Root canal therapy involves the process of removing the pulp from an infected tooth and replacing it with a biocompatible material called gutta-percha. Gutta percha does not react within the human body, making it an excellent material for root canals. 

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The most common cause for needing a root canal is an infection. Once the root is infected, antibiotics will help, but they cannot clear the source of the infection. At that point the only long-term solutions are to extract the tooth or perform root canal therapy. Sometimes the tooth is unrestorable, but generally we can save the tooth through root canal therapy. 

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Teeth that have undergone root canal therapy are more prone to breaking and fracturing and therefore generally need to be crowned. This protects the tooth long term.