Everything You Must Know about Molar Root Canal Treatment

Root canal treatment is one of the popular dental procedures which is mainly performed to heal infected pulp or periapical infections. Typically, this treatment involves removing the infected pulp, cleaning, and shaping the tooth root canals and filling the tooth with plastic or rubber-like material.

Root canal therapy is slightly complicated when it comes to molar teeth due to the presence of two or more roots and root canals. It is essential to have a sound knowledge about the tooth anatomy of molars before accessing the root canals. Any failure can lead to severe complications post-treatment.


Some of the post-treatment complications of molar root canal therapy include a crack in the tooth, bacterial contamination, and improper removal of the infected pulp. Today’s article will highlight the procedure of the molar root canal. Furthermore, we will discuss the complications and costs of molar root canal treatment.

Why is the root canal performed in molars?

Root canal treatment is an invasive dental procedure that involves painless removal of the infected tooth pulp and periapical infection. Moreover, it also consists of the cleaning and shaping of each root canal followed by filling of the tooth with a rubber-like material called gutta-percha. (1)

Most posterior teeth, such as molar teeth, usually require dental crown placement after root canal therapy to protect the treated tooth’s integrity and longevity. There are several reasons why root canal therapy may be required to save the mouth’s molar tooth. Some of these indications include –

  • A grossly decayed tooth that cannot be repaired with a tooth filling
  • Severe pain and discomfort on chewing and biting, especially during sleeping
  • A deep crack or fracture of the tooth
  • Prolonged tooth sensitivity
  • Gum disease that has initiated periapical infection
  • Infected tooth pulp
  • Periapical tooth abscess that involves one or more molar roots

What are the benefits of the root canal procedure?

Some of the critical benefits of molar root canal therapy include –

  • Relief from continuous pain and discomfort caused by a tooth infection
  • Relieves pressure from the inflamed pulp in the tooth
  • Saves the tooth in the mouth and increase its longevity
  • Saves the patient from undergoing tooth extraction (2)
  • Prevents spread of infection into the gums and periodontium
  • Prevents further bone loss

What are the considerations for molar root canal treatment?

Usually, molar root anatomy is slightly complicated as compared to anterior teeth such as incisors and canines. It is essential to be thorough about the anatomy of the molar root. These complex clinical challenges require diagnostic approaches, access modification, and clinical skills to successfully localize, negotiate, disinfect, and seal the root canal system.

  • Usually, upper molars have three-tooth roots with one root canal in each tooth root – palatal root canal, mesial root canal, and distal root canal. In most cases, the mesial root can have one or two root canals. (3)
  • Lower molars have two tooth root mesial and distal with one root canal each. However, like upper molars, the mesial root in lower molars have the probability of an extra root canal.

How is the molar root canal performed?

Usually, the molar root canal treatment is performed under local anesthesia. The stepwise procedure for molar root canal therapy include the following –

  • Cleaning the root canal is crucial as it involves the complete removal of the infected tooth pulp—Moreover, the removal of bacteria from the tooth root and the periapical area. Usually, the dentist drills the tooth to access the canal orifice. Furthermore, he uses the root canal files to reach the apical region of the tooth root. (4)
  • Filling the root canal – once the channel is thoroughly cleaned and intercanal medicament is placed to treat the bacteria, the tooth is filled with obturating material such as gutta-percha, which is a rubber-like material that acts as artificial pulp.
  • After root canal therapy, the tooth becomes weak and fragile. Therefore, Dental crown placement is necessary, especially for molar teeth, as it strengthens the tooth and increases its longevity.

On average, the completion of root canal treatment takes around 2-3 appointments over one week.

What are the complications of molar root canal treatment?

Some of the complications that may occur while performing a molar root canal are –

  • In some cases, the dentist may negotiate only three root canals in a tooth that has four. This leaves the extra canal untreated, which may re-infect the tooth.
  • Sometimes, the filling material may not reach the apices of the tooth root causing improper seal; such cases can also lead to infection. (5)
  • Overuse of instruments can cause tooth root fracture or breakage of instrument tips that may perforate the canal. This makes it hard to fill the tooth effectively.

What is the cost of molar root canal treatment?

The cost of the molar root canal usually depends on the number of root canals, the complex anatomy, and the tooth’s alignment to gain access. Moreover, the dentist’s clinical experience or specialty may also be considered while calculating the cost of root canal treatment.

On average, the cost of a molar root canal may range between $500 – $900 per tooth.

Take away message

Root canal treatment is a dental procedure typically performed to treat a grossly decayed tooth, infected pulp, tooth abscess, or tooth fracture. Molar teeth usually have two to three-tooth root with one or more root canal in each root.

Therefore, root canal treatment in molars is slightly complicated compared to that in anterior teeth with single tooth root and canal. Moreover, the complex anatomy may also increase the risk of complications such as missing a root canal, over instrumentation, and the inability to fill the tooth root appropriately.


It is best to consult a dentist who has good experience in performing root canal treatments. If possible, look for an endodontist who specializes in performing root canal treatments effectively.


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