What to expect during a root canal

This page is awaiting clinical review by Dr. Renuka.

If your dentist has mentioned root canal treatment, you may feel anxious. It is a very common procedure, and understanding what it involves can make it feel much more manageable. Root canal treatment aims to save a natural tooth that might otherwise need to be removed.

Why root canal treatment may be needed

Inside each tooth is the pulp, a soft tissue that contains nerves and blood vessels. Deep decay, a crack, repeated dental work or an injury can let bacteria reach the pulp. The pulp may then become inflamed or infected. Signs can include lingering sensitivity to hot or cold, toothache, pain when biting, or swelling near the tooth. Sometimes there are no symptoms at all and the problem is found on an X-ray.

Before treatment

Your dentist will examine the tooth and usually take an X-ray to look at the roots and surrounding bone. They will explain whether root canal treatment is suitable, what the alternatives are, and how many visits may be needed. This is a good time to ask questions and mention any medical conditions or medicines.

During treatment: step by step

• Numbing: local anaesthetic is used to keep you comfortable. You may feel pressure but should let the dentist know if you feel discomfort.
• Isolation: the tooth is often kept dry and clean, for example with a thin rubber sheet called a dental dam.
• Access: a small opening is made in the tooth to reach the pulp.
• Cleaning and shaping: the affected pulp is removed, and the narrow canals are cleaned, disinfected and shaped with fine instruments.
• Medication or filling: the canals may be filled and sealed in the same visit, or a medicine may be placed inside and the tooth temporarily sealed until the next visit.

The length of each appointment and the number of visits depend on the tooth, the number of canals and whether infection is present. Back teeth often have more canals and may take longer.

Why a crown is often recommended

After root canal treatment, a tooth can be more brittle, especially if it was already heavily filled or decayed. A crown, often called a cap, covers and protects the tooth so it is less likely to crack. Your dentist will advise whether a crown or a filling is the better option for your tooth.

After treatment

It is common for the tooth and gum to feel tender for a few days. This usually settles. Your dentist may advise suitable pain relief. Contact the clinic if pain gets worse rather than better, if swelling develops, or if a temporary filling falls out.

• Wait until the numbness wears off before eating, to avoid biting your cheek or tongue
• Avoid chewing hard foods on the treated tooth until the final restoration is in place
• Keep brushing and cleaning between your teeth as normal
• Attend your follow-up appointment for the crown or permanent filling
• Follow the specific instructions your dentist gives you

Common worries

Many people worry that root canal treatment will hurt. Local anaesthetic is used to numb the area, and many patients say it feels similar to having a filling. Others ask whether it is better to remove the tooth. Extraction is sometimes an option, but keeping your natural tooth can help with chewing and avoid the need to replace a gap. Your dentist will explain the pros and cons for your situation.

Root canal treatment is a well-established procedure, but no treatment works in every case. Occasionally a treated tooth may need further treatment in the future. Good oral hygiene and regular checkups help protect the tooth.

When to seek urgent care

If you have facial swelling that is spreading, a fever, or difficulty breathing or swallowing, seek urgent medical care straight away.