Which Tooth is a Root Canal Most Often Done for?

If your toothache is the result of inflammation or infection in the roots of the tooth, your dentist might recommend endodontic treatment, i.e., a root canal. In a root canal, the pulp (nerves and other tissue) inside the roots are removed and replaced with a filling material to seal the space. This procedure will save the natural tooth. It stops the pain and keeps the tooth functional in all ways.


Common Root Canal Causes

The most common cause of root infection is tooth decay, and, much less frequently, periodontal disease (inflammation of the gum and bone surrounding the tooth). Root canal causes could also be infections from injuries to the teeth, such as cracks or chips.

Most Common Teeth Treated

The teeth that most commonly targeted for root canal treatment are the posterior teeth (molars), and they are more often in the mandibular (lower) jaw than the maxillary (upper) jaw. Among the mandibular molars, the first molar presents for endodontic treatment more often than any other:

  • The first molars are the primary grinders used in chewing. Consequently, the greatest amount of food is pressed against these teeth.

  • The molar chewing surface is not smooth; it has tiny pits and small crevices called fissures.

  • Poor oral hygiene allows bacteria to act on food stuck in the fissures (especially sugary food), and the bacterial action produces acids which lead to tooth decay. Once decay starts, it proliferates rapidly and reaches a stage where root canal is the only option to save the tooth.

  • Front teeth are smooth and do not contain the pits and fissures that molars do. Also, the front end of the tongue acts as a wiper and constantly cleans the front teeth with saliva. The chewing surfaces of molars do not benefit from the tongue cleaning as much as the front teeth do.

  • The premolars have a smaller surface area and, therefore, less food-sticking area compared to the molars.

  • The upper jaw is fixed, and the lower molars serves as the anvil, thus receiving most of the pressure created by chewing motions.

The cumulative impact of these factors, particularly in a state of poor hygiene, renders the lower first molar the most vulnerable and most prone to caries and consequent root canal procedures.

Tooth Conservation is the Trend

Extraction is no longer the treatment of choice for bad teeth. More than 15 million root canals are performed every year, and that number is increasing as more people are finding ways to preserve natural teeth and request more conservative treatment options.

Most root canals are performed by endodontists, dentists who received two or more years of additional training focused on diagnosing tooth pain and performing root canals and other procedures relating to the interior of the tooth. They are the specialists at getting to the “root” of your pain.