What to Expect During a Root Canal Treatment

"Root canal" – those two words often strike fear into people's hearts. But root canals have an unfair reputation. Thanks to modern dentistry, a root canal is no more uncomfortable than getting a filling, and the procedure can save your natural tooth and relieve the severe pain caused by infection. Let's walk through what really happens during a root canal and dispel some common myths.

What Is a Root Canal?

A root canal (also called endodontic treatment) is a procedure to save a severely damaged or infected tooth. Inside each tooth is soft tissue called pulp, which contains nerves, blood vessels, and connective tissue. When the pulp becomes inflamed or infected due to deep decay, repeated dental procedures, cracks, or trauma, it can cause severe pain and lead to an abscess if left untreated.

During a root canal, we remove the infected or inflamed pulp, clean and disinfect the inside of the tooth, and then fill and seal it. This allows you to keep your natural tooth instead of having it extracted.

Signs You Might Need a Root Canal

Common symptoms that may indicate the need for a root canal include:

• Severe toothache when chewing or applying pressure
• Prolonged sensitivity to hot or cold, even after the stimulus is removed
• Darkening or discoloration of the tooth
• Swelling and tenderness in nearby gums
• A persistent or recurring pimple on the gums (abscess)

However, sometimes there are no symptoms at all, which is why regular dental checkups are so important. We can identify problems through X-rays before you experience pain.

The Root Canal Procedure: Step by Step

Step 1: Examination and X-rays

First, we'll take X-rays to assess the extent of infection and examine the shape of your root canals. This helps us plan the procedure and identify any potential complications.

Step 2: Anesthesia

We'll numb the area with local anesthetic to ensure you're comfortable throughout the procedure. Contrary to popular belief, root canals are not painful – the anesthetic eliminates discomfort, and many patients report that the relief from their pre-existing toothache makes the experience worthwhile. If you're anxious, we can also discuss sedation options.

Step 3: Isolation and Access

We'll place a rubber dam (a small protective sheet) around the tooth to keep it dry and free of saliva during the procedure. Then, we'll create a small opening in the crown of the tooth to access the pulp chamber and root canals.

Step 4: Cleaning and Shaping

Using specialized instruments, we'll carefully remove the infected or inflamed pulp from the pulp chamber and root canals. We'll then clean and shape the canals to prepare them for filling. This step is crucial for removing all bacteria and preventing future infection.

Step 5: Filling the Canals

After thorough cleaning, we'll fill the canals with a biocompatible material called gutta-percha, along with an adhesive cement to seal the canals completely. This prevents bacteria from re-entering the tooth.

Step 6: Temporary Filling

We'll close the opening in your tooth with a temporary filling to protect it until you return for your permanent restoration. In some cases, if there's an active infection, we may place medication inside the tooth before sealing it temporarily.

Step 7: Final Restoration

At a follow-up visit (usually a few weeks later), we'll remove the temporary filling and place a permanent restoration – either a filling or a crown. Because root canal-treated teeth can become brittle over time, we often recommend a crown to protect and strengthen the tooth, especially for molars that withstand significant chewing pressure.

How Long Does It Take?

Most root canals can be completed in one or two appointments, each lasting about 60-90 minutes. The time required depends on which tooth is affected (front teeth have fewer canals and are quicker to treat than molars) and the complexity of the case.

Recovery and Aftercare

After the procedure, you may experience some sensitivity or mild discomfort for a few days, especially when biting down. This is normal and can be managed with over-the-counter pain medication. Most people can return to their normal activities the same day.

Tips for recovery:

• Avoid chewing on the treated tooth until the permanent restoration is placed
• Take pain medication as recommended
• Maintain good oral hygiene – continue brushing and flossing, being gentle around the treated tooth
• Avoid hard, crunchy, or sticky foods until your tooth is fully restored
• Attend your follow-up appointment to complete the restoration

Success Rate and Longevity

Root canal therapy has a success rate of over 95%. With proper care and restoration, a tooth that has had a root canal can last a lifetime. The key is protecting it with a crown and maintaining excellent oral hygiene and regular dental visits.

Root Canal vs. Extraction

While extracting the tooth might seem simpler, saving your natural tooth through a root canal is almost always the better choice. Natural teeth are superior to any replacement option in terms of function and aesthetics. Tooth extraction also requires additional procedures to fill the gap (like implants or bridges) and can lead to bone loss and shifting of surrounding teeth.

Debunking Root Canal Myths

Myth: Root canals are extremely painful.
Reality: Modern anesthetics and techniques make root canals no more uncomfortable than getting a filling. The pain you feel before the procedure is usually much worse than any discomfort during or after treatment.

Myth: Root canals cause illness.
Reality: This myth stems from long-debunked research from the 1920s. Modern research shows no valid scientific link between root canal treatment and disease elsewhere in the body. Root canals are a safe, effective way to save infected teeth.

Myth: Extraction is better than root canal treatment.
Reality: Saving your natural tooth is almost always the best option. Nothing artificial can fully replicate the function and aesthetics of your natural tooth.