Is root canal treatment painful? What happens, step by step

Root canal treatment has a bad reputation. Most of that comes from the toothache that leads to it, not the treatment itself. Here is what actually happens.

Why a tooth needs a root canal

Inside every tooth is soft tissue called the pulp, which holds the nerve. Deep decay, a crack or an old large filling can let bacteria reach it. The pulp then gets inflamed or infected. Common signs are:

• a toothache that throbs on its own or wakes you at night
• pain with hot or cold that stays after the food is gone
• pain when you bite on one tooth
• swelling in the gum or face near a tooth

What happens during treatment

1. X-ray and check. The dentist confirms which tooth is the problem and looks at its roots.
2. Numbing. The tooth and the area around it are numbed with local anaesthetic.
3. Cleaning. The infected pulp is removed, and the narrow canals inside the roots are cleaned and shaped.
4. Sealing. The canals are filled and sealed so bacteria cannot get back in.
5. Protecting the tooth. A tooth that has had a root canal is weaker. Back teeth often need a crown to stop them cracking.

What you will feel

With the tooth numb, most people feel pressure and vibration rather than pain. Because the treatment removes the inflamed pulp, it usually relieves the toothache that brought you in.

Afterwards, the tooth can feel tender when you bite for a few days. This settles on its own or with the medicines the dentist prescribes. If swelling increases or the pain gets worse instead of better, contact the clinic.

Is removing the tooth easier?

Taking the tooth out can seem quicker, but it leaves a gap. That gap often needs an implant or bridge later so the teeth around it do not shift. Keeping your own tooth is usually the better choice when it can be saved.

Read more about root canal treatment at Anaya Dental, or about crowns that protect the tooth afterwards.