Endodontist Questions Cavities

Is root canal the only way to treat a tooth cavity?

I have a bad cavity in my tooth, and the dentist told me that I needed to have a root canal to treat it. Is it the only way? What determines that a root canal should be treated with a root canal?

29 Answers

Your dentist will determine the need for root canal treatment. Generally it is based on depth of decay and symptoms.
Dear if caries is deep enough to hurt nerv then yes
If your cavity is deep enough and too close to the nerve inside the tooth, then Root Canal Therapy may be the only option. Alternative could be and extraction and either an implant or fixed bridge, or even removable appliance. All of that depends on how deep the caries is and your symptoms.
Watch the movie "Root Cause" All root canals fail....and worse.
What determines Root Canal Therapy versus Restorative treatment with Composites or Amalgams depends on the extent of the cavity. Once the cavity/decay get very close to the nerve (pulp chamber) of the tooth. Then Root Canal Therapy is the main treatment recommended. I hope this helps
You can extract the tooth if it's really bad. If it is not bad you can do a root canal and save the tooth. And if the tooth is really bad then extraction will be your only hope and you can use an implant to replace the tooth.
When the decay reaches to the nerve of the tooth (bad cavity), the tooth starts to be sensitive to hot, cold, and sweet, and the pain becomes severe and intolerable. Then, root canal treatment is necessary.
The death of the nerve is what determines the need for root canal or extraction
If the decay from a cavity is into the nerve of the tooth or very close to it, then the proper treatment (if enough tooth structure is left) would be root canal therapy.
The other option is to have the tooth removed. I recommend to discuss the restorability of the tooth after the root canal. It will need a crown after the root canal, but it is a great option to maintain your overall health.
Teeth are normally hard structures. Because they are hard, they enable you to chew your food. A cavity is a soft and sticky area in the tooth structure. The cavity is caused by bacteria that invade a defect in the enamel surface of the tooth. The bacteria "eats away" at the healthy tooth structure leaving decay (soft tooth) around it. When the decay and the bacteria reach the pulp of the tooth, you usually (but not always) feel pain. The only way to treat the bacterial invasion into the pulp is with Root Canal Therapy. During this treatment , the pulp is removed from the inside of the tooth, the pulp canals are cleaned out, enlarged, sterilized and filled. This is all done from the inside of the tooth. it would be nice if the bacteria could be killed with antibiotics like anyplace else in your body, but the limited blood supply to the tooth, makes this treatment unsuccessful as a long term fix.
Small cavities are treated with fillings. When cavities are deep and reach the nerve of the tooth the nerve of the tooth becomes infected and leads to pain. The therapy for this is a root canal. A root canal cleans the nerve out of the tooth. After a root canal the tooth typically needs to be restored with a crown to protect it for the future. When the nerve of a tooth is dead or dying there are typically two options. Root canal therapy or extraction of the tooth.
If a tooth has a deep cavity, either into or close to the nerve of the tooth, it will likely need a root canal. If a large amount of tooth structure is decayed, in some cases it is better to extract the tooth and place an implant, or a bridge.
The depth of the decay and the sensitivity or pain the patient is in, are the factors in determining whether a tooth needs a root canal
If the cavity is deep enough to reach the nerve, or has caused enough trauma that the nerve starts to die, or cause irreversible pulp inflammation, and there is enough toithvremaining to restore with a buildup and crown, then a root canal is the wise choice.
You need a root canal if the nerve dies or becomes infected. Your other option is to have it extracted. BEST option is to save your tooth with a root canal!
If your dentist has recommended a root canal to treat your cavity, that suggests the cavity is large and encroaching the nerve. You should follow your doctor's advice. Delaying therapy can lead to infection, tooth fracture, pain and all the unwanted stress that goes with these symptoms.
If the decay has reached the pulp of your tooth then the options are to do a root canal filling and crown, or extract the tooth.
A cavity is nothing more than an infection of the tooth. Normally, the dentist can remove the infected part of the tooth and fill in the resulting void. When the infection extends all the way into the root canal area, the infection must be cleaned from the root canal to prevent the infection from spreading into the tissues beyond the tooth.
Generally root canals are only recommended when the Decay has progressed to the point where it has inflamed the nerve canal which rapidly spreads to the root and pressure is increased from the infection itself. The purpose of the root canal is to relieve the pressure and replace the infection with an inert substance that is sterile and then the tooth needs to be restored
If the cavity is so deep that it extends into the nerve tissue of the tooth, then a root canal would be required. If you didn't want to go through with the root canal, a possible alternative would be to extract the tooth and replace it with a single implant crown.
Dear patient,

When the cavity is too big and very close to the nerve, the right treatment is to have a root canal done. If it's not that close to the nerve, we can try some medication as a base, a permanent filling, and observe the tooth. If the pain comes back, then that tooth really needs a root canal.
I hope I made it clear.


Dr. Zau
If the cavity is that large or the tooth already hurts to chew, then there really is no other way to treat. Sometimes a careful, but large filling would help the pain and solve the problem, but your dentist can tell how close the cavity is to the nerve.

Good luck,

Dr. David Wiseman
When a tooth has a lot of decay, traditionally, a dentist does a root canal to treat the bacteria buildup inside the tooth. There are other options if the nerve of the tooth is not dead. For example, the dentist can remove most of the decay and kill the remaining bacteria with a couple of different substances like: silver iodine, MTA or Biodentin. My favorite is to use Ozone gas on the tooth. By using some of these, I have had successfully cut down the number of roof canals I did 20 years ago by about 75% and the teeth remain alive for years and even decades without further need for a root canal therapy. A Bio-mimetic dentist usually has the knowledge to treat a tooth that has a lot of decay without having to always do a root canal to treat infection.


Dr. Platt
A cavity can be treated by a filling/restoration if the decay is not very deep. If the deep is so deep that it has reached the nerve, then the tooth has to be root canal treated. If the decay has reached the nerve and is not treated then it can lead to problems in the future.
What determines that a tooth needs a root canal or just a filling is the proximity of the decay to the nerve pulp.
Your tooth has nerve tissue in a chamber inside the tooth. If the decay is so bad that it goes into the nerve chamber and destroys the nerve then the nerve will need to be removed from the tooth to prevent infection. The process to remove the bad nerve and decay and fill the nerve chamber to keep the tooth is called a root canal treatment.
This is a complicated answer because root canals do not treat cavities. Let me explain the parts of a tooth. What you see is an enamel shell. The enamel shell is supported by dentin which is similar to enamel in hardness; however is filled with fluid filled tubules which are intended to transfer nutrients from the core of the tooth. When germs get into the dentin they damage the tooth eight times faster than when they were localized only in the enamel. For that reason decay is 'watched' by a dentist when in enamel or perhaps treated with a sealant to prevent further penetration. When it is deemed through the enamel and into the dentin, it then is treated with a filling which can be of a variety of materials which is a whole discussion of its own. The core of the tooth is the pulp which involves the center of the tooth and canals which extend down the center of the roots into the bone. Blood vessels and nerves are in the pulp. When germs penetrate completely through the dentin and infect the pulp, then there are two infections. One in the dentin and the other in the pulp. A 'root canal' treats the infected pulp. A filling treats the infected dentin. Best to see a dentist regularly and prevent decay from penetrating into the pulp.
Exam of tooth X-Ray, symptoms.
If your cavity is deep enough to extend to the area where the nerve is located, then yes it is necessary to have root canal treatment & have the tooth restored. If you don’t get it treated, there will be an infection within your tooth and you can end up with a painful abscess.