Root canal treatment – when and why?

Last updated on: 5 Aug, 2026

A root canal is required when the root is severely damaged by infection, trauma or advanced tooth decay and the tooth can no longer be saved through conservative treatment. 

The procedure aims to remove the source of infection, prevent its spread to surrounding tissues, and protect the remaining teeth and jawbone. The decision to extract is made following a thorough diagnosis, which includes a clinical examination and imaging tests.

In the following sections, we will examine the circumstances in which a tooth root needs to be removed, the symptoms indicating that the problem has reached a critical stage, and how the procedure itself is carried out. We will also look at the potential risks, the recovery period, and modern alternatives which, in some situations, allow the tooth to be preserved.

Image: freepik

Reasons for tooth root extraction

There are various clinical situations in which the extraction of a damaged tooth root is necessary. When conventional treatment fails, surgical intervention is the only way to protect the oral cavity from more serious complications. Here are the main reasons why specialists recommend this procedure.

Tooth infections

Untreated tooth decay can affect the deep structures of the tooth, including the dental pulp, and cause inflammation of the tooth. In severe cases, bacteria reach the root tip and form an abscess or granuloma. 

If a single root canal treatment fails to control the infection, the affected root must be removed. A decayed tooth root poses a serious risk to neighbouring teeth and to the patient’s overall health.

Periodontitis

Periodontitis is an inflammatory process that affects the tissues surrounding the tooth root and gradually destroys the jawbone. In advanced stages, the stability of the tooth is compromised and it begins to wobble. 

These dental problems cannot be resolved with medication alone and require specialist periodontal treatment. Removing the affected root protects the surrounding tissues from further destruction.

Trauma and fractures

A blow or accident can lead to a root fracture, rendering the tooth non-functional. In a vertical fracture, the root splits lengthwise and cannot be restored. 

A broken tooth with a fracture below the gum line usually requires surgical removal. Prompt action prevents further damage to neighbouring structures and infection of the wound.

Symptoms requiring root extraction

Certain symptoms indicate that damage to the tooth root has reached a critical point. If you notice one or more of the signs listed below, it is important to seek dental care without delay. 

The most common symptoms are:

• Pain when chewing and persistent dental discomfort that does not subside with painkillers.
• Swelling and redness of the gums around the affected root, sometimes accompanied by pus.
• Bad breath that is not affected by oral hygiene measures and is an indicator of an active inflammatory process. 
• Increased sensitivity to hot and cold or spontaneous, vague pain

Early detection of the problem significantly increases the chances of successful treatment.

How does the tooth root extraction procedure work?

The tooth or root extraction procedure is planned in advance. Each procedure is carried out following a thorough diagnosis, including a panoramic X-ray. In some cases, 3D tomography (CBCT) is also used. Local anaesthesia ensures comfort and a pain-free experience during the procedure.

  Image: freepik

In more complex cases, oral surgery involves an incision in the soft tissues and the removal of a small amount of bone tissue to access the root. After its removal, the socket is cleaned of inflammatory tissue and sutured if necessary.

Are there any risks or complications?

Although tooth extraction is a routine procedure, it carries certain risks. Bleeding after the procedure is normal, but prolonged bleeding requires medical intervention. Alveolitis, known as ‘dry socket’, can occur if the blood clot detaches from the wound. This condition causes severe pain and delays normal wound healing. 

When extracting upper molars, there is a risk of perforating the maxillary sinus. An experienced surgeon at the dental clinic takes precautions to minimise these risks. 

It is essential to inform the dentist about any medication you are taking and any chronic conditions before the procedure. Patients with blood clotting problems require additional preparation.

How long is the recovery period?

In the first 24 hours after the extraction, applying a cold compress is recommended to reduce swelling. The patient should avoid hot food and drinks, smoking and physical exertion. Soft food is preferable in the first few days so as not to disrupt the wound healing process. Painkillers should be taken as prescribed by the treating dentist.

Initial healing of the soft tissues occurs within 1–4 weeks. Good oral hygiene, without vigorous rinsing in the extraction area, is crucial for successful recovery. 

To speed up healing, DentaTime Clinic also offers PRF therapy. If you experience severe pain, a fever or prolonged bleeding after the fourth day, you should seek dental treatment.

Image: freepik

Alternatives to tooth extraction

Modern dentistry offers methods that allow the tooth to be preserved even in cases of severe root damage. Endodontic treatment (root canal treatment) is the most common alternative, in which the tooth’s canals are cleaned, disinfected and filled. When standard root canal treatment is unsuccessful, apical resection is performed – the surgical removal of the root tip.

In multi-rooted teeth, a hemisection of the tooth is performed, allowing only the damaged root to be removed whilst preserving the rest of the tooth. Similar to this is root amputation, in which only the damaged root is removed, preserving the possibility of functional restoration of the crown. 

These methods have uncertain success rates and are suitable when the infection is limited to a single root and the others are healthy. Following the procedure, the tooth is reinforced through prosthetic restoration with a crown or bridge.

If saving the tooth is not possible, dental implants offer a reliable long-term solution for replacing the missing tooth. An alternative option is dentures, which restore chewing function and the aesthetics of the smile. The choice depends on the patient’s general health, the volume of available bone, and individual expectations. 

Conclusion

Tooth extraction is a procedure that becomes necessary when all options for preserving the tooth have been exhausted. Timely diagnosis and the correct choice of treatment approach are crucial for oral health. 

They are a prerequisite for precise surgical treatment and full recovery. Do not delay your visit to the dentist, as early intervention prevents complications and ensures long-lasting results.

Frequently asked questions

How many days does it hurt after a root canal?

The discomfort usually lasts two to three days and gradually subsides. If the pain worsens after the fourth day, seek medical advice.

Can an implant be placed immediately after a root extraction?

In certain cases, it is possible to place an implant at the same time as the extraction. This depends on the condition of the bone and the absence of an active infection.

Is an X-ray mandatory before a root extraction?

An X-ray is used to assess the shape, length and position of the root. Without it, the risks of complications increase significantly.