Root canal treatment is made necessary when a cavity is allowed, through neglect, to reach all the way to the nerve, also known as pulp tissue, inside of the tooth. (Regular cleanings and checkups prevent and detect problems early.) Sometimes deep restorations or trauma to a tooth may cause the nerve to be damaged to the point it needs root canal therapy also. Once this occurs, the pulp becomes infected, and can even extend through the root tip and begin to eat away at the surrounding bone (this is an abscess). By the time the pulp is infected it must be treated, and cannot heal on its own. It can even weaken the entire immune system. This is dangerous, not to mention very painful. Symptoms that the pulp has become infected may include sensitivity to hot/cold, sensitivity to sweets, general pain, swelling, pain to biting or pressure, and/or a bad taste in the mouth.

Sometimes, however, no symptoms are apparent and the person is unaware of any problem until a checkup. A root canal is then performed to clean out the infected tooth pulp, and disinfect the canals of the tooth. The only other treatment option would be to extract the tooth. Once the infection is resolved, the canal(s) are filled in to prevent any further infection. Usually a crown, and perhaps additional procedures, are recommended for restoring a tooth that has had root canal therapy.