A root canal treatment is a procedure that repairs a tooth that was either infected, decayed in an advanced way, or that has been traumatized. The procedure involves removing the tooth’s pulp, which is infected or non-vital. The pulp is the inner part of the tooth where the nerve is located. When the pulp is ill, the dentist must perform a root canal treatment in order to save the tooth or prevent a more serious bacterial infection.

A tooth that has had root canal treatment becomes more weak, and this because of the little amount of remaining healthy tooth after the cavity was or the fracture. That tooth may break over time under the chewing forces. It is recommended to put a crown on a tooth with a root canal, or at least a dental post to give it strength.

When do you need a root canal

Cavity infected toothThe dental pulp is the tissue inside of a tooth and extends all the way to the root tips (apex). The pulp contains nerves and blood vessels which were previously useful in the development of the tooth and it’s eruption in the mouth. When a tooth is cracked or when a cavity is deep, bacteria can penetrate into the pulp without it being necessarily painful. If this is not treated, the pulp may become non-vital or even develop a dental abscess while causing lots of pain.

Here are some situations where you may need a root canal:

  • presence of a deep cavity that reaches the pulp;
  • dental pulp irritated by trauma;
  • dental pulp irritated by a very deep filling;
  • a damaged tooth in need of a dental crown but that first requires the additional support of a post;
  • a periapical lesion, which is an infectious lesion or abscess located at the end of a tooth root (apex) that can be seen on an x-ray.

Steps of preparing a root canal

Root canal treatment step by step

The term “root canal” may scare some people because it is sometimes associated with pain. But with dental treatments progress and current local anaesthetics, most people have little or no pain during root canal treatment. In fact, it is probably more suffering to stay with a decayed tooth in the mouth than repairing it with a root canal.

Here are the preparation steps:

  • local anaesthesia performed by the dentist;
  • removal of caries and infected tissue within the tooth and the dental pulp;
  • cleaning of the inside of the tooth by mechanical action: scraping of the inner surface of the canals with manual or mechanical files, and this process is associated with a chemical cleaning by irrigating with disinfectant;
  • sealing of the cleaned canals by filling them; the material used most often is the heated gutta percha (insulating and highly biocompatible polymer);
  • placement of a dental post in one of the canals; the post serves as a pillar for the final restoration of the tooth that is either a filling or preferably a dental crown; some dentists choose not to place a post, but rather fill a portion of the canals with a filling material, usually composite.

Success rates and complications

The only alternative treatment of a root canal is tooth extraction, and replacement of a tooth by either a partial denture, a bridge, or a dental implant.

Root canal treatments have a very good success rate, which is approximately 85 %. If well maintained, teeth treated by a root canal can last a lifetime.

Despite all the efforts that the dentist has made to clean and disinfect the canals of a tooth, it is slightly possible that new infections arise months or years later. The possible reasons (about 15 %) that can lead to root canal complications are:

  • a tooth that is not well maintained by good dental hygiene with brushing and flossing over the years;
  • a tooth that is not properly restored by a dental crown or a filling; this tooth may therefore crack or break;
  • a greater number of canals in the tooth which are hidden and not found by the dentist or endodontist;
  • undetected fracture in the root of a tooth;
  • a piece of the cleaning instrument that separates and remains stuck in the canal during the operation by the dentist; in these cases the tooth may lead to complications, but can also always remain well without pain or symptoms.

If there’s ever a complication, a tooth can be retreated, which means to have a new root canal redone on it. Another possible treatment is an apicoectomy, which is surgical removal of the tip of the infected root through the gingiva. If no treatment has completely cured the infection, the tooth should be extracted.

A tooth that has had a root canal treatment can still get a cavity like any other tooth. When this happens, no pain is felt because there is no more nerve inside. It is therefore very important to maintain good oral hygiene to keep the tooth very long. In addition, it is prudent to restore a root canal tooth with a crown to make it more solid.

Cost of a root canal

Teeth and moneyThe price of a root canal treatment can vary depending on the country or part of a country where one lives. The price also varies depending on the number of canals in the tooth. Note that a tooth can have between one and four canals, rarely 5 or 6 canals. Generally the cost ranges between $800 and $1,500 (£500 and £950), where the price of the crown is excluded.

The only alternative treatment of a root canal is tooth extraction, and replacement of a tooth by either a partial denture, a bridge, or a dental implant.


  1. Myths About Root Canals and Root Canal Pain (American Association of Endodontists).
  2. Endodontic therapy (Wikipedia).
  3. Further Information (British Endodontic Society).

The information above should be used as a reference only. Any medical decision should not be taken before consulting a health care professional.

The masculine gender may have been more used in the article, but without prejudice, to make reading easier.

Category Treatments