In a root canal treatment the root of dead or inflamed tooth is extracted in order to save the residual structure. Inflammation and injury-damage to the pulp make this procedure an absolute necessity. The contents of the dental pulp (nerve, artery, vein of the tooth) are physically removed and the resulting cavity is replaced by a root filling.


Is root canal therapy painful?

No. A root canal treatment is painless, as it is performed under local anesthesia. With acute pulpitis, repeated injections of anesthesia may be necessary.

When is a root canal treatment necessary?

In cases of deep caries, pathogens penetrate and reach down deep into the tooth. They can either cause a painful inflammation of the dental pulp (pulpitis), or evoke the pulp to die slowly and painlessly, spreading germs through out the root canal. In the latter case we speak of gangrene, which may at a later point cause an inflammation of the gums (apical periodontitis).
All of those cases (very deep caries, pulpitis, gangrene, apical periodontitis) require a root canal treatment.

Are there any alternatives to a root canal?

The only alternative is to extract the tooth. However, it is in your best interest to keep as many innate teeth as possible...
A root canal treatment represents the last attempt to save a tooth.

What is the goal of a root canal treatment?

As mentioned before, the goal is to remove germs from the canals of the tooth (including the inflamed or disintegrated pulp) in order to save it and to prevent further infection.

How long does root canal treatment take?

Root canal treatments in the back of the mouth (molars) are the most time consuming. Sometimes, several dental visits may be necessary for a treatment. In the first session the inflamed dental pulp is removed, the root canals are cleaned and extended, a medical insert is embedded, and the tooth is then temporarily sealed. After a "recovery time" of 7-14 days, most teeth are ready for a permanent filling. Exceptions are usually gangrenous teeth (purulent teeth), which require more sessions to ensure the complete removal of all pathogens.

What is the life expectancy of an endodontically treated tooth?

Predictions are hard to make, since many factors effect the longevity.

In general, root-treated teeth are preserved for several years (if not for decades). They may even be used as a base for crowns (with or without internal pins), or as an abutment for a bridge.

Statistically, a once purulent tooth does not sustain the life expectancy of a dental structure that has not been previously colonized by bacteria (root canal treatment after deep caries or acute inflammation of the nerves). When considering the only alternative (a tooth extraction), a root canal treatment is well worth the attempt.

Can root-treated teeth induce pain?

Yes, in the following cases:

Pain after the injection wears off: sometimes, a hypersensitivity may arise after treatment and can be perceived in several ways. The range spans from pressure/bite sensitivity all the way to intense pain requiring painkillers. Discomfort subsides usually after 2-3 days.

Pain months or years after treatment: even after years, it is quite possible for a root-treated tooth to fester and cause severe and acute pain. We do stress the importance of follow-up appointments, given that a timely discovery can prevent a chronic inflammation of the root tip, and an unnecessary painful outcome.

Inflammation even after the nerve has been removed?

Because of the dissemination of bacteria to the surrounding area of the bone (initial cause of the inflammation / reason for root canal treatment), a chronic inflammation of the root tip, and associated pain, may develop and become intensified. It may even lead to a swelling of the jaw (an abscess), requiring surgical and antibiotic treatment.

Do root-treated teeth darken with time?

Unfortunately, yes. A root-treated tooth may darken over time. The natural appearance of once treated teeth can be restored by various methods (bleaching, crowns).

Are root-treated teeth more prone to breaking?

Yes. As a result of the missing supply of nutrients, root canal-treated teeth are usually weakened in their substance and become brittle. Such disintegration can be counteracted by the application of crowns. Cracking of a wall or even a complete break-off are possible, if crowning is not completed in time. At that point, the only thing left that can be done is an extraction.

Can root-treated teeth still get cavities?

Yes, of course. One does not preclude the other. Causes of tooth decay