Decades ago, having a toothache meant having the tooth extracted. Today, most teeth with infected nerve tissue can be saved by performing a root canal. Unfortunately, root canals have a bad reputation for causing discomfort. In most instances, root canal therapy does not need to be painful. Root canals need to be done when decay has infected the nerve and the nerve needs to be removed. Root canal therapy can usually be done in 1 visit, followed by a crown to maintain the tooth’s integrity. Discomfort may be the result of a larger infection involving the nerve and surrounding bone of the root. For this reason, you should always get decayed teeth restored as soon as they are diagnosed to avoid advancement of the decay to the nerve and to avoid the need for a root canal.