After examining a problematic tooth, your dentist may suggest that you need a root canal. The procedure may not have a glowing reputation as far as you're concerned, but many of the negative associations with root canals are based on outdated information. Advances in pain relief, techniques, and technology mean that although a root canal once had the potential to be a painful experience, this is certainly no longer the case. But still, you might feel some hesitation, leading you to wonder—what's the worst that could happen if you didn't have a root canal? At a minimum, the pain you're experiencing will get a lot worse.

Pulp Problems

Root canals are intended to neutralize the problem you're currently experiencing in your dental pulp. This is achieved by removing the dental pulp, irrigating and disinfecting the pulp chamber, and then filling the site. This filling material (typically a type of latex called gutta-percha) ensures that the removal of the pulp doesn't weaken the tooth. The tooth will receive additional reinforcement once the root canal has been completed. This reinforcement will involve a filling, often followed by a dental crown to fully encase the tooth, in order to create the strongest restoration possible. 

Infection and Inflammation

The pulp is located (logically enough) in the pulp chamber at the center of the tooth. Your pulp is experiencing an infection that has resulted in its inflammation. Once this infection has advanced to the point that pulp necrosis (death of the dental pulp) is unavoidable, then a root canal becomes similarly unavoidable. In a nutshell, a root canal is recommended because this procedure is most appropriate for retaining the tooth.

Possible Complications for an Untreated Tooth

Since healthy, pain-free retention of the tooth is the goal, you can probably already guess the ultimate outcome for refusing a root canal when one is needed. That's right—total loss of the tooth becomes far more probable when infected dental pulp is not removed. However, you can reasonably expect a few other unfortunate events before (and even after) the tooth is lost:

• The continuing inflammation of your dental pulp will lead to increased pain. Over-the-counter pain relief will be inadequate, and this pain will continue until a root canal is performed.
• The infection in your dental pulp can expand to the tooth's support structures (gingival tissues and periodontal ligaments). At this stage, the tooth may become mobile (loose), and is likely to soon detach from its support structures.
• Infection that has spread to your bones can lead to ​​osteonecrosis of the jaw. This is literally the death of this section of bone and can require immediate comprehensive treatment. Jaw surgery may be required.
• Advanced infection can lead to the development of sepsis, an extremely serious condition that can impact your immune system to the point of being fatal.

To summarize, aside from some minor discomfort during the healing process, there's no downside to receiving a root canal. However, failing to get a root canal when one is needed can have catastrophic effects on your health.