Root canal treatment: nine things that make it easier
Root canal treatment has the worst reputation in dentistry and it is largely out of date. It is the procedure that stops the pain rather than causing it. Here is how to make it go smoothly.
Root canal treatment has the worst reputation in dentistry, and most of that reputation is decades out of date.
Here is the reframe that matters. The agony people associate with root canals is the infection. The treatment is what takes it away. People arrive in real pain and leave with it gone, and the procedure gets blamed for the thing it fixed.
That said, there are things that make the appointment go much better. These are the nine that matter.
First, what it actually is
Inside every tooth is a soft core of nerve and blood vessels, running down through the roots. If decay, a crack or an injury lets bacteria in there, it becomes infected.
That core cannot heal itself and antibiotics cannot reach it properly, because the blood supply is being destroyed by the infection. So there are two options: remove the infected tissue and keep the tooth, or remove the whole tooth.
Root canal treatment is the first one. The infected tissue is cleaned out, the canals are disinfected and shaped, and they are sealed so nothing can get back in. The tooth stays.
1. Go early
This is the most useful thing on the list.
A tooth that has been badly infected for weeks is harder to numb properly, because inflamed tissue is more acidic and local anaesthetic works less well in it. The pain is worse, the appointment is longer, and the outlook for the tooth is poorer.
Treated earlier, everything is easier. So the throbbing that wakes you at night, the tooth that hurts for a long time after something hot or cold, the tenderness on biting, the pimple on the gum near a tooth, and the tooth that has darkened are all reasons to ring now rather than see how it goes.
2. Know what will happen
A great deal of dental fear is fear of the unknown.
You will be numbed and given time for it to work properly. A thin sheet is placed to isolate the tooth and keep it dry, which also stops anything reaching the rest of your mouth. The infected tissue is cleaned out through a small opening in the top of the tooth. The canals are cleaned and shaped, then sealed. The opening is closed with a filling.
What you will feel is pressure and vibration. What you will hear is quite a lot of nothing much happening.
3. Say you are anxious when you book
Not once you are in the chair. It changes how the appointment is set up.
We can allow more time, explain as we go or not at all depending on which you prefer, and agree a stop signal. If you need more than that, sedation options run from light relaxation to being much less aware of the whole thing.
4. Ask about pain management before, not during
Discuss what to take beforehand and afterwards. For a tooth that is already inflamed, taking appropriate pain relief before the appointment, as directed, can make it easier to get properly numb.
Ask us rather than deciding for yourself, since it depends on the tooth, the infection and your medical history.
5. Say something the moment you feel anything
This is the tip patients most often ignore, usually out of politeness.
If you feel a twinge, tell us straight away. There is always more anaesthetic and there is no cost to using it. What causes bad experiences is somebody deciding to be stoic for ten minutes.
Agree the signal beforehand and use it. Nobody will be annoyed.
6. Turn up rested and fed
Have something to eat first, since you may be numb for a few hours afterwards. Avoid a lot of caffeine, which makes people jittery and more sensitive to everything.
Book a time of day when you are not rushing. Feeling under time pressure makes the whole thing harder.
7. Bring something to listen to
Headphones and your own music or a podcast. For many people the sound is the actual trigger rather than the sensation, and removing it changes the experience considerably.
8. Follow the aftercare exactly
Afterwards, expect some tenderness for a few days, particularly on biting. That is the surrounding tissue settling, not a sign of failure.
- Take pain relief as directed rather than waiting for it to build
- Chew on the other side until the tooth is permanently restored
- Do not test it by biting on it to see how it feels
- Keep brushing normally, including that tooth
- Ring us if pain increases after a few days rather than easing, or if there is swelling
9. Get the permanent restoration done
This is the step people skip once the pain has gone, and it is the most common reason a successful root canal ends in a lost tooth.
A treated tooth has lost internal structure and become more brittle. Under chewing forces, especially on a back tooth, it can crack, and a cracked root usually cannot be saved.
So it needs a proper restoration, usually a crown. A temporary filling is temporary. If cost is the obstacle, say so, because there are 0% interest payment plans and that conversation is far better than losing the tooth.
Where a crown is needed, ours are made in our own lab at Southport, which means adjustments happen the same day rather than by post.
Is it worth saving the tooth?
Usually yes.
Keeping your own tooth preserves the bone around it and the position of its neighbours in a way no replacement quite matches. An extraction is cheaper on the day and then the gap needs filling eventually, so the comparison is rarely as simple as the two prices.
Sometimes the tooth genuinely cannot be saved, and we will tell you when that is the case. There is a fuller comparison at root canal vs extraction.
If it hurts right now
Call 1800 833 844. We keep emergency room at all six clinics.
Facial swelling, especially with difficulty swallowing or breathing, is a medical emergency and needs immediate attention rather than an appointment tomorrow.
Restorative dentistry FAQ
Is a root canal painful?
The treatment itself should not be. The area is fully numbed, and most people say it felt much like having a filling, just over a longer appointment. The severe pain people associate with root canals is the infection that brings them in, and the treatment is what removes it.
How long does the procedure take?
Longer than a filling, and it depends on the tooth. Front teeth generally have one canal and back teeth have several, so molars take more time. Some cases are done in one visit and others across two. Your dentist will tell you which after looking at the tooth and the x-ray.
What happens if I ignore an infected tooth?
It does not resolve on its own. The infection spreads through the root into the surrounding bone, forming an abscess, and can cause facial swelling. At that point the tooth is often no longer savable, so a treatable problem becomes an extraction. Facial swelling with difficulty swallowing or breathing is a medical emergency.
Do I always need a crown afterwards?
Not always, but often, particularly on back teeth. A tooth that has had root canal treatment has lost internal structure and is more likely to crack under chewing forces. A crown holds it together. Front teeth with minimal damage can sometimes be restored with a filling instead.
Is it better to just have the tooth out?
Usually not, if the tooth can be saved. Keeping your own tooth preserves the bone and the neighbouring teeth in a way no replacement quite matches, and an extraction leads to its own costs, since the gap needs filling eventually. There is a fuller comparison on our root canal versus extraction page.
