Few dental phrases cause as much worry as “you need a root canal.” Most of that fear comes from old stories. With modern local anaesthetic, the treatment usually feels much like having a filling, and it relieves the pain of an infected tooth rather than causing it. Here is what root canal treatment is, the signs you might need one, what happens step by step, and what recovery is really like.
What Is a Root Canal?
Inside every tooth, beneath the hard enamel and dentin, is soft tissue called the pulp. It contains nerves and blood vessels and runs down through narrow channels in the roots, the root canals.
When deep decay, a crack or repeated dental work lets bacteria reach the pulp, it becomes inflamed or infected. The pulp cannot heal itself, and the infection can spread to the bone at the tip of the root and form an abscess. Root canal treatment, also called endodontic treatment, removes the damaged pulp, cleans and disinfects the canals, then fills and seals them so the tooth can be kept.
Signs You Might Need a Root Canal
- Lingering sensitivity to hot or cold that lasts after the food or drink is gone
- Severe or throbbing toothache, sometimes keeping you awake at night
- Pain when you bite or press on the tooth
- Swollen or tender gums near the tooth
- A small pimple-like bump on the gum that may leak pus, a sign of an abscess
- A tooth that has turned grey or dark, often after an old injury
- Swelling in the face or jaw
Sometimes an infected tooth causes no pain at all and is spotted on a dental X-ray. Pain in the jaw is not always dental, though. Our guides to jaw pain on one side and wisdom tooth pain cover other common causes.
What Happens During a Root Canal
Treatment is carried out by a dentist or an endodontist, a dentist who specialises in root canals. It usually takes one or two visits.
- X-rays and assessment. The dentist checks the shape of the roots and how far the infection has spread.
- Numbing. A local anaesthetic is injected so the tooth and surrounding area are numb.
- Isolation. A thin rubber sheet (a dental dam) is placed around the tooth to keep it clean and dry.
- Access. A small opening is made in the top of the tooth to reach the pulp.
- Cleaning and shaping. The infected pulp is removed, and the canals are cleaned, shaped and rinsed with disinfecting solution.
- Filling. The canals are filled with a rubber-like material called gutta-percha and sealed.
- Restoring the tooth. A temporary or permanent filling closes the opening. Back teeth often need a crown afterwards, because a root-filled tooth becomes more brittle.
If there is a lot of infection, the dentist may place medicine inside the tooth and finish the treatment at a second appointment.
Does a Root Canal Hurt?
During the procedure, you should feel pressure and vibration but not sharp pain, because the area is numb. Tell your dentist straight away if you feel pain, and they can give more anaesthetic.
Afterwards, the tooth and gum are commonly sore or tender for a few days, especially when chewing. Over-the-counter pain relief such as ibuprofen or paracetamol (acetaminophen) usually controls this. Contact your dentist if pain gets worse after a few days, if swelling appears, or if your bite feels uneven.
Recovery and Aftercare
- Avoid chewing on the treated side until the numbness wears off, and until the permanent filling or crown is fitted.
- Brush and floss as normal. A root-filled tooth can still get decay.
- Go back for the crown if one is recommended. Leaving a weakened back tooth without one raises the risk of it cracking.
- Keep up regular checkups so your dentist can make sure the area has healed.
According to the NHS, root canal treatment is usually successful, and in about 9 out of 10 cases the tooth can survive for up to 10 years. Good oral hygiene and a well-fitting crown help it last much longer.
Alternatives to a Root Canal
The main alternative is removing the tooth. This is sometimes the right choice, for example when a tooth is too broken down to restore. But extraction leaves a gap that usually needs filling with an implant, a bridge or a denture to stop neighbouring teeth from shifting and to keep chewing comfortable. Keeping your natural tooth is generally preferred when it can be saved.
Antibiotics alone do not cure an infected pulp. They may be prescribed if infection is spreading, but the source still needs treatment.
Keeping tartar under control lowers your risk of the gum disease and decay that lead to treatment like this. See how to remove tartar safely.
FAQ
How long does a root canal take?
Each appointment usually lasts 60 to 90 minutes. Simple front teeth may be finished in one visit, while back teeth with several roots or a bad infection often need two.
Can I go to work after a root canal?
Most people go back to work or school the same day or the next day. You may want to avoid eating until the numbness wears off.
What happens if I do not get a root canal?
The infection will not go away on its own. It can lead to an abscess, bone loss around the tooth, spreading infection and eventually losing the tooth.
Can a root canal fail?
Occasionally, if bacteria remain or the seal breaks down. A failed root canal can often be redone, or treated with a small surgical procedure at the root tip.
How can I avoid needing a root canal?
Catch decay early. Our guide on how to get rid of cavities explains how fluoride, cleaning between teeth and regular checkups stop decay before it reaches the nerve.
The Bottom Line
A root canal removes infected or inflamed pulp from inside a tooth, relieves the pain and lets you keep the tooth. It is done under local anaesthetic, usually over one or two visits, with a few days of mild soreness afterwards. If you have lingering sensitivity, severe toothache or swelling, see a dentist promptly: the earlier an infected tooth is treated, the better the chance of saving it. Find more guides in our ear, nose, throat and dental hub.
This article is for general information and is not a substitute for advice from your dentist.
Sources
- NHS: Root Canal Treatment
- Cleveland Clinic: Root Canal
- National Institute of Dental and Craniofacial Research: Tooth Decay
Medical disclaimer: This article is for general information only and is not a substitute for advice, diagnosis or treatment from a qualified health professional. If your symptoms are severe, sudden or getting worse, contact a doctor or emergency services.
Ear, Nose, Throat and Dental
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