When a tooth gets infected it can cause serious pain, this may also be accompanied by a fever and/or facial swelling. Usually there are two options a dentist will discuss with you: root canal procedure or tooth extraction.

Let’s look at the two options:

Root Canal

This treatment, also known as endodontic treatment, is when the infected pulp (the inside of the tooth) is removed under local anaesthetic. First a protective sheet, known as a rubber dam, is used to isolate the tooth. A hole is then drilled to access the tooth to enable the dentist to remove the infected pulp. The area is then disinfected to ensure all of the bacteria causing the infection have been removed and the tooth is then filled. In some cases, a crown may be required on the top of the tooth. Depending on the complexity of the case your dentist may refer you to a specialist endodontist.

The ideal situation is to keep the tooth by having root canal treatment, however this may not be suitable for all situations, in which case an extraction will be recommended.

The diagram below shows the procedure for a tooth needing a root canal due to tooth decay

Extraction

If the tooth is severely infected and cannot be saved, your dentist may recommend extraction. They will take into account factors such as the condition of the tooth, the severity of the infection, the presence of surrounding gum and bone disease, and the potential for successful root canal treatment. A tooth with a crack that continues below the gum line for example is likely to need removing.

Your dentist will numb the area around the tooth that is to be removed so that you don’t feel any pain. You will feel some pressure, but it should not hurt.

If a tooth is extracted, it is important to consider tooth replacement options. This is because the teeth on either side of the gap of the extracted tooth will begin to fall in on the space which can change your facial appearance. There may also be difficulties in chewing/speaking and aesthetic concerns particularly if it is one of your front teeth.

Often patients with severe tooth ache understandably just want the tooth pulled out to stop the pain, but ideally preserving the natural tooth is always the preferred option where possible.

Misconceptions

We often hear or read misconceptions or myths surrounding root canal treatments which contribute to patients being scared of the procedure. These stories about them being painful or even dangerous are out of date and not based on current technology. If you are nervous, please do tell your dentist. They can explain exactly what they are doing to help put you at ease.

Here is a review we received where the patient had heard scary stories about root canal procedures!

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