Root Canal Treatment A root canal treatment is needed when a tooth's nerve and associated blood vessels are irreversibly damaged. They may be damaged by trauma, which may fracture a tooth, or by having deep decay that has infected the nerve. The end result is the same, an infection that leads to an abcess at the base of the tooth. Usually there is a throbbing pain in the tooth especially noticable when laying horizontal, ie. in bed at night. There also may be a swelling in your jaw and it may be painful to chew on. Your tooth can usually be saved at this time. If the abcess remains too long the tooth dies and the bone around the tooth is destroyed. The tooth must be removed if this happens. A dentist or endodontist (root canal specialist) can save a tooth by removing the diseased nerve tissue, cleansing and then filling the nerve chamber with a rubberlike material. This procedure can be done in one to three or more visits depending on the condition of the nerve. If there is an abcess antibiotic therapy may be used as well as possibly draining the infected site.