When a dental pulp (nerve) is traumatized, diseased, or dead, it must be removed and replaced with a root canal filling. The filling material may vary from the most popular, rubber like material, gutta-percha, to sterling silver, other metals, plastic, or various cements. The procedure usually requires one or two appointments. The root canal procedure typically is not painful, but some discomfort may be present during treatment and healing. In most situations the therapy is not finished after the root canal has been completed, because the tooth is now weak. Often, a reinforcing post is inserted into the tooth through the opening in the top of the tooth. Many teeth are still too weak or unpleasant looking, and a crown (cap) is required to make the tooth both functional and beautiful. The minimal therapy required for a dead tooth is a root canal only. If more of the tooth is missing because of decay (caries) or old fillings, the most accepted therapy is (1) a root canal, (2) a post, and (3) a crown (cap).

A. Advantages: The tooth remains in your mouth, pain free. Although the cost of root canal (Endodontic) therapy is significant, replacing the tooth with fixed or removable prostheses (bridges) usually costs more than the root canal therapy.

B. Disadvantages: There is a necessary time involvement to accomplish root canal therapy (one or more appointments): one or two additional appointments are often required to restore the dead tooth with a crown (cap). The cost is significant but well worth it.

C. Risks: There are not many risks to standard root canal therapy, but some exist:

D. Alternative Therapy: You do not have many alternatives. You may extract the tooth, or, in the event of a painless or infrequently painful tooth, you may postpone therapy for a short time. The tooth will not heal by itself, and root canal therapy is almost always the best selection.

E. Cost of Various Alternatives: Root canal therapy costs vary significantly around the world. The fee for a root canal for a single-rooted tooth costs much more than removal of the tooth. Root canal therapy costs more for a multiple-rooted than a single-rooted tooth. There is usually an additional cost if the tooth requires a post, and if a crown (cap) is needed there is a further cost. In summary, when a root canal is accomplished, that may be the only cost, but more frequently, the costs for a reinforcing internal post and a crown are necessary also.

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Result of Non-treatment of a Dead Tooth: If you do not treat a tooth with a diseased or dead pulp, continued infection will almost always occur with increased bone degeneration around the tooth, pain, and discomfort. These conditions will ultimately force you to root canal therapy or tooth extraction.