What is Involved in a Molar Root Canal?

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  • Written By: B. Chisholm
  • Edited By: Nancy Fann-Im
  • Last Modified Date: 27 September 2019
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A molar root canal is performed by a dentist or endodontist and entails the removal of the tooth pulp of a molar, or back tooth. This may be necessary due to an infection of the tooth, an abscess, or physical trauma to the tooth. The procedure is normally performed in the dentist's rooms, under local anesthetic, and may require a number of visits, depending on the tooth and the damage. If done well, it shouldn't entail too much pain, if any.

The tooth is comprised of three sections: an outer hard layer of enamel, a slightly softer inner layer of bone-like material called dentin, and the inner canal, which contains what is referred to as soft pulp. It is, in fact, not really pulp, but actually blood vessels and nerves that run down the root or roots of the tooth and join the gums and jaw. Depending on the tooth, there may be one or up to four canals per tooth.


When a molar root canal is required, the pulp of the molar has become damaged, either by tooth decay, infection or trauma. Tooth decay generally occurs due to a lack of dental hygiene and can, in most cases, be avoided. The mouth is filled with bacteria that help to break down food. While breaking down carbohydrates and sugars, the bacteria produce acid, which can combine with particles of food to produce plaque, a sticky film that covers the teeth. The plaque damages the enamel and can eventually allow bacteria through, which may cause infections.

In some cases an abscess may form in the tooth, which may need antibiotic treatment before a molar root canal is performed. Trauma, too, such as a blow to the jaw, may cause damage to the tooth and exposure of the nerve, necessitating a molar root canal. Symptoms of an infection or exposed nerve include tenderness when eating or drinking hot or cold foods, swelling of the gums or cheek, and pain.

A molar root canal may take a couple of hours. X-rays are taken of the infected tooth to establish how many canals are present and where the work will be done. Molars can have two to four canals and may require multiple visits. In some cases antibiotics may be given prior to, during, or after the molar root canal procedure.

Local anesthetic is administered around the area where the molar root canal will be performed. The tooth is then opened up and the soft pulp removed completely. The root canals are generally very small, so dentists typically use a file to expand the area and make it even before filling it. If the molar root canal is performed over a number of visits, temporary fillings will be done. A small amount of antibiotic may be inserted in the canal to prevent further infection.

Once the procedure is completed, the dentist will usually put a crown on the tooth. The molar root canal may cause the tooth to be slightly weaker than other teeth, and the crown should prevent any further damage. During and after root canal treatment, the patient should take care not to eat anything too hard or sticky, until the crown is completed. Some pain may be experienced for a little while after, for which analgesia can be prescribed.


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