When root canal treatment should be carried out 

Root canal treatment is only required when it's clear that the soft tissue at the centre of the tooth, called the pulp, has been damaged by a bacterial infection.

Your dentist can test your teeth and use X-rays to establish whether there's a bacterial infection. Dental X-rays use radiation to take images of your teeth and can be used to identify any problems.

Pulp infection

A pulp infection is usually caused by tooth decay.

The symptoms of a pulp infection include:

  • pain when eating or drinking hot or cold food and drink
  • pain when biting or chewing
  • a loose tooth

As the infection progresses, these symptoms often disappear as the pulp dies. Your tooth then appears to have healed, but the infection has in fact spread through the root canal system. Further symptoms eventually occur, such as:

  • pain when biting or chewing
  • swelling of the gum near the affected tooth
  • pus oozing from the affected tooth
  • facial swelling
  • the tooth becoming a darker colour

It's important to see your dentist if you develop toothache.

Tooth removal

If your tooth is infected, the pulp can't heal by itself. Leaving the infected tooth in your mouth may make it worse. There may also be less chance of the root canal treatment working if the infection within your tooth becomes established.

If you need root canal treatment, the only alternative is to have the tooth removed. However, this isn't usually recommended, because it's better to keep as many of your natural teeth as possible.

Antibiotics (medication to treat bacterial infections) aren't effective in treating root canal infections. This is because the active ingredient in antibiotics can only work by reaching the site of the infection through your blood, and the bacteria that cause the infection are within the root canal system.

Repeated courses of antibiotics may also lead to bacteria adapting and finding ways to survive the medication's effects. They become resistant to antibiotics, which means that the antibiotic no longer works.

Read more about the Antibiotic Awareness Campaign.

Page last reviewed: 23/07/2014

Next review due: 23/07/2016