Do I need a root canal? If the cause of your teeth pain is serious decay or infection in the tooth pulp, your dentist may recommend a root canal. A root canal is a multi-step dental procedure that involves removing the infected tooth pulp (and sometimes the nerve) from a tooth and sealing it to protect against future teeth pain. Endodontic treatment is necessary when the pulp, the soft tissue inside the root canal, becomes inflamed or infected. The inflammation or infection can have a variety of causes: deep decay, repeated dental procedures on the tooth, or a crack or chip in the tooth.