The short answer: it should feel like a filling
No, a root canal should not hurt during the procedure. Your dentist numbs the tooth first, and most people say it feels about like getting a filling. You may feel pressure and hear sounds, but not sharp pain.
The pain people fear usually comes from the infection, not the treatment. An infected tooth can throb, keep you up at night and make hot or cold drinks hard to take. The root canal is what takes that pain away, which is why so many people feel better after it.
If a tooth hurts right now, do not wait for it to go away. Pain that comes and goes, then comes back stronger, is a common sign that the nerve inside the tooth is damaged.
Many people say the worst part was the worry before the visit. If that sounds like you, tell the office when you book. A short chat before the day can take a lot of the fear away.
What a root canal actually is
Inside every tooth is soft tissue called pulp. It holds the nerve and the blood vessels. When deep decay, a crack, a chip or repeated dental work lets germs reach the pulp, it can get inflamed or infected.
A root canal removes that damaged pulp. Your dentist then cleans and shapes the small channels inside the root, fills them and seals the tooth. The goal is to save your natural tooth instead of pulling it.
Mayo Clinic, the American Association of Endodontists (AAE, the root canal specialists' group) and the American Dental Association's MouthHealthy site all describe it this way: a way to repair and keep a badly damaged tooth. The tooth still sits in your jaw and still chews. It just no longer has a living nerve inside.
The word "canal" is the reason for the name. Each root of your tooth has a narrow channel running through it, and that channel carries the pulp. When your dentist cleans that channel, that is the root canal.
Signs you may need one
Only a dentist can tell you for sure, with an exam and an X-ray. But these signs are common:
- Pain when you bite or press on the tooth
- Lingering sensitivity to hot or cold, even after the drink is gone
- A tooth that has turned darker or gray
- A pimple-like bump on the gum near the tooth
- Swelling or tenderness in the gum or face
- A deep cavity or a cracked tooth
What happens during the visit, step by step
First, your dentist takes an X-ray and checks the tooth. Then you get numbing medicine. A small sheet of rubber goes around the tooth to keep it clean and dry.
Next, your dentist makes a small opening in the top of the tooth and removes the pulp. The canals are cleaned, shaped and disinfected, then filled and sealed. A temporary filling closes the opening.
Cleveland Clinic says most root canals take about 60 to 90 minutes. The AAE says many can be done in one or two visits. A tooth with several roots, like a back molar, can take longer.
You are awake the whole time, and you can raise your hand if you need a break. If you feel anxious, say so before you start. Dentists can slow down, explain each step and check that you are numb before they begin.
Recovery, and why a crown usually follows
Expect some soreness for a few days. The area around the tooth may feel tender when you chew. The numbness from the medicine wears off in a few hours, so wait to eat until you can feel your lips and tongue again, so you do not bite them by accident.
Research reviews find that most pain after a root canal is short. In one review of studies, roughly 1 in 10 people still had some pain a week later, and the number dropped much lower over the next months. Many people go back to normal activities within a day or two.
Store-bought pain relievers usually take care of it. Ask your dentist which one is right for you, especially if you take other medicines. Chew on the other side until the tooth feels normal.
A tooth without a living nerve can become more brittle over time. Mayo Clinic notes that a back tooth usually needs a crown after a root canal for this reason. A crown is a cap that covers the whole tooth and protects it from cracking.
Your dentist will place a temporary filling first and then schedule the crown. Do not skip this step. Teeth that wait a long time for their crown can crack or get new decay, and a cracked tooth may no longer be savable.
How well do root canals work?
Very well. The AAE says studies show a success rate of more than 90 percent. Many treated teeth last for years, and often for life, with good brushing, flossing and regular checkups.
Sometimes a treated tooth gets infected again. This can happen if a canal was hard to clean, a crack went unseen or the crown came loose. A failed root canal can often be treated again with a repeat procedure, and in some cases with a small surgery at the root tip.
Some people worry that root canals cause illness elsewhere in the body. The AAE says this idea goes back to a theory from the early 1900s that has been discredited, and current evidence does not support it.
The best way to protect a treated tooth is simple. Get the final crown or filling placed on time, brush and floss every day, and keep your regular exams. X-rays at those visits let your dentist watch the bone around the root, so a problem is caught early instead of after it hurts.
When to call right away
See a dentist soon if you have pain that does not improve in a few days, swelling, a fever, or a bad taste in your mouth. Call 911 or go to an emergency room if swelling spreads to your eye or neck, or makes it hard to swallow or breathe. A spreading tooth infection can be serious.
Call us if your temporary filling falls out or your bite feels high after treatment. Both are easy to fix.
Root canal care at KDA
Root canal therapy is part of the care we offer at Kendall Dental Associates, so you can often stay with the same team for your exam, your root canal and the crown that protects the tooth afterward. We have served South Florida since 1973 from the Kendall Mall, and we will walk you through each step before we start.
Fear is normal. Tell us how you feel, and we will go at your pace. If you have a toothache now, call 305-271-1421. Our office hours are Monday to Friday, 8:00 AM to 5:00 PM, and emergency care is available 24/7. You can find us at 8833 SW 107th Ave, Miami, FL 33176. We accept most dental insurances and most Medicare supplemental plans, and financing is available.
Common questions
Is a root canal painful?
Not during the procedure. The tooth is numb, so you should feel pressure but not sharp pain. Some soreness for a few days afterward is normal.
How long does a root canal take?
Cleveland Clinic says most take about 60 to 90 minutes. Many are done in one or two visits. Back teeth with more roots can take longer.
Do I need a crown after a root canal?
Often yes, especially for back teeth. A tooth without a living nerve can become brittle, and a crown protects it from cracking. Your dentist will tell you what your tooth needs.
Can I go to work after a root canal?
Many people do within a day or two. Plan around the numbness, which lasts a few hours, and expect some tenderness when you chew.
What happens if I do not get the root canal?
The infection usually does not go away on its own. It can spread to the bone and gums, cause an abscess and may lead to losing the tooth. See your dentist soon.
This article is general information, not medical advice. Your dentist will confirm what is right for you at your exam. General information checked against: aae.org, mayoclinic.org, my.clevelandclinic.org, mouthhealthy.org.