Does a Root Canal Hurt?

The quick version

• Root canal treatment is done under full local anaesthetic, so the procedure itself should not hurt.

• The severe pain people associate with root canals comes from the infection beforehand.

• Most patients say the appointment felt similar to having a large filling done.

• Mild tenderness for a few days afterwards is normal and settles steadily.

Root canal treatment has a reputation it no longer deserves. The procedure is carried out under full local anaesthetic and most patients describe it as feeling much like having a large filling placed. The severe pain people associate with root canals is the pain of the infection that made the treatment necessary, and the treatment is what relieves it. Dr. Kyle Lesko performs root canal treatment in house at TLC Family Dental Centre in Leduc, so patients are usually not referred elsewhere partway through a painful problem.

Where the reputation came from

The fear is inherited rather than current. Root canal treatment from decades ago was slower, anaesthetic techniques were less refined, and the instruments were less precise, so appointments took longer and were harder to sit through.

There is a second reason the reputation stuck. People arriving for root canal treatment are frequently already in significant pain from an infected nerve, sometimes having been awake with it for nights. The memory of that week understandably attaches itself to the treatment rather than to the infection that caused it.

Why it is needed in the first place

Inside every tooth is a chamber containing nerve and blood vessels. When decay reaches it, or a crack lets bacteria in, or trauma damages it, that tissue becomes inflamed and then infected. Because it is enclosed in hard tissue, the pressure has nowhere to go, which is why the pain can be so intense and so hard to ignore.

Root canal treatment removes the infected tissue, disinfects the canal system, and seals it so bacteria cannot return. The alternative to treating it is usually removing the tooth, since the infection will not resolve on its own.

What the appointment is actually like

The tooth is frozen thoroughly and you are checked to confirm it is fully numb before treatment begins. A small sheet called a rubber dam is placed to isolate the tooth, which keeps the area clean and dry and also stops water and materials reaching the rest of your mouth.

An opening is made in the top of the tooth, the canals are cleaned and shaped with fine instruments, and the space is disinfected and filled with a sealing material. You will hear sounds and feel pressure, but you should not feel pain. Sometimes an infected tooth is harder to freeze completely, and there are additional techniques for that, so say something rather than tolerating it.

Appointment length varies with the tooth. A front tooth with a single canal is quicker than a molar with several, and some cases are completed across two visits.

How you feel afterwards

Expect the tooth to be tender for a few days, particularly when biting. The ligament around the root has been irritated, and that settles steadily. Over the counter pain relief is usually enough, and taking it before the freezing fully wears off tends to work better than waiting.

The important pattern is direction. Discomfort should reduce each day. Pain that is increasing after day two or three, noticeable swelling, or a fever are reasons to call rather than wait.

• Chew on the other side until the tenderness settles.

• Keep brushing and flossing the area normally.

• Take pain relief as directed rather than letting discomfort build.

• Call the office if pain is worsening rather than easing.

Why a crown usually follows

A tooth that has had root canal treatment has lost internal structure and no longer has a blood supply, which makes it more brittle than a living tooth. Back teeth in particular take substantial force every time you chew.

For that reason a crown is usually recommended afterwards to hold the tooth together and protect it from fracturing. It is not an upsell, it is the step that protects the investment already made in saving the tooth. A tooth that fractures below the gum line after successful root canal treatment often cannot be saved at all.

Root canal treatment or extraction

Both are legitimate options and the right choice depends on the tooth. Keeping your own tooth preserves the bone around it, maintains your bite, and avoids the neighbouring teeth drifting, so it is usually the first preference where the tooth is restorable.

Sometimes it is not. A tooth with a vertical fracture, very little remaining structure, or advanced bone loss may be better removed. Dr. Kyle Lesko will set out honestly what each option involves, including what happens to the gap if the tooth comes out, so the decision is made with the full picture rather than under pressure.

Common questions

Is a root canal painful during the procedure?

It should not be. The tooth is fully frozen first and most patients compare the experience to having a large filling. Tell us immediately if you feel anything sharp, because more anaesthetic can be given.

How long does the appointment take?

It depends on the tooth. A front tooth with one canal is quicker than a molar with several, and some cases are completed over two visits.

How long does the soreness last afterwards?

Usually a few days of tenderness, especially when biting, easing steadily. Pain that increases after day two or three, swelling, or fever should be reported to the office.

Do I definitely need a crown afterwards?

For back teeth it is usually recommended, because a treated tooth is more brittle and takes heavy chewing force. Front teeth are assessed individually depending on how much structure remains.

Would it be simpler to just have the tooth out?

Sometimes extraction is the better option, but removing a tooth creates its own consequences for the bite and neighbouring teeth. Where a tooth is restorable, keeping it is usually preferable, and both options will be explained to you.

Can I drive myself home afterwards?

Yes, in almost all cases. Root canal treatment is done under local anaesthetic, so you are fully alert throughout and afterwards. Your lip and tongue will stay numb for a few hours, so take care with hot drinks and avoid chewing until the freezing has fully worn off.

If you have a toothache or have been told you need root canal treatment, you do not need to dread it. Dr. Kyle Lesko performs root canal treatment in house at TLC Family Dental Centre in Leduc, will explain each step as it happens, and will provide a clear written estimate after your exam. Book online or call us at 780.980.5115.