Endodontics. Root canal is necessary when decay or trauma affects the pulp or nerve of a tooth. The blood flow in the tooth rushes to the site of inflammation to aid the tooth. What actually occurs is a pressure on the nerve endings, generating pain, which usually occurs at night or when lying down, and can be triggered by hot or cold. What occurs is a slow progression of decay traveling through the canal and settling at the end of the root. This results in an abscess (or swelling) at this site.

Other causes of nerve pain can be tooth fractures, excessively large fillings, or constant trauma to the tooth. Occasionally, it is difficult to diagnose which tooth may be the culprit. Treatment involves cleaning the canal space by removing the affected nerve, washing the space and filling the space with an inert, rubber-like material that helps seal the space. Biocompatible cements are used with this material to seal any smaller openings.

Why de we need root canals? Because the tooth will not heal by itself. Without treatment, the infection will spread. The bone around the tooth will begin to degenerate, and the tooth may fall out. Pain usually worsens until one is forced to seek emergency dental attention.

The only alternative is usually extraction of the tooth, which can cause surrounding teeth to shift crookedly, resulting in other problems. Though an extraction is cheaper, the space left behind will require an implant or a bridge, which is more expensive than root canal therapy. If you have the choice, it's always best to keep your original teeth.