Cheongdam-dong Dental Clinic: Is Root Canal Treatment Really Necessary? What Happens If You Don’t Get It?

“Please don’t do a root canal—just fill it.”

Have you ever thought that at least once? Hello, this is Ceramix Dental Clinic, a dental clinic in Cheongdam-dong.

“People say teeth get weaker after a root canal, so can’t I just skip it?”

“I heard on YouTube that if a root canal goes wrong, you can end up having the tooth extracted anyway..”

“If painkillers make the pain go away, do I really need a root canal?”

I hear these questions in the treatment room every single day.

Online, there are countless pieces of content with provocative titles like “Don’t get a root canal” or “Natural healing is possible.” I think it’s only natural for patients to feel anxious.

In particular, because pain goes away temporarily after taking painkillers, many people think, “Oh? Is it better now?” and postpone visiting the dentist.

But just because the pain is gone does not mean the problem has been solved. Today, as a dentist, I’ll honestly explain what root canal treatment actually is, why it’s necessary, and what really happens if you don’t get it.

What exactly is root canal treatment?

A tooth may look like a hard piece of stone on the outside, but inside there is living nerve and blood vessel tissue called the pulp. This pulp supplies nutrients to the tooth and plays an important role in transmitting sensations of cold and heat.

However, when a cavity becomes deep or the tooth is injured, bacteria can invade this pulp. Once the pulp is infected by bacteria, it cannot recover on its own. Medically, this is called “irreversible damage.”

Here is the root canal treatment process in order

Step	Process	Description
①	Anesthesia	Sufficient anesthesia for a painless procedure
②	Removal of decay and opening of the tooth	Opening the infected area to access the inside
③	Removal of infected nerve and pulp tissue	Thoroughly removing contaminated tissue
④	Root canal cleaning and disinfection	Thoroughly disinfecting the canal where the nerve runs
⑤	Filling with biocompatible material	Filling the empty space with a safe material
⑥	Final restoration with a crown, etc.	Firmly protecting the weakened tooth

It usually takes 1 to 3 visits to complete, and the success rate of properly performed root canal treatment is about 85–97%.

If a crown is properly placed after the root canal, the tooth can be used for decades depending on how well it is cared for. In other words, the key point is that root canal treatment is a treatment that “saves” the tooth.

“Since the pain went away after I took medicine, can’t I just skip it?” – the most dangerous misconception

This is the most important part of today’s article. Let me go through the three most common misconceptions one by one.

Misconception ① – “If the pain goes away, it means it’s healed”

Pain may lessen after taking painkillers or as time passes. But this does not mean the nerve has “recovered”; it means it is “dying.” Once the nerve has completely necrosed, the pain may temporarily disappear, but the infection continues spreading toward the tip of the tooth root.

If a fire alarm stops ringing, it does not mean the fire is out; it means the alarm has burned out.

The pain disappeared because the nerve (the alarm) died, so there is no longer any nerve left to feel pain.

Misconception ② – “Root canal treatment weakens the tooth, so it will end up being extracted anyway”

That statement is both true and false. It is true that after a root canal, the tooth receives less nutrient supply and becomes somewhat drier. However, if it is properly protected with a crown, it can still be used for a long time. In fact, if you don’t get the root canal and the infection spreads, you may end up needing the tooth extracted entirely.

	Root canal + crown	Leaving a root canal untreated
Tooth lifespan	Can be used for decades depending on care	High chance of extraction
Cost	Relatively low	Much higher (extraction + implant)
Treatment period	3–5 visits	Several months until infection treatment + extraction + prosthetics

Misconception ③ – “Root canal treatment is extremely painful”

In the past, it’s true that pain was severe because anesthesia techniques were not as developed. But in modern dentistry, it is performed with sufficient anesthesia and is almost painless. In fact, the spontaneous pain you experience while delaying treatment, or the nighttime pain that keeps you from sleeping, is far more severe.

⚠️ What actually happens if you leave it untreated?

Infected pulp → pus pocket at the root tip (apical abscess) → infection spreading to the jawbone (osteomyelitis) → facial swelling, severe inflammation → in extremely rare cases, infection extending to the neck and even sepsis

Cases of patients being taken to the emergency room because of untreated tooth infections are reported every year. This is by no means an exaggeration.

In conclusion, there are very limited cases where you do not need a root canal. If a dentist recommends root canal treatment, it means the tooth is already at a stage that cannot be reversed.

Then in what cases is root canal treatment absolutely necessary?

✅ Cases where root canal treatment is definitely needed

• When there is spontaneous pain, with the tooth throbbing even without any stimulus

• When pain lasts for more than several tens of seconds after contact with something cold or hot

• When the cavity is so deep that the nerve is exposed

• When a black shadow (periapical lesion) is seen at the tip of the tooth root on an X-ray

• When the nerve is exposed because the tooth has broken due to trauma

• When a pus pocket has formed in the gum

The key criteria are judged by the dentist by combining “X-ray + symptoms + clinical examination.” It can be very dangerous for patients to decide on their own, “I don’t need a root canal.”

How to care for your tooth after root canal treatment

Step	Care item	Description
①	Crown completion is essential	If you only get the root canal and do not get a crown, the tooth is at high risk of cracking
②	Regular follow-up observation	Even after completion, an X-ray check every 6 months to 1 year is recommended
③	Be careful with hard foods	Avoid habits such as biting ice or candy
④	Maintain basic oral hygiene	Keep up with flossing and brushing

The most important thing is the “timing.” If caught early, root canal treatment itself may not even be necessary; if you delay once it becomes necessary, it can progress to extraction. In terms of treatment cost as well, root canal treatment + crown is much less expensive than extraction + implant.

Don’t miss the “last chance” to save your tooth

To sum up, root canal treatment is the “last resort” for saving a tooth without extracting it. I completely understand the desire to avoid it, but the longer you put it off, the more complicated the treatment becomes and the higher the cost.

Don’t feel reassured just because the pain has disappeared. It may actually be a more dangerous sign.

I do not recommend making a rash decision to say, “Just pull it,” or judging from internet information alone, “I probably don’t need a root canal.” Please get an accurate examination and consultation first.

If you have any questions, please feel free to contact us anytime.

We will treat you with the same care and honesty as if it were our own tooth. 😊