How to avoid a root canal

How do you prevent a root canal?

Cleveland Clinic says the main causes of pulp infection are deep cavities and cracks, and that good oral hygiene lowers the risk of both. It advises brushing after meals, flossing daily and getting regular dental checkups. The NHS advice on preventing tooth decay is to clean your teeth at least twice a day with fluoride toothpaste and spit out the excess instead of rinsing, clean between teeth once a day with floss or interdental brushes, limit sugary foods and drinks, and keep up regular dental visits even without problems. Cleveland Clinic's cavities page adds brushing with a soft-bristled brush, cutting back on sugary and starchy foods, visiting the dentist about twice a year and asking about sealants.

Treat cavities early

Cleveland Clinic says in the earliest stages fluoride can repair enamel and reverse early signs of decay, and that fillings remove decayed tissue and fill the space. The NHS says early decay may be reversed with fluoride mouthwash or varnish prescribed by a dentist and that a cavity usually needs a filling, with deeper decay needing root canal treatment. Cleveland Clinic says leftover decay can make a cavity grow larger. Decay at the enamel level often has no symptoms, so checkups catch what you cannot feel. See our guides on whether cavities can be reversed.

Protect against cracks

Cleveland Clinic names cracks as a main cause of pulp infection. The American Association of Endodontists says long-term success depends on a timely permanent restoration such as a crown, good hygiene, regular checkups and avoiding habits that raise fracture risk, and that retreatment can be needed if new bacteria enter the tooth through a cracked or loose filling, a delayed crown, new decay or trauma. The sources we read do not list the habits; general advice such as not chewing ice and wearing a mouth guard for grinding or sport is ours and is flagged.

Can you avoid a root canal once a tooth is infected?

The sources we read say no. Cleveland Clinic says an infected tooth will not heal on its own, and that left untreated the infection can spread and damage the jawbone and the tooth may loosen. The NHS says a dental abscess needs prompt treatment from a dentist and will not clear up on its own. The American Association of Endodontists says an infected tooth will not heal on its own, the infection can worsen and delay often leads to tooth loss. Our sources do not support treating an infection without a dentist.

Is extraction an alternative?

The American Association of Endodontists prefers keeping a natural tooth with a root canal whenever possible, because natural teeth help preserve bite alignment, jawbone and chewing. It says extraction may seem faster but often leads to implants, bridges or partial dentures, which can take more time, and that implants require surgery, healing time and more appointments. It says ozone therapy and other holistic or biologic approaches lack strong scientific support as replacements for root canal cleaning and sealing. Cleveland Clinic says if a root canal is not possible, the tooth may be pulled and replaced with a bridge or implant. Not every tooth can be saved: the AAE lists severe damage, extensive decay, fractures below the gumline or insufficient bone support.

How to prepare for a root canal

Cleveland Clinic's page does not list specific preparation steps such as fasting or medication changes. It says your dentist or endodontist will numb the area first, and if you are anxious you can ask for medication to help you relax, which may leave you drowsy afterwards. It describes most sessions as taking about 60 to 90 minutes, with some cases needing more than one visit, and says you usually feel pressure and mild soreness, not much more than a regular filling. Most people recover in about a week. Ask your dentist about any preparation specific to you.

Can an untreated root canal kill you?

Rarely. Cleveland Clinic's cavities page says untreated decay can progress to an abscess and that rarely an infection from a tooth abscess can be fatal. The American Association of Endodontists says an untreated infection poses a greater health risk than a properly treated tooth. See our guides on tooth infection. The sources we read do not discuss reversing a root canal.

Questions to ask your dentist

Take these to your check-up.

• Do you see any decay or cracks that could threaten a nerve?
• Should a large filling be replaced with a crown?
• Do I grind my teeth, and would a night guard help?
• If I need a root canal, should an endodontist do it?
• What can I do now to protect my other teeth?

Frequently asked questions