The words "root canal" make many people anxious. Yet with today's anaesthetics and techniques the procedure feels little different from an ordinary filling. The real pain comes from putting treatment off.
Why is root canal treatment needed?
In the centre of the tooth is a soft tissue called the pulp, which contains nerves and blood vessels. When deep decay, a fracture or a blow reaches this tissue, the pulp becomes inflamed. Trapped between the hard walls of the tooth, an inflamed pulp causes severe pain and cannot heal by itself. Root canal treatment removes this tissue, cleans the canals and fills them; the tooth stays in the mouth.
Does it hurt during the procedure?
No. Before the procedure the tooth and the area around it are numbed with local anaesthetic. What you feel is not pain but pressure, vibration and the tiredness of keeping your mouth open for a while. In very inflamed teeth the anaesthetic may take a little longer to work; in that case your dentist gives more. If you feel anything during the procedure, just raise your hand.
Is pain after treatment normal?
Mild tenderness when biting or chewing for the first few days is to be expected. It is caused by the tissues at the root tip healing after the procedure. It usually passes with simple painkillers.
Call your dentist if:
- The pain is getting worse rather than better
- Your face or gum has swollen
- The temporary filling has come out or broken
- The tooth feels high when you bite
How many sessions does it take?
Front teeth usually have one canal, back teeth three or four. Many teeth can be completed in a single session. If the infection is heavy, medication is placed in the canal and treatment is finished at a second session. A session lasts about 45 minutes to an hour and a half, depending on the tooth.
What is done to the tooth after treatment?
Root canal treatment repairs the inside of the tooth; the outside needs repairing too. If little tooth has been lost, a filling is enough. If much of the tooth is gone, especially in back teeth, a crown is recommended to prevent fracture. Delaying the final restoration is one of the most common reasons for treatment failing.
Do antibiotics take the pain away?
Antibiotics do not heal an inflamed pulp; they only suppress spreading infection and ease symptoms temporarily. A toothache that "goes away" with painkillers or antibiotics does not mean the problem is over. Often the nerve has died and the infection moves quietly on to the root tip.
What happens if I put treatment off?
The infection spreads from the root tip into the bone, an abscess may form and the face may swell. In time the tooth becomes impossible to save and has to be extracted. Root canal treatment done early is both easier and extends the life of the tooth. For details of the process see our root canal treatment page.
Frequently asked questions
How long does a root-filled tooth last?
With properly done root canal treatment and a filling or crown fitted in good time, the tooth can stay in the mouth for many years, often for life. Regular check-ups and good oral care extend that time.
Can root canal treatment be done during pregnancy?
Yes. If there is pain and infection, treatment is not postponed; local anaesthetic can be used safely in pregnancy. The second trimester is the most suitable period for planned treatment.
Does the tooth go dark after root canal treatment?
With today's techniques discolouration is rare. If it happens, it can be corrected with internal whitening or a crown.
This article is for general information and is not a substitute for diagnosis or treatment. If you have a complaint, please see your dentist.