If the pulp becomes injured or diseased, it cannot repair itself, and the tissue dies.
If there is a deep cavity, a cracked tooth, or a loose filling, bacteria can enter the pulp.
The bacteria will eventually destroy the pulp. If the bacteria penetrate through the root openings, it can cause an infection in the bone.
An infection will weaken the bone and break it down. The ligaments around the tooth will swell, and the tooth will become loose.
A pulp injury will make the tooth sensitive to high and low temperatures. There may be a pain when chewing, and some people have continuous, throbbing pain.
Without treatment, the infection will spread. Eventually, the tooth will become loose and need extracting.
Some patients opt for extraction, especially if it hurts a lot or if the tooth cannot be restored, for example, if there is large decay, trauma, or loss of bone due to periodontal, or gum, disease.
However, removing a tooth may mean that the surrounding teeth start to move and become crooked. This can look unsightly, and it can make it hard to have a good bite.
Root canal therapy will usually save the tooth and eliminate the pain.