the natural tooth structure and promoting the long-term health of the tooth and surrounding tissues.

          What happens during a biological root canal?

          During a biological root canal procedure, the dentist will first numb the area with local anesthesia. Then, a small hole will be drilled in the crown of the tooth to access the infected or damaged pulp inside. The dentist will remove the pulp and clean out the root canals before filling them with a biocompatible material. The tooth will then be sealed and a crown may be placed to protect it.

          Is a biological root canal painful?

          Thanks to modern anesthetics and techniques, a biological root canal is not painful. Patients may feel some pressure or minor discomfort during the procedure, but this can be managed with local anesthesia. After the procedure, some mild soreness or sensitivity may be present, but this can be relieved with over-the-counter pain medication.

          What are the benefits of a biological root canal?

          A biological root canal is an enhancement to the traditional root canal procedures. It preserves the natural tooth structure, promotes healing, and reduces the risk of reinfection. 

          How long does a biological root canal take?

          The length of a biological root canal procedure can vary depending on the complexity of the case. On average, it can take 1-2 hours to complete. However, the dentist may schedule multiple appointments if the tooth requires additional treatment or if there are complications.

          Are there any risks or side effects of a biological root canal?

          As with any dental procedure, there are some risks and potential side effects associated with a biological root canal. These may include temporary discomfort, swelling, or bruising at the injection site. However, these risks are rare and can be minimized with proper aftercare and following the dentist’s instructions.